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L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation

This summary provides context for the role of L-methylfolate (LMF) in treating antidepressant non-responders. Bidirectional relationships have been observed between obesity and/or inflammation and depression. Studies have shown an increased prevalence of depression among patients with elevated body...

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Autor principal: Macaluso, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968318/
https://www.ncbi.nlm.nih.gov/pubmed/35370812
http://dx.doi.org/10.3389/fpsyt.2022.840116
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author Macaluso, Matthew
author_facet Macaluso, Matthew
author_sort Macaluso, Matthew
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description This summary provides context for the role of L-methylfolate (LMF) in treating antidepressant non-responders. Bidirectional relationships have been observed between obesity and/or inflammation and depression. Studies have shown an increased prevalence of depression among patients with elevated body mass index and/or chronic inflammation and an increased risk of becoming obese and experiencing chronic inflammation in those with depression. These relationships can negatively affect the pathophysiology of depression. Elevated cytokine levels have been found to be among the factors that correlate with poor antidepressant treatment responsiveness. Low baseline neurotransmitter levels (e.g., serotonin) can also be associated with reduced effectiveness of commonly used antidepressants [e.g., selective serotonin reuptake inhibitors (SSRIs)]. LMF is an approved nutritional adjunctive antidepressant therapy that increases central neurotransmitter levels and thereby improves the effectiveness of antidepressant therapy. LMF can increase clinical response when used adjunctively in patients with major depressive disorder (MDD) and who are SSRI-resistant. In 2 randomized controlled trials, the pooled results showed increased response rates (32.3 vs. 14.6%; P = 0.04) as measured by a ≥50% reduction or final score ≤ 7 on the Hamilton Depression Rating Scale (HAM-D) and greater mean HAM-D reductions (−5.6 vs. −3.0; P = 0.05) when LMF was added to an SSRI compared with an SSRI plus placebo. Additionally, LMF has demonstrated effectiveness in real-world studies, with 67.9% of patients responding to therapy, using the 9-item Patient Health Questionnaire (P < 0.001). Post-hoc analyses found that patients with inflammation and/or obesity responded better to adjunctive LMF therapy compared with the overall sample (mean HAM-D reduction: −2.74 vs. +0.99).
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spelling pubmed-89683182022-04-01 L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation Macaluso, Matthew Front Psychiatry Psychiatry This summary provides context for the role of L-methylfolate (LMF) in treating antidepressant non-responders. Bidirectional relationships have been observed between obesity and/or inflammation and depression. Studies have shown an increased prevalence of depression among patients with elevated body mass index and/or chronic inflammation and an increased risk of becoming obese and experiencing chronic inflammation in those with depression. These relationships can negatively affect the pathophysiology of depression. Elevated cytokine levels have been found to be among the factors that correlate with poor antidepressant treatment responsiveness. Low baseline neurotransmitter levels (e.g., serotonin) can also be associated with reduced effectiveness of commonly used antidepressants [e.g., selective serotonin reuptake inhibitors (SSRIs)]. LMF is an approved nutritional adjunctive antidepressant therapy that increases central neurotransmitter levels and thereby improves the effectiveness of antidepressant therapy. LMF can increase clinical response when used adjunctively in patients with major depressive disorder (MDD) and who are SSRI-resistant. In 2 randomized controlled trials, the pooled results showed increased response rates (32.3 vs. 14.6%; P = 0.04) as measured by a ≥50% reduction or final score ≤ 7 on the Hamilton Depression Rating Scale (HAM-D) and greater mean HAM-D reductions (−5.6 vs. −3.0; P = 0.05) when LMF was added to an SSRI compared with an SSRI plus placebo. Additionally, LMF has demonstrated effectiveness in real-world studies, with 67.9% of patients responding to therapy, using the 9-item Patient Health Questionnaire (P < 0.001). Post-hoc analyses found that patients with inflammation and/or obesity responded better to adjunctive LMF therapy compared with the overall sample (mean HAM-D reduction: −2.74 vs. +0.99). Frontiers Media S.A. 2022-03-17 /pmc/articles/PMC8968318/ /pubmed/35370812 http://dx.doi.org/10.3389/fpsyt.2022.840116 Text en Copyright © 2022 Macaluso. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Macaluso, Matthew
L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title_full L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title_fullStr L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title_full_unstemmed L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title_short L-Methylfolate in Antidepressant Non-responders: The Impact of Body Weight and Inflammation
title_sort l-methylfolate in antidepressant non-responders: the impact of body weight and inflammation
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968318/
https://www.ncbi.nlm.nih.gov/pubmed/35370812
http://dx.doi.org/10.3389/fpsyt.2022.840116
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