Leucovorin as an Antidepressant Adjunct in Elderly Inpatients With Treatment-resistant Depression

To assess the safety and tolerability of folinic acid as an augmentation agent among geriatric inpatients with depression and to determine whether this augmentation was associated with decreased days of clinically needed hospitalization.

A retrospective chart review was conducted of the medical records of patients > 60 years of age discharged from a geriatric psychiatry unit between June 1, 2014, and February 1, 2016. Two groups were compared: those with depression who received folinic acid (leucovorin) supplementation (n = 35) and those with depression who did not receive leucovorin (n = 80). The primary outcome measure was number of clinically needed days of hospitalization.

The mean ± SD number of days (logged) of clinically needed hospitalization in the leucovorin group was 2.0 ± 0.7 compared with 2.4 ± 0.6 in the nonintervention group. Unpaired t group analysis yielded the following: t₁₁₅ = 3.47, P < .0001 (2-tailed).

The patients who received leucovorin had a significantly reduced requirement of days of hospitalization, which translates to reduced cumulative cost of treatment during hospitalization. Further studies, including randomized controlled trials, are recommended to explore this treatment option.