ISMNT NEWS: Disease Prevention by Exploring Molecular Mechanisms Linked to Nutrition

ISMNT News #12 relates to recent intriguing findings that folate deficiency could lead to manifestation of depressive symptoms, one of the most common neuropsychiatric disorders. Although an association between folate deficiency and depressive symptoms has been described as early as 1962 (Trans. Assoc. Am. Physicians 1961;75:307-20), it became only recently established that dietary folate could indeed be a key to depression. It has been proposed to evaluate the folate status in medically ill depressed patients and folate/methylfolate supplementation may represent an effective antidepressant approach.

The key reference is by:

Fava M; Borus JS; Alpert JE; Nierenberg AA; Rosenbaum JF; Bottiglieri T

FOLATE, VITAMIN B12, AND HOMOCYSTEINE IN MAJOR DEPRESSIVE DISORDER

from

Depression Clinical and Research Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA

in

Am J Psychiatry, 1997 Mar, 154:3, 426-8

...OBJECTIVE: The authors examined the relationships between levels of three metabolites (folate, vitamin B12, and homocysteine) and both depressive subtype and response to fluoxetine treatment in depressed patients.

METHOD: Fluoxetine, 20 mg/day for 8 weeks, was given to 213 outpatients with major depressive disorder. At baseline, depressive subtypes were assessed, and a blood sample was collected from each patient. Serum metabolite levels were assayed. Response to treatment was determined by percentage change in score on the 17-item Hamilton Depression Rating Scale.

RESULTS: Subjects with low folate levels were more likely to have melancholic depression and were significantly less likely to respond to fluoxetine. Homocysteine and B12 levels were not associated with depressive subtype or treatment response.

CONCLUSIONS: Overall, the results are consistent with findings linking low folate levels to poorer response to antidepressant treatment. Folate levels might be considered in the evaluation of depressed patients who do not respond to antidepressant treatment.