Folate and unipolar depression

Background: Although major depressive disorder (MDD) is a treatable disease, the remission rates associated with antidepressant monotherapy are still far from optimal. Folate is an inexpensive, easily tolerated natural augmenting agent, which has been reported to improve medication treatment outcomes in patients with MDD. Objective: The aim of this study was to review the literature on the clinical utility of folate augmentation for patients with MDD. Folate and depression: Patients with depression have consistently been found to have lower levels of serum and red blood cell folate than normal or nondepressed psychiatric patients. Decreased folate levels have been associated with lowered response rates to standard antidepressant pharmacotherapy. Recent studies have shown that augmentation with a folate supplement increases medication response in both treatment-naïve and treatment-resistant depressed patients irrespective of whether there is folate deficiency. Conclusions: Depressed patients with both low and normal folate levels may benefit from augmenting a primary antidepressant medication either initially, at the onset of treatment, or later after some degree of treatment resistance has been recognized.