TY - JOUR
T1 - Adjunctive folate for major mental disorders
T2 - A systematic review
AU - Zheng, Wei
AU - Li, Wen
AU - Qi, Han
AU - Xiao, Le
AU - Sim, Kang
AU - Ungvari, Gabor S.
AU - Lu, Xiao Bin
AU - Huang, Xiong
AU - Ning, Yu Ping
AU - Xiang, Yu Tao
PY - 2020/4/15
Y1 - 2020/4/15
N2 - Objectives: This is a meta-analysis of randomized controlled trials (RCTs) to examine the efficacy and safety of adjunctive folate for three major mental disorders (schizophrenia, bipolar disorder, and major depressive disorder (MDD)). Methods: Review Manager Program Version 5.3 was used to analyze data. Results: Fourteen studies with 16 RCTs (n = 1,520) on folate for schizophrenia (4 RCTs, n = 210), mood disorders (i.e., unipolar and bipolar depression) (1 RCT, n = 60), bipolar disorder (2 RCTs, n = 189) and MDD (9 RCTs, n = 1,061) were analyzed separately by diagnosis. For schizophrenia, adjunctive folate was not superior to placebo in terms of total psychopathology (standardized mean difference (SMD) = −0.14, 95% confidential interval (CI): −0.67, 0.39; I2 = 30%, P = 0.60), and positive (SMD = 0.09, 95% CI: -0.44, 0.62; I2 = not applicable, P = 0.74), negative (SMD = −0.39, 95% CI:−0.84, 0.05; I2 = 50%, P = 0.08), and general symptom scores (SMD = −0.33, 95%CI:−0.87, 0.20; I2 = not applicable, P = 0.22). For bipolar and unipolar depression, adjunctive folate was significantly superior to placebo in improving depressive symptoms. For bipolar disorder, adjunctive folate was effective in treating the acute phase of mania in bipolar disorder, but not in the acute phase of depression. For MDD, adjunctive folate was significantly superior to placebo in improving depressive symptoms (SMD = −0.38, 95%CI: −0.66, −0.09; I2 = 71%, P = 0.01), which was confirmed in 5 of the 10 subgroups. Discontinuation due to any reason and adverse drug reactions were similar between folate and placebo in each diagnostic category. Conclusion: This systematic review found adjunctive folate appeared to be effective and safe for MDD and bipolar manic episode, but it was not effective in treating schizophrenia.
AB - Objectives: This is a meta-analysis of randomized controlled trials (RCTs) to examine the efficacy and safety of adjunctive folate for three major mental disorders (schizophrenia, bipolar disorder, and major depressive disorder (MDD)). Methods: Review Manager Program Version 5.3 was used to analyze data. Results: Fourteen studies with 16 RCTs (n = 1,520) on folate for schizophrenia (4 RCTs, n = 210), mood disorders (i.e., unipolar and bipolar depression) (1 RCT, n = 60), bipolar disorder (2 RCTs, n = 189) and MDD (9 RCTs, n = 1,061) were analyzed separately by diagnosis. For schizophrenia, adjunctive folate was not superior to placebo in terms of total psychopathology (standardized mean difference (SMD) = −0.14, 95% confidential interval (CI): −0.67, 0.39; I2 = 30%, P = 0.60), and positive (SMD = 0.09, 95% CI: -0.44, 0.62; I2 = not applicable, P = 0.74), negative (SMD = −0.39, 95% CI:−0.84, 0.05; I2 = 50%, P = 0.08), and general symptom scores (SMD = −0.33, 95%CI:−0.87, 0.20; I2 = not applicable, P = 0.22). For bipolar and unipolar depression, adjunctive folate was significantly superior to placebo in improving depressive symptoms. For bipolar disorder, adjunctive folate was effective in treating the acute phase of mania in bipolar disorder, but not in the acute phase of depression. For MDD, adjunctive folate was significantly superior to placebo in improving depressive symptoms (SMD = −0.38, 95%CI: −0.66, −0.09; I2 = 71%, P = 0.01), which was confirmed in 5 of the 10 subgroups. Discontinuation due to any reason and adverse drug reactions were similar between folate and placebo in each diagnostic category. Conclusion: This systematic review found adjunctive folate appeared to be effective and safe for MDD and bipolar manic episode, but it was not effective in treating schizophrenia.
KW - Bipolar disorder
KW - Folate
KW - Major depressive disorder
KW - Meta-analysis
KW - Schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85079415586&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2020.01.096
DO - 10.1016/j.jad.2020.01.096
M3 - Review article
C2 - 32063563
AN - SCOPUS:85079415586
VL - 267
SP - 123
EP - 130
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -