NAD+ for Anxiety and Depression: What the Research Shows

Why it matters

If you are in crisis or thinking about harming yourself, call or text 988, the Suicide & Crisis Lifeline, at any hour. In an emergency, call 911.

How common these conditions are

About 1 in 12 American adults has an episode of major depression in a given year, and about 1 in 5 has an anxiety disorder. Both are medical conditions with effective treatments. They are not a sign of weakness, and they are not something a vitamin can be expected to fix.

Why researchers connect NAD+ and mood

Brain energy. The brain uses about a fifth of the body's energy, and NAD+ is required to produce it. Brain imaging studies have found differences in energy metabolism in some people with depression. Whether low energy production is a cause or a result is not settled.

A shared building block with serotonin. The body makes both serotonin and NAD+ from the amino acid tryptophan. During chronic inflammation and stress, more tryptophan is routed down the pathway that leads toward NAD+ and less toward serotonin, and some of the intermediate products affect nerve cells. This pathway, called the kynurenine pathway, is an active area of depression research.

Niacin deficiency. Severe lack of niacin, the vitamin the body uses to build NAD+, causes a disease called pellagra. Its symptoms include depression, anxiety, confusion and memory loss, and they resolve when niacin is replaced. This shows that very low NAD+ affects mood. It does not show that adding NAD+ helps someone whose levels are normal.

Stress systems and sleep. In animal studies, NAD+ and the sirtuin proteins it activates influence the body clock and the stress response.

What the human evidence shows

• Infusions. No randomized controlled trial has tested NAD+ infusions for depression or anxiety.
• NADH. A few small studies from the 1990s reported mood improvement with NADH, a related form. They had no placebo group and have not been repeated to modern standards.
• Building blocks (NR and NMN). Trials in healthy adults have focused on physical measures. They have not shown a reliable effect on mood.
• Animal studies. In mice, raising NAD+ has reduced depression-like behavior. Results in mice often fail to carry over to people.
• Client reports. After NAD+ drips, some people describe clearer thinking, steadier energy and better sleep, which can make a hard period easier to manage. These are individual reports. They are not evidence of treating a mood disorder.

The research gives reasons to keep studying NAD+ and mood. It does not support using NAD+ as a treatment.

What is proven to help

• Talk therapy. Cognitive behavioral therapy and related approaches work for both depression and anxiety, and the benefits last.
• Medication. Antidepressants help many people, particularly with moderate to severe symptoms. They take several weeks to work.
• Exercise. A 2024 analysis of more than 200 trials in The BMJ found that exercise, including walking, jogging, yoga and strength training, reduced depression symptoms, with effects comparable to therapy for some people.
• Sleep. Regular sleep is both a treatment target and a protective factor.
• Less alcohol. Alcohol worsens both anxiety and depression.
• Connection. Time with other people, and telling someone what you are going through.

Medical causes worth checking

Several physical conditions cause or worsen low mood and anxiety, and a blood test finds them:

• An underactive or overactive thyroid
• Low vitamin B12 or folate
• Low vitamin D
• Anemia and low iron
• Blood sugar problems
• Low testosterone, and hormone changes around menopause

Some medications also affect mood. If your symptoms are new, ask your doctor to check for these.

If you are being treated and want to try NAD+

• Keep taking your medication. Stopping an antidepressant suddenly can cause withdrawal symptoms and relapse. Any change goes through the prescriber.
• Keep your appointments with your therapist and doctor.
• Tell your prescriber you are considering NAD+, and tell our provider about your diagnosis and every medication on the video call before your first drip.
• Treat it as general wellness support, with the same expectations as anyone else: possibly more energy and clearer thinking for a period, possibly no noticeable change.
• If your mood gets worse, contact your doctor. If you have thoughts of self-harm, call or text 988.

What we will and will not do

Zen IV Spa does not diagnose or treat depression, anxiety or any mental health condition, and we do not offer NAD+ as a treatment for them. We offer NAD+ drips in 250, 500 or 1,000 mg for general wellness, after a licensed provider reviews your health history. If what you describe on that call sounds like a mood disorder that is not being treated, the provider will tell you so and point you toward care. We can also draw blood at home to check thyroid, vitamin and hormone levels. We serve all of New York & New Jersey, and our medical director oversees every treatment.

Quick answers

Can NAD+ treat depression or anxiety? No. No controlled trial supports that.

Why do some people say it helps? Some feel more energy and mental clarity for a period, which can make daily life easier. That is different from treating the condition.

Can I stop my antidepressant if I start NAD+? No. Never stop or change a prescribed medication without your prescriber.

Is NAD+ safe with antidepressants? There is no large study of the combination. Tell both your prescriber and our provider before booking.

Should I get blood work? Yes, if low mood or anxiety is new. Thyroid problems and vitamin deficiencies are common and treatable causes.

Where can I get help right now? Call or text 988 at any hour. For treatment referrals, the SAMHSA National Helpline is 1-800-662-4357, free and confidential.

Want to rule out a physical cause? Book thyroid, vitamin and hormone testing at home: zenivspa.com/labs-testing/.

All treatments are medical services. Every guest is screened, and every treatment is provided only under the clearance, prescription or standing protocol of a licensed medical provider. Compounded peptides are not FDA-approved unless stated. Nothing on this page is a diagnosis or a promise of results.