B-vitamins and Depression

Abstract

Introduction

B-vitamin insufficiency is associated with depression but it is uncertain if treatment with these is effective in prevention or treatment.

Objectives and Aims

1. 1. To determine if daily supplementation with B-vitamins enhances response to antidepressants.

2. 2. Systematic review and meta-analysis of randomised, placebo-controlled trials of B-vitamins for depressive symptoms in adults.

Methods

1. 1. The B-VITAGE trial is a 52 week randomised, double-blind, placebo-controlled trial of citalopram together with vitamin B12, B6 and folic acid in older adult participants with major depression.

2. 2. Systematic review of 13 eligible trials of B-vitamin supplementation for the reduction, remission and prevention of clinically significant depressive symptoms.

Results

Remission was achieved by 78.1% and 79.4% of participants treated with placebo (n=76) and vitamins (n=77) by week 12 (p=0.328), and by 75.8% and 85.5% at week 52 (effect of intervention over 52 weeks: odds ratio, OR=2.49; 95% confidence interval, 95%CI=1.12,5.51). The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamin group (OR=0.33, 95%CI=0.12,0.94).

Short-term use of vitamins did not improve depressive symptoms in adults with major depression treated with antidepressants (standardised mean difference=-0.12, 95% CI=-0.45,0.22), but more prolonged consumption decreased the risk of relapse (OR=0.33, 95%CI=0.12,0.94) and the onset of clinically significant symptoms in people at risk (risk ratio=0.65, 95%CI=0.43,0.98).

Conclusions

Short-term use of B-vitamins does not appear to benefit depressive symptoms although longer use may enhance and sustain antidepressant response and decrease the risk of relapse or onset of clinically significant depression.