Is Depression Related to Low Folate Levels in People with Epilepsy? An Observational Study and Meta-analysis

Area of Science:

• Neurology
• Clinical Psychiatry
• Nutritional Neuroscience

Background:

• Depression and low serum folate are prevalent in people with epilepsy (PWE).
• Patients on hepatic enzyme-inducing antiepileptic drugs (AEDs) are particularly susceptible to low folate levels.
• The relationship between folate status and depression in PWE requires further investigation.

Purpose of the Study:

• To investigate the association between serum folate levels and depression in people with epilepsy (PWE).
• To determine the prevalence of depression and low folate levels in a cohort of PWE.
• To conduct a meta-analysis to consolidate findings on folate levels and depression in PWE.

Main Methods:

• A cross-sectional study involving 201 PWE assessed for depression using IDS-SR and IDS-Clinician Rated.
• Serum folate levels were measured concurrently with depression assessments.
• A literature search identified six additional studies for meta-analysis, examining depression and folate levels in PWE.

Main Results:

• Depression was found in 65.68% and low serum folate (<4 ng/ml) in 48.75% of the studied PWE.
• No statistically significant correlation was observed between depression and low folate levels within the study cohort.
• Meta-analysis of six studies, including the present one, revealed a statistically significant mild negative correlation (r = -0.1690, P = 0.0464).

Conclusions:

• Depression and low folate levels are common comorbidities in people with epilepsy (PWE).
• A mild but significant negative correlation exists between low folate levels and depression in PWE, particularly evident in pooled data.
• Folate supplementation is recommended for PWE on older antiepileptic drugs (AEDs) to potentially mitigate depression risk.