L-Methylfolate: Who Will benefit

Q: Which Patients with Depression are Candidate for L-Methylfolate Treatment?

1. Low levels of folate and its active metabolites such as L-methylfolate.

  • Documented low levels of MTHFR (methylene tetrahydrofolate reductase). Note:- RBC folate level preferred.
  • Documented high homocysteine levels (inverse relation with folate levels)

2. Poor or Inadequate response to antidepressants.

3. High risk populations:

(a) Alcoholism
(b) Pregnancy
(c) Eating disorders
(d) Gastrointestinal disorders
(e) Hispanic and Mediterranean populations: decreased levels of MTHFR (methylene tetrahydrofolate reductase)
(f) Patients with C677-T polymorphism: decreased levels of MTHFR (methylene tetrahydrofolate reductase)

4. Medications that can interfere with the conversion of folate to L-methylfolate:

  • Lamotrigine
  • Valproate
  • Oral contraceptives
  • Metformin
  • Warfarin
  • Fenofibrates
  • Certain retinoids.



1. Stephen M. Stahl. L-methylfolate: A vitamin for your monoamines. J Clin Psychiatry 69:9, September 2008.
2. L-methylfolate: Another weapon against depression Current Psychiatry. 2012 January;11(1):72-72.

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Dr. Harvinder Singh, M.D. (Admin)

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