The Role of L-Methylfolate in Depressive Disorders

Abstract

Major depressive disorder (MDD) is a debilitating illness affecting 7% to 12% of men and 20% to 25% of women. It is usually a recurrent illness, with up to 30% of patients experiencing a depressive episode lasting over 2 years. Depression may also increase the morbidity and mortality of numerous medical conditions, such as cardiac disease, myocardial infarction, chronic pain, diabetes, cerebrovascular events, and respiratory illnesses. The goal of antidepressant therapy is to achieve full remission and functional recovery, and continuing treatment beyond the acute phase is usually necessary to maintain remission. In contrast with full remission, individuals who experience residual symptoms, however mild, have a higher chance of experiencing one or more additional episodes.

The Role of Micronutrient for Depressed Patients

“…Folic acid deficiencies lead the development depression and slow down the response to antidepressant medication [23,24]. In some cases the first clinical manifestation of vitamin B12 deficiency is a psychiatric disorder and relatively common in old age in which mostly associated with cognitive impairments [25][26][27].…”

Cardiometabolic Risks in Schizophrenia and Directions for Intervention, 3: Psychopharmacological Interventions

“…The issue merits study because the 677T allele is present in about half of the population. 12 There is presently no information about the safety and efficacy of conventional (approved) weight loss treatments in antipsychotic-receiving patients with schizophrenia; these treatments include lorcaserin, liraglutide, the phenterminetopiramate combination, the naltrexone-bupropion combination, and others. However, an important limitation of focusing on weight alone is that there is no evidence that other criteria that define the metabolic syndrome will meaningfully attenuate, as shown with metformin.…”

The Role and Postulated Biochemical Mechanism of L-Methylfolate Augmentation in Major Depression: A Case-Report

“…Other important roles for folate include the catabolism and breakdown of proteins, along with effective red blood cell maturation and cell reproduction. 1 In addition, folate's role in methylation facilitates several important central nervous system (CNS) reactions that are described in the following text.…”

“…In addition to the possibility of a gene polymorphism in MTHFR as described previously, low L-methylfolate levels can result from smoking, excessive alcohol intake, gastrointestinal/absorptive disorders, and medications. 1 For example, superoxide generated from the metabolism of ethanol to acetaldehyde can lead to cleavage of folic acid before it can be absorbed and converted to L-methylfolate.…”

“…1 Several older studies have reported that low folate levels may be a risk factor for a depressive episode, and recent studies have implied that depressed patients who are folate deficient may respond more poorly to treatment with standard antidepressants. 2 The U.S. Food and Drug Administration (FDA) mandated folate supplementation for many foods in 1996, making clinical folate deficiency a seemingly rare occurrence; however, rates of major depression have remained consistent in U.S. men and women since then.…”