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Adjunctive folate for major mental disorders: A systematic review.
1The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Journal of Affective Disorders
|February 18, 2020
Summary
Adjunctive folate is effective for major depressive disorder (MDD) and bipolar mania but not for schizophrenia. This meta-analysis found folate safe and effective for these conditions, with similar adverse events compared to placebo.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Mental disorders like schizophrenia, bipolar disorder, and major depressive disorder (MDD) significantly impact global health.
- Nutritional interventions, including folate supplementation, are being explored as adjunctive therapies for psychiatric conditions.
- Evidence on the efficacy of folate as an add-on treatment for these disorders remains inconclusive.
Purpose of the Study:
- To conduct a meta-analysis of randomized controlled trials (RCTs).
- To evaluate the efficacy and safety of adjunctive folate therapy for schizophrenia, bipolar disorder, and MDD.
- To synthesize current evidence on folate's role in managing major mental illnesses.
Main Methods:
- Systematic review and meta-analysis of 16 RCTs involving 1,520 participants.
- Data analyzed using Review Manager Program Version 5.3.
- Studies were categorized and analyzed separately for schizophrenia, bipolar disorder, and MDD.
Main Results:
- Adjunctive folate showed no significant benefit over placebo for schizophrenia symptoms.
- Folate supplementation was significantly superior to placebo in improving depressive symptoms for bipolar and unipolar depression.
- Folate was effective for acute manic episodes in bipolar disorder but not for depressive episodes.
- For MDD, adjunctive folate significantly improved depressive symptoms (SMD = -0.38, 95% CI: -0.66 to -0.09).
- Discontinuation rates and adverse drug reactions were comparable between folate and placebo groups across all diagnoses.
Conclusions:
- Adjunctive folate appears effective and safe for treating major depressive disorder (MDD) and acute bipolar mania.
- Folate supplementation did not demonstrate efficacy in treating schizophrenia.
- Further research may clarify folate's role in specific psychiatric conditions and patient subgroups.
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