Folate, vitamin B12, and homocysteine in major depressive disorder.
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.


METHODS
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.
Fava
M
M
Depression Clinical and Research Program, Clinical Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA. favam@A1.mgh.harvard.edu
Borus
J S
JS
Alpert
J E
JE
Nierenberg
A A
AA
Rosenbaum
J F
JF
Bottiglieri
T
T
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D003866:Depressive Disorder / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D005492:Folic Acid / Q000097:blood*; D005494:Folic Acid Deficiency / Q000097:blood; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood*; D014806:Vitamin B 12 Deficiency / Q000097:blood
D005473:Fluoxetine; D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12