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Over the past several decades, researchers have been interested in a potential link between folate deficiency and major depressive disorder (MDD). Although the relevance of this association is yet to be fully understood, two recent papers in the Journal of Clinical Psychiatry found a connection between low folate levels and both treatment-refractory depression and relapse rates in patients with MDD.
"There have been a number of studies suggesting that low folate levels can predict poor outcome to first-line treatment of major depressive disorder, but no one had examined the relationship between low folate levels and relapse among antidepressant remitters or prognosis for patients with treatment-resistant depression," George I. Papakostas, M.D., Clinical Instructor in Psychiatry at Harvard Medical School and lead author of the study told The Update.
Folate (also known as folic acid) is a water-soluble vitamin in the B-complex group that is an important precursor for many biological processes, including DNA synthesis and amino acid metabolism. Certain conditions can contribute to low folate levels, such as malnutrition and alcohol abuse. In 1996, the FDA began requiring the addition of folic acid to enriched breads, cereals, and other grain products to supplement the natural dietary sources of folic acid.
Because folate is a precursor molecule, its levels can affect the levels of other potentially important factors. For example, both homocysteine and s-adenosylmethionine (SAMe) levels can be influenced by folate levels. Like folate, both of these molecules have been investigated as markers for medical and psychiatric conditions, and SAMe has been considered as a potential treatment for depression and other disorders.
Folate and depression …