When combined with other antidepressants to modify monoamine availability, combination therapies for major depressive disorder (MDD) have the potential to increase antidepressant efficacy as well as long-term impacts on the patient. It has been shown that low folate levels in the serum and red blood cells are associated with severe depression symptoms, and that some persons are less likely to respond to antidepressants when their folate levels are low. 1 Even in people who have appropriate folate levels in their serum or red blood cells, it is possible to have insufficient folate levels in the central nervous system.
The B vitamin L-methylfolate is a vital regulator of the manufacture of the serotonin which aretrimonoamine in nature, norepinephrine and dopamine. It’s also a key regulator of the vitamin tetrahydrobiopterin, which is needed for serotonin production (BH4). BH4 is required for the formation of serotonin by the enzyme tryptophan hydroxylase, as well as the production of dopamine and norepinephrine by the enzyme tyrosine hydroxylase, both of which are neurotransmitters.
Evidence suggests that providing L-methylfolate to serotonin or selective serotonin reuptake inhibitors (SSRIs)–norepinephrine reuptake inhibitors (SNRIs) when begining treatment results in a high amount of decrease of anxiety symptoms in a less period of time than SNRI monotherapy or SSRI, respectively.
Compared to SSRIs with placebo, supplementary L-methylfolate (15 mg/d) resulted in increased response rates in a research of persons with MDD (major depressive disorders) who either responds less to or did not respond to SSRIs after being given the supplement. Methylfolate was also well controlled when used in addition with antidepressant medications such as SSRIs or SNRIs. When comparing patients who received L-methylfolate in conjunction with an SSRI or SNRI to those who had SSRI or SNRI monotherapy, it was discovered that the incidence of adverse effects was not statistically significantly different between the two treatment groups. 1
Those who have low amounts of folate and its bioactive components, like L-methylfolate, as well as those who have had a poor response to antidepressant medication, may benefited from L-methylfolate. Low folate levels are more common in patients with alcoholism, anorexia, the genetic polymorphism (which affects 50% of the normal community), or digestive problems than in the general population. Furthermore, the danger increases for expecting moms and their newborns.
While folic acid must be converted to L-methylfolate before it can pass through the blood-brain barrier and be absorbed by the body, L-methylfolate may be utilised directly by the brain.
Supplemental L-methylfolate may be advantageous in certain situations, especially if the patient is taking drugs that may interfere with the conversion of folate to L-methylfolate. Metformin, oral contraceptives, lamotrigine, warfarin, retenoids and some fenofibrates are only a handful of the drugs that have been related to stroke. It has been shown that patients with the C677-T polymorphism, as well as those of Hispanic or Mediterranean origin, have a lower capacity to convert L-methylfolate to folate.
