Blood plasma B vitamins in depression and the therapeutic response to electroconvulsive therapy

Abstract

A growing body of research has indicated a role for B vitamins in depression, with some previous studies suggesting that B vitamin status in patients with depression can impact on antidepressant response. Here we aimed to investigate B vitamin plasma concentrations in medicated patients with depression ( n ​= ​94) compared to age- and sex-matched healthy controls ( n ​= ​57), and in patients with depression after electroconvulsive therapy (ECT) in a real-world clinical setting. Our results show that nicotinamide (vitamin B3), N1-methylnicotinamide (vitamin B3 metabolite), and pyridoxal 5′-phosphate (PLP; vitamin B6) concentrations were significantly reduced in patients with depression compared to controls. The Cohen’s d effect sizes for nicotinamide, N1-methylnicotinamide, and PLP were moderate–large (−0.47, −0.51, and −0.59, respectively), and likely to be of clinical relevance. Functional biomarkers of vitamin B6 status (PAr index, 3-hydroxykynurenine: hydroxyanthranilic acid ratio, 3-hydroxykynurenine: xanthurenic acid ratio, and HKr) were elevated in depressed patients compared to controls, suggestive of reduced vitamin B6 function. Over 30% of the patient cohort were found to have low to deficient PLP concentrations, and exploratory analyses revealed that these patients had higher IL-6 and CRP concentrations compared to patients with PLP levels within the normal range. Treatment with ECT did not alter B vitamin concentrations, and B vitamin concentrations were not associated with depression severity or the therapeutic response to ECT. Overall, reduced plasma PLP, nicotinamide, and N1-methylnicotinamide concentrations could have wide ranging effects on pathways and systems implicated in depression. Further studies are required to understand the reasons why patients with depression present with low plasma B vitamin concentrations.

The tryptophan catabolite or kynurenine pathway in a major depressive episode with melancholia, psychotic features and suicidal behaviors; a systematic review and meta-analysis

“…We employed MESH terms and keywords (all shown in ESF, Table 1) to perform the initial search process, including inspection of 10861 articles. Based on our exclusion criteria 35 studies were selected as eligible in our systematic review and meta-analysis (Cowen, Parry-Billings et al 1989, Anderson, Parry-Billings et al 1990, Maes, Jacobs et al 1990, Price, Charney et al 1991, Quintana 1992, Maes, Meltzer et al 1993, Møller 1993, Maes, De Backer et al 1995, Maes, Wauters et al 1996, Song, Lin et al 1998, Hoekstra, Fekkes et al 2006, Miller, Llenos et al 2006, Myint, Kim et al 2007, Myint, Kim et al 2007, Gabbay, Klein et al 2010, Steiner, Walter et al 2011, Sublette, Galfalvy et al 2011, Erhardt, Lim et al 2013, Bay-Richter, Linderholm et al 2015, Bradley, Case et al 2015, Busse, Busse et al 2015, Dahl, Andreassen et al 2015, Savitz, Drevets et al 2015, Brundin, Sellgren et al 2016, Clark, Pocivavsek et al 2016, Zhou, Zheng et al 2018, Aarsland, Leskauskaite et al 2019, Pompili, Lionetto et al 2019, Sellgren, Gracias et al 2019, Achtyes, Keaton et al 2020, Ryan, Allers et al 2020, van den Ameele, van Nuijs et al 2020, Milaneschi, Allers et al 2021, Trepci, Sellgren et al 2021).…”

Non-Invasive Brain Stimulation Effects on Biomarkers of Tryptophan Metabolism: A Scoping Review and Meta-Analysis

“…38 included studies recruited humans ( Table 2 ) [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ] and 27 studied animal models ( Table 3 ) [ 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 ,…”

Environmental science and pollution research role of heavy metal concentrations and vitamin intake from food in depression: a national cross-sectional study (2009–2017)

“…We also found dietary vitamin B3 intake was associated with a reduced risk of depression, which also agrees with previous studies (Smesny et al 2010;Thompson and Proctor 1953). In a recent study, it was reported vitamin B3 levels were substantially lower in patients with depression than in controls (Ryan et al 2020). It may be that vitamin B3 is transf o r m e d i n v i v o i n t o n i c o t i n a m i d e , w h i c h h a s benzodiazepine-like effects on the γ-aminobutyric acid (GABA) system (Möhler et al 1979;Tallman et al 1980).…”