Nutrition and Depression: The Role of Folate

Jonathan E. Alpert, MD, PhD, Maurizio Fava, MD

Disclosures

Medscape Psychiatry & Mental Health eJournal. 1997;2(1) 

In This Article

Abstract & Introduction

A relationship between folate and neuropsychiatric disorders has been inferred from clinical observation and from the enhanced understanding of the role of folate in critical brain metabolic pathways. Depressive symptoms are the most common neuropsychiatric manifestation of folate deficiency. Conversely, borderline low or deficient serum or red blood cell folate levels have been detected in 15% to 38% of adults diagnosed with depressive disorders. Recently, low folate levels have been linked to poorer antidepressant response to selective serotonin reuptake inhibitors. Factors contributing to low serum folate levels among depressed patients as well as the circumstances under which folate and its derivatives may have a role in antidepressant pharmacotherapy must be further clarified.

Among common nutritional deficiencies with potential relevance to neuropsychiatric disorders, folate deficiency appears to be the most closely linked to depressive disorders. Evidence has been steadily mounting over the past several decades implicating folate in processes thought to underlie the regulation of mood and the mediation of antidepressant drug effects.[1,2,3] Of particular importance are associations between low serum or RBC folate concentrations and depressive states in medical and psychiatric populations; relationships between folate levels and response to antidepressant treatment; observations regarding the impact of folate supplementation on treatment outcome; and elucidation of key metabolic processes within the CNS in which folate is involved. (See box, "Folate and Metabolism.")

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