Prediction of treatment response in geriatric depression from baseline folate level: interaction with an SSRI or a tricyclic antidepressant.
Depressed geriatric patients have lower levels of folate (FOL) than controls. Also, FOL supplement can reduce depressive morbidity. One hypothesis consistent with this is that FOL deficiency causes a lowering of CNS serotonin that contributes to depression. The present report is from one site of a multicenter study that compared an SSRI (sertraline) with a nonspecific tricyclic antidepressant (nortriptyline) in geriatric depressed patients. We added measures of FOL at baseline and outcome for 22 depressed patients older than 60 years. Both treatments were effective. At baseline, FOL levels were within the normal range. Higher FOL levels at baseline predicted greater improvement. Further study of FOL interaction with SSRI is warranted. For the group treated with the SSRI, baseline FOL level was a more efficient predictor of improvement, especially for results on a self-rating depression scale (POMS).
Alpert
Murray
M
Department of Psychiatry, New York University Medical Center, 550 First Avenue, New York, NY 10016, USA.
Silva
Raul R
RR
Pouget
Enrique R
ER
D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000097:blood* / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005492:Folic Acid / Q000097:blood*; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016037:Single-Blind Method; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D005492:Folic Acid; D017367:Selective Serotonin Reuptake Inhibitors