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B Vitamins to enhance treatment response to anti-depressants in middle-aged and older adults

Anti-depressants – B Vitamins to enhance treatment response

A study has shown that B vitamins did not increase the 12-week efficacy of antidepressant treatment, but enhanced and sustained antidepressant response over 1 year. Replication of these findings would mandate that treatment guidelines adopt the adjunctive use of B vitamins as a safe and inexpensive strategy to manage major depression in middle-aged and older adults.

This study demonstrated evidence in favour of the benefits of B Vitamins in depression. This was regarding enhanced anti depressant response to B Vitamins  with citalopram and reduced relapse compared to placebo combined with antidepressant.

The doses of multi B vitamins were: 0.5 mgs Vitamin B12, 2 mgs Folic acid and 25 mgs Vitamin B6. The greatest benefits were obtained with those subjects who had the higher plasma Homocysteine concentrations within the 50 percentile. This more associated with older age and male gender. Since the benefit was not identified at 12 weeks could this have been to the lack of power of the study or and the need for a pharmacodynamic study in order to identify an effective dose range for the anti depressant effects. Thus ideally a dose response study could prove useful to identify the effective doses required. In treatment refractory cases this could be a useful adjunct.

Almeida O P., et al.,  British Journal of Psychiatry 2014, 205, 450-457