The effect of folate supplementation on inflammatory markers in individuals susceptible to depression: a systematic review

Helen Barnett, Nathan D'Cunha, Ekavi Georgousopoulou, Duane Mellor, Andrew McKune, Nenad Naumovski

Research output: Contribution to journalReview article

Abstract

Background & objectives: Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of Neural Tube Defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Methods: Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Results: Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p>0.05). The single L-MTHF trial explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton Depression Rating Scale from adjunctive treatment with 15mg/day of L-MTHF compared with placebo (-6.8±7.2 vs. -3.7±6.5; p=0.017), and improvement with L-MTHF for most genetic markers. Conclusions: Currently there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.
Original languageEnglish
Pages (from-to)86-100
JournalExploratory Research and Hypothesis in Medicine
Volume2
DOIs
Publication statusPublished - 2017

Fingerprint

Folic Acid
Genetic Polymorphisms
Placebos
Leucovorin
Neural Tube Defects
Flour
Genetic Markers
Methylation
Antidepressive Agents
Libraries
Public Health
Clinical Trials
Databases
Guidelines

Cite this

The effect of folate supplementation on inflammatory markers in individuals susceptible to depression: a systematic review. / Barnett, Helen; D'Cunha, Nathan; Georgousopoulou, Ekavi; Mellor, Duane; McKune, Andrew; Naumovski, Nenad.

In: Exploratory Research and Hypothesis in Medicine, Vol. 2, 2017, p. 86-100.

Research output: Contribution to journalReview article

Barnett, Helen ; D'Cunha, Nathan ; Georgousopoulou, Ekavi ; Mellor, Duane ; McKune, Andrew ; Naumovski, Nenad. / The effect of folate supplementation on inflammatory markers in individuals susceptible to depression: a systematic review. In: Exploratory Research and Hypothesis in Medicine. 2017 ; Vol. 2. pp. 86-100.
@article{d3ff0e626e5348e5a25aac3496ff7643,
title = "The effect of folate supplementation on inflammatory markers in individuals susceptible to depression: a systematic review",
abstract = "Background & objectives: Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of Neural Tube Defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Methods: Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Results: Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p>0.05). The single L-MTHF trial explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton Depression Rating Scale from adjunctive treatment with 15mg/day of L-MTHF compared with placebo (-6.8±7.2 vs. -3.7±6.5; p=0.017), and improvement with L-MTHF for most genetic markers. Conclusions: Currently there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.",
author = "Helen Barnett and Nathan D'Cunha and Ekavi Georgousopoulou and Duane Mellor and Andrew McKune and Nenad Naumovski",
year = "2017",
doi = "10.14218/ERHM.2017.00025",
language = "English",
volume = "2",
pages = "86--100",
journal = "Exploratory Research and Hypothesis in Medicine",
issn = "2472-0712",
publisher = "Xia and He Publishing",

}

TY - JOUR

T1 - The effect of folate supplementation on inflammatory markers in individuals susceptible to depression: a systematic review

AU - Barnett, Helen

AU - D'Cunha, Nathan

AU - Georgousopoulou, Ekavi

AU - Mellor, Duane

AU - McKune, Andrew

AU - Naumovski, Nenad

PY - 2017

Y1 - 2017

N2 - Background & objectives: Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of Neural Tube Defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Methods: Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Results: Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p>0.05). The single L-MTHF trial explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton Depression Rating Scale from adjunctive treatment with 15mg/day of L-MTHF compared with placebo (-6.8±7.2 vs. -3.7±6.5; p=0.017), and improvement with L-MTHF for most genetic markers. Conclusions: Currently there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

AB - Background & objectives: Folate has been proposed to be an efficacious treatment strategy for depression. The mandatory fortification of flour with synthetic folic acid (FA) in over 80 countries has yielded improvements in folate intake; however, depression is still a considerable public health concern. While there are established benefits of FA fortification in reducing risk of Neural Tube Defects, the implications regarding depression are unclear, especially in individuals with certain genetic polymorphisms. Therefore, a systematic review was conducted to examine the effects of folate to treat depression. Methods: Following PRISMA guidelines, a systematic review was conducted of electronic databases (PUBMED, Scopus, CINAHL, and Cochrane Library) to identify human clinical trials examining the effects of folate (including FA) supplementation in the management or prevention of depression, the impact on inflammatory markers and if genetic polymorphisms were considered. Results: Ten trials met the inclusion criteria. Seven trials examined effects of either adjunctive FA or L-methylfolate (L-MTHF) supplementation with antidepressants in the management of depression and three examined effects of FA supplementation alone for prevention of depression. No benefit of FA was found compared to placebo (all, p>0.05). The single L-MTHF trial explored the interplay of genetic polymorphisms and methylation status found benefit in the Hamilton Depression Rating Scale from adjunctive treatment with 15mg/day of L-MTHF compared with placebo (-6.8±7.2 vs. -3.7±6.5; p=0.017), and improvement with L-MTHF for most genetic markers. Conclusions: Currently there is no evidence to support FA supplementation for the management or prevention of depression. More research is required to determine the efficacy of L-MTHF and folinic acid in certain clinical populations.

U2 - 10.14218/ERHM.2017.00025

DO - 10.14218/ERHM.2017.00025

M3 - Review article

VL - 2

SP - 86

EP - 100

JO - Exploratory Research and Hypothesis in Medicine

JF - Exploratory Research and Hypothesis in Medicine

SN - 2472-0712

ER -