Details

Autor(en) / Beteiligte

• Lam, Nelson Siu Kei
• Long, Xin Xin
• Li, Xuegang
• Saad, Mirette
• Lim, Florence
• Doery, James CG
• Griffin, Robert C.
• Galletly, Cherrie

Titel

The potential use of folate and its derivatives in treating psychiatric disorders: A systematic review

Ist Teil von

• Biomedicine & pharmacotherapy, 2022-02, Vol.146, p.112541-112541, Article 112541

Ort / Verlag

France: Elsevier Masson SAS

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• To examine the strengths and limitations of existing data to provide guidance for the use of folate supplements as treatment, with or without other psychotropic medications, in various psychiatric disorders. To identify area for further research in terms of the biosynthesis of mechanism of folate and genetic variants in metabolic pathway in human. A systematic review of published literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to assess whether folate supplements are beneficial in certain psychiatric disorders (depression, bipolar disorder, schizophrenia, autism spectrum disorder, and attention deficit hyperactivity disorder). Methodology of this review is registered with Prospero (Registration number CRD 42021266605). Eligible studies were identified using a systematic search of four electronic databases: Embase, Pubmed, PsycINFO, and Cochrane. The search strategy covered the time period from 1974 to August 16th, 2021. Therefore, this review examines randomized control trials or open-label trials completed during this period. We identified 23 studies of folate supplements in various psychiatric disorders for critical review. Of these, 9 studies investigated the efficacy of folate supplements in major depressive disorders, 5 studies in schizophrenia, 6 studies in autism spectrum disorder, 2 studies in bipolar affective disorder and 1 study in attention deficit hyperactive disorder. The most consistent finding association of oral levomefolic acid or 5-methylfolate with improvement in clinical outcomes in mental health conditions as mentioned above, especially in major depressive disorder (including postpartum and post-menopausal depression), schizophrenia, autism spectrum disorder, attention deficit hyperactivity disorder and bipolar affective disorder. Folate supplements were well tolerated. Our results are not representative of all types of studies such as case reports or case series studies, nor are they representative of the studies conducted in languages that are not in English or not translated in English. Increasing evidence from clinical trials consistently demonstrate folate supplements, especially levomefolic acid or 5-methylfolate, may improve clinical outcomes for certain psychiatric diseases, especially as an adjunct pharmacotherapy with minimal side effects. [Display omitted] •Folate supplements especially levomefolic acid (L-5-methylfolate) demonstrated improvement in clinical outcomes in certain mental health conditions, such as in major depressive disorder (including postpartum and post-menopausal depression), schizophrenia, autism spectrum disorder, attention deficit hyperactivity disorder and bipolar affective disorder. Daily dosage range is 50 microgram to 15 mg orally daily depending on the clinical diagnosis and clinical presentation.•Levomefolic acid can be transported across the blood brain barrier (BBB) and reach the central nervous system to be used for neural transmitter synthesis without influenced by rate-limiting enzyme the Methylene tetrahydrofolate reductase in the metabolic pathway.•Levomefolic acid, the biological active form of folate can be used in food fortification instead of folic acid might be more effective for the general population as it is not affected by the Methylene tetrahydrofolate reductase polymorphism in the folate-mediated one-carbon cycle in human.