Aim and background: Depression is a heterogeneous disorder, and recent research evidence has identified links between depression and levels of three metabolites, namely vitamin B12, folic acid, and homocysteine. Research has consistently highlighted that when nutrient supplementation is given along with antidepressants, it has a better response compared to antidepressant monotherapy. In this study, we examined the impact of supplementation of vitamin B12 and folic acid on treatment outcomes of persons with depression when compared to subjects without supplementation.
Materials and methods: The study included 56 subjects diagnosed with depression using the 10th Revision of the International Classification of Diseases and Related Health Problems (ICD-10), and its severity was assessed using the Hamilton Depression Rating Scale (HAM-D). Out of 56 subjects, one group (n = 28) was treated with the antidepressant tab escitalopram 10 mg alone, and the other group (n = 28) was supplemented with vitamin B12 (1500 µg/day) and folic acid (5 mg/day) along with the tab escitalopram 10 mg for 3 months and reassessed.
Results: There is a statistically significant reduction of HAM-D score in persons with depression and improvement in the severity of depression with respect to nutrient supplementation of vitamin B12 and folic acid (p ≤ 0.05) compared to those without supplementation. It is also shown that there is a significant difference in postsupplementation subjects with respect to levels of vitamin B12 and folate with p < 0.05 compared to presupplementation subjects.
Conclusion: Vitamin B12 and folic acid supplementation, along with antidepressant escitalopram, not only significantly improved treatment outcomes in depression, but their serum levels can also be used as biomarkers to assess the severity of depression.
Clinical significance: Supplementation can be used as adjunctive therapy alongside conventional treatments such as medication and psychotherapy. Incorporating supplementation into treatment plans can empower patients to take an active role in managing their depression. A combination of vitamin B12 (1500 µg/day) and folic acid supplementation with tab escitalopram represents a promising approach to improving treatment outcomes in depression. Additionally, their serum levels can serve as valuable biomarkers for assessing depression severity and guiding clinical decision-making, ultimately enhancing the quality of care for individuals living with depression.
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