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.

 


Source:

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.


Please do post your questions or comments below. 


Dr. Harvinder Singh, M.D. (Admin)


Enroll in our online course to have access to all important clinically relevant psychiatry topics in one place.


Related Articles