Antidepressant effects of coumarins and their derivatives: A critical analysis of research advances

Coumarins and their derivatives are non-flavonoids polyphenols with diverse pharmacological activities including anti-depressant effects. This study systematically examines the antidepressant effects of coumarins and their derivatives in relation to time series of research progress in the pharmacological pathways, association with other diseases, toxicity and bibliometric analysis. The review was approached using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) coupled with R package involving Biblioshiny, a web interface for Bibliometrix analysis and VOSviewer software analytic tools. Literature searches were conducted in Scopus, Web of Science, and PubMed from the inception through January 21, 2023. Coumarins, depression, coumarin derivatives and treatment were the main search terms used which resulted in the inclusion of 46 eligible publications. Scopoletin, psoralen, 7-hydroxycoumarin, meranzin hydrate, osthole, esculetin/umbelliferone were the most studied coumarins with antidepressant effects. Coumarins and their derivatives exerted antidepressant effects with a stronger affinity for monoamine oxidase-B (MAO-B) inhibition and, their inhibitory effect via neurotransmitter pathway on MAO is well-studied. However, epigenetic modification, neuroendocrine, neurotrophic pathways are understudied. Recent research focuses on their antidepressant effects which targeted cytokines and fibromyalgia. There is a link between the gut microbiome, the brain, and depression; meranzin hydrate exerts an antidepressant activity by remodelling the gastrointestinal system. We established that empirical data on some coumarins and their derivatives to support their antidepressant effects are limited. Likewise, the safe dose range for several coumarins and their derivatives is yet to be fully determined.