Systematic analysis of the pharmacology of saffron extracts in the context of complex pharmacotherapy for depression

Pharmacotherapy for depression is in urgent need of effective and safer drugs. A promising area of research in this field is the use of pharmaceutically standardized saffron extracts containing bioactive substances such as safranal, crocin, bioflavonoids and their derivatives. This paper presents the results of a systematic computer analysis of 3,157 publications on the pharmacology of saffron extracts, with an emphasis on the results of studies of the antidepressant properties of the extracts. Unlike most synthetic antidepressants, which narrowly target a particular neurotransmission system, the molecular components of saffron extracts have a much more complex modulating effect on neurotransmission. In addition, standardised saffron extracts exhibit pronounced antioxidant, anti-inflammatory (NF- κB inhibition) and neurotrophic effects (primarily through increased levels of the brain-derived neurotrophic factor – BDNF), which is also important for the pathogenetic treatment of depressive states. Randomised clinical trials and their meta-analyses show that preparations based on standardised saffron extracts, both as part of complex therapy and as monotherapy, have therapeutic effects comparable to those of known antidepressants (imipramine, fluoxetine, etc.). The available data from fundamental and evidence-based studies suggest that saffron extracts can be used by patients taking various classes of antidepressants without adverse effects. Moreover, the use of saffron extracts may increase the safety of antidepressant therapy. Further research into the combination of saffron extract standardised for safranal with the 'psychobiotic' bifidobacterial strain Bifidobacterium longum 1714 and vitamin B 6 is promising.