Anemia and macrocytosis in the prediction of serum folate and vitamin B12 status, and treatment outcome in major depression

David Mischoulon, Jane K. Burger, Maya K. Spillmann, John J. Worthington, Maurizio Fava, Jonathan E. Alpert

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: Folate and B12 deficiencies may result in macrocytic anemia, and are common in major depression; hypofolatemia may result in poorer antidepressant response. We wished to determine whether anemia or macrocytosis predict hypofolatemia, low B12, or refractoriness to antidepressants. Methods: After obtaining serum folate, B12, and hematological indices, 213 depressed adults were treated with fluoxetine 20 mg/day. Amelioration of depressive symptoms was measured. Results: Neither macrocytosis nor anemia predicted low serum folate/B12, or antidepressant refractoriness. Among 39 patients with hypofolatemia, none had macrocytosis; 28% had low HCT; 41% had low RBC. Among 25 patients with low B12, none had macrocytosis; 24% had low HCT; 28% had low RBC. Among non-responders, 3% had macrocytosis; 24% had low HCT; 25% had low RBC. Conclusion: Anemia and macrocytosis should not be used to predict folate or B12 deficiencies, or refractoriness to antidepressants. Measurement of folate and B12 should be considered when evaluating treatment refractoriness.

Original languageEnglish (US)
Pages (from-to)183-187
Number of pages5
JournalJournal of Psychosomatic Research
Volume49
Issue number3
DOIs
StatePublished - Dec 1 2000
Externally publishedYes

Keywords

  • Anemia
  • B12
  • Depression
  • Folate
  • Macrocytosis

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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