Depression can run in families, and some researchers think that they have good reason to believe that some depression, especially drug-resistant depression, might be able to be treated with certain vitamins. This has been speculated about for decades. A 1994 study that was published in the Journal of Affective Disorders examined a form of vitamin B12, to test the theory that B12 supplementation might help with seasonal depression. That study turned out to be a bust, because when they supplemented participants with the form commonly found in daily vitamins; it had no effect on improving the mood disorder. Genetic research has shed some light on why supplementing with the standard form of B12 and folic acid isn’t as effective the way researchers theorized it could be.
People with the fairly common thermolabile variant of MTHFR have been found to have an elevated incidence of depression, “and require higher levels of folate,” according to an article in Journal of Psychiatry Neuroscience. Folic acid doesn’t seem to do the trick though. Even though it’s in our daily vitamins and our enriched breads, it doesn’t seem to help some people. Medications aren’t always helpful. Psychology Today reported that as many as seven-in-10 patients on antidepressants fail to experience remission of their symptoms.
“For these patients, clinical trials and case studies suggest that l-methylfolate can improve response to antidepressants.”
According to Psychology Today, folic acid is the wrong form for treating many people with depression and other mood disorders.
“L-Methylfolate is the only form of folic acid that crosses the blood-brain barrier and plays a role in neurotransmitter synthesis. It indirectly facilitates the synthesis of serotonin, dopamine, and norepinephrine, three neurotransmitters involved in mood regulation and other important functions. L-methylfolate has been shown in several studies to enhance the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), two commonly prescribed classes of antidepressants.”
As it turns out, l-methylfolate can help treat depression, especially when used with the right form of B12. Cyanocobalamin can often be the wrong form of B12, and methylcobalamin is the form that should be used for certain patients, new research indicates. It turns out, we might have been supplementing foods and using vitamins that are ineffective and even be aggravating symptoms for most people with depression.
Traditional drugs block re-uptake of neurotransmitters, but L-methylfolate spurs the production of more neurotransmitters, according to Psych Congress.
“It primes the pump from within,” said Dr. Draud, Clinical Professor of Psychiatry at University of Tennessee College of Medicine in Memphis, in regards to L-methylfolate.
Additionally, Current Psychology reported that patients who take certain medications that interfere with the conversion of folate to L-methylfolate should probably be given L-methylfolate supplementation. The medications that can do this “include lamotrigine, valproate, oral contraceptives, metformin, warfarin, fenofibrates, and certain retinoids.” Additionally, patients with a certain genetic polymorphism and people with Hispanic or Mediterranean genetic makeup also seem to be unable to convert folic acid to L-methylfolate, and should avoid folic acid and instead supplement with L-methylfolate.
“In a study of patients with MDD who partially responded or did not respond to SSRIs, adjunctive L-methylfolate, 15 mg/d, produced greater response rates compared with SSRIs plus placebo. L-methylfolate also was well tolerated in combination with SSRI or SNRI therapy. The rates of adverse effects were not significantly different in patients taking L-methylfolate plus an SSRI or SNRI compared with those taking SSRI or SNRI monotherapy.”
Sound Psychiatric Solutions advises that people with depression should also supplement with other B vitamins like niacin, thiamine, pantothenic acid, and pyridoxine, in addition to methylcobalamin and L-methylfolate.