Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1

Predictors of clinical response in fluoxetine-resistant depression

George I. Papakostas, Timothy Petersen, David Mischoulon, Julie L. Ryan, Andrew A. Nierenberg, Teodoro Bottiglieri, Jerrold F. Rosenbaum, Jonathan E. Alpert, Maurizio Fava

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Objective: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels and clinical response in patients with major depressive disorder (MDD) who had previously failed to respond to open treatment with fluoxetine 20 mg/day and were enrolled in a 4-week, double-blind trial of either (1) fluoxetine dose increase, (2) lithium augmentation of fluoxetine, or (3) desipramine augmentation of fluoxetine. Method: Fifty-five outpatients (mean ± SD age = 41.7 ± 10.6 years; 50.9% women) with MDD as assessed with the Structured Clinical Interview for DSM-III-R who were enrolled in the double-blind trial had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to fluoxetine treatment initiation). Folate levels were classified as either low (≤ 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (≤ 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (≥ 13.2 μmol/L) or normal. With the use of a logistic regression, we then assessed the relationship between (1) low or normal folate levels, (2) normal or low B12 levels, and (3) elevated or normal homocysteine levels and clinical response to double-blind treatment. The study was conducted from November 1992 to January 1999. Results: Low serum folate levels (χ2 = 3.626, p = .04), but not elevated homocysteine (p > .05) or low vitamin B12 levels (p > .05), were associated with poorer response to treatment. The response rates for patients with (N = 14) and without (N = 38) low folate levels were 7.1% versus 44.7%, respectively. Conclusion: Low serum folate levels were found to be associated with further treatment resistance among patients with fluoxetine-resistant MDD.

Original languageEnglish (US)
Pages (from-to)1090-1095
Number of pages6
JournalJournal of Clinical Psychiatry
Volume65
Issue number8
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Fluoxetine
Homocysteine
Vitamin B 12
Folic Acid
Depression
Serum
Major Depressive Disorder
Therapeutics
Desipramine
Major Depressive Disorder 1
Lithium
Diagnostic and Statistical Manual of Mental Disorders
Outpatients
Logistic Models
Interviews

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1 : Predictors of clinical response in fluoxetine-resistant depression. / Papakostas, George I.; Petersen, Timothy; Mischoulon, David; Ryan, Julie L.; Nierenberg, Andrew A.; Bottiglieri, Teodoro; Rosenbaum, Jerrold F.; Alpert, Jonathan E.; Fava, Maurizio.

In: Journal of Clinical Psychiatry, Vol. 65, No. 8, 08.2004, p. 1090-1095.

Research output: Contribution to journalArticle

Papakostas, GI, Petersen, T, Mischoulon, D, Ryan, JL, Nierenberg, AA, Bottiglieri, T, Rosenbaum, JF, Alpert, JE & Fava, M 2004, 'Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1: Predictors of clinical response in fluoxetine-resistant depression', Journal of Clinical Psychiatry, vol. 65, no. 8, pp. 1090-1095. https://doi.org/10.4088/JCP.v65n0810
Papakostas, George I. ; Petersen, Timothy ; Mischoulon, David ; Ryan, Julie L. ; Nierenberg, Andrew A. ; Bottiglieri, Teodoro ; Rosenbaum, Jerrold F. ; Alpert, Jonathan E. ; Fava, Maurizio. / Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1 : Predictors of clinical response in fluoxetine-resistant depression. In: Journal of Clinical Psychiatry. 2004 ; Vol. 65, No. 8. pp. 1090-1095.
@article{a242db03997344ed9d87666d39d07194,
title = "Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1: Predictors of clinical response in fluoxetine-resistant depression",
abstract = "Objective: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels and clinical response in patients with major depressive disorder (MDD) who had previously failed to respond to open treatment with fluoxetine 20 mg/day and were enrolled in a 4-week, double-blind trial of either (1) fluoxetine dose increase, (2) lithium augmentation of fluoxetine, or (3) desipramine augmentation of fluoxetine. Method: Fifty-five outpatients (mean ± SD age = 41.7 ± 10.6 years; 50.9{\%} women) with MDD as assessed with the Structured Clinical Interview for DSM-III-R who were enrolled in the double-blind trial had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to fluoxetine treatment initiation). Folate levels were classified as either low (≤ 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (≤ 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (≥ 13.2 μmol/L) or normal. With the use of a logistic regression, we then assessed the relationship between (1) low or normal folate levels, (2) normal or low B12 levels, and (3) elevated or normal homocysteine levels and clinical response to double-blind treatment. The study was conducted from November 1992 to January 1999. Results: Low serum folate levels (χ2 = 3.626, p = .04), but not elevated homocysteine (p > .05) or low vitamin B12 levels (p > .05), were associated with poorer response to treatment. The response rates for patients with (N = 14) and without (N = 38) low folate levels were 7.1{\%} versus 44.7{\%}, respectively. Conclusion: Low serum folate levels were found to be associated with further treatment resistance among patients with fluoxetine-resistant MDD.",
author = "Papakostas, {George I.} and Timothy Petersen and David Mischoulon and Ryan, {Julie L.} and Nierenberg, {Andrew A.} and Teodoro Bottiglieri and Rosenbaum, {Jerrold F.} and Alpert, {Jonathan E.} and Maurizio Fava",
year = "2004",
month = "8",
doi = "10.4088/JCP.v65n0810",
language = "English (US)",
volume = "65",
pages = "1090--1095",
journal = "Journal of Clinical Psychiatry",
issn = "0160-6689",
publisher = "Physicians Postgraduate Press Inc.",
number = "8",

}

TY - JOUR

T1 - Serum folate, vitamin B12, and homocysteine in major depressive disorder, part 1

T2 - Predictors of clinical response in fluoxetine-resistant depression

AU - Papakostas, George I.

AU - Petersen, Timothy

AU - Mischoulon, David

AU - Ryan, Julie L.

AU - Nierenberg, Andrew A.

AU - Bottiglieri, Teodoro

AU - Rosenbaum, Jerrold F.

AU - Alpert, Jonathan E.

AU - Fava, Maurizio

PY - 2004/8

Y1 - 2004/8

N2 - Objective: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels and clinical response in patients with major depressive disorder (MDD) who had previously failed to respond to open treatment with fluoxetine 20 mg/day and were enrolled in a 4-week, double-blind trial of either (1) fluoxetine dose increase, (2) lithium augmentation of fluoxetine, or (3) desipramine augmentation of fluoxetine. Method: Fifty-five outpatients (mean ± SD age = 41.7 ± 10.6 years; 50.9% women) with MDD as assessed with the Structured Clinical Interview for DSM-III-R who were enrolled in the double-blind trial had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to fluoxetine treatment initiation). Folate levels were classified as either low (≤ 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (≤ 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (≥ 13.2 μmol/L) or normal. With the use of a logistic regression, we then assessed the relationship between (1) low or normal folate levels, (2) normal or low B12 levels, and (3) elevated or normal homocysteine levels and clinical response to double-blind treatment. The study was conducted from November 1992 to January 1999. Results: Low serum folate levels (χ2 = 3.626, p = .04), but not elevated homocysteine (p > .05) or low vitamin B12 levels (p > .05), were associated with poorer response to treatment. The response rates for patients with (N = 14) and without (N = 38) low folate levels were 7.1% versus 44.7%, respectively. Conclusion: Low serum folate levels were found to be associated with further treatment resistance among patients with fluoxetine-resistant MDD.

AB - Objective: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels and clinical response in patients with major depressive disorder (MDD) who had previously failed to respond to open treatment with fluoxetine 20 mg/day and were enrolled in a 4-week, double-blind trial of either (1) fluoxetine dose increase, (2) lithium augmentation of fluoxetine, or (3) desipramine augmentation of fluoxetine. Method: Fifty-five outpatients (mean ± SD age = 41.7 ± 10.6 years; 50.9% women) with MDD as assessed with the Structured Clinical Interview for DSM-III-R who were enrolled in the double-blind trial had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to fluoxetine treatment initiation). Folate levels were classified as either low (≤ 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (≤ 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (≥ 13.2 μmol/L) or normal. With the use of a logistic regression, we then assessed the relationship between (1) low or normal folate levels, (2) normal or low B12 levels, and (3) elevated or normal homocysteine levels and clinical response to double-blind treatment. The study was conducted from November 1992 to January 1999. Results: Low serum folate levels (χ2 = 3.626, p = .04), but not elevated homocysteine (p > .05) or low vitamin B12 levels (p > .05), were associated with poorer response to treatment. The response rates for patients with (N = 14) and without (N = 38) low folate levels were 7.1% versus 44.7%, respectively. Conclusion: Low serum folate levels were found to be associated with further treatment resistance among patients with fluoxetine-resistant MDD.

UR - http://www.scopus.com/inward/record.url?scp=4544374205&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4544374205&partnerID=8YFLogxK

U2 - 10.4088/JCP.v65n0810

DO - 10.4088/JCP.v65n0810

M3 - Article

VL - 65

SP - 1090

EP - 1095

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

SN - 0160-6689

IS - 8

ER -