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Adjunctive folate for major mental disorders: A systematic review
Zheng,Wei1; Li,Wen2,3; Qi,Han4; Xiao,Le4; Sim,Kang5; Ungvari,Gabor S.6,7; Lu,Xiao Bin1; Huang,Xiong1; Ning,Yu Ping1; Xiang,Yu Tao2,3
Source PublicationJournal of Affective Disorders

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; I = 30%, P = 0.60), and positive (SMD = 0.09, 95% CI: -0.44, 0.62; I = not applicable, P = 0.74), negative (SMD = −0.39, 95% CI:−0.84, 0.05; I = 50%, P = 0.08), and general symptom scores (SMD = −0.33, 95%CI:−0.87, 0.20; I = 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; I = 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.

KeywordBipolar Disorder Folate Major Depressive Disorder Meta-analysis Schizophrenia
URLView the original
Indexed BySCIE ; SSCI
WOS Research AreaNeurosciences & Neurology ; Psychiatry
WOS SubjectClinical Neurology ; Psychiatry
WOS IDWOS:000519542100017
Scopus ID2-s2.0-85079415586
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Cited Times [WOS]:4   [WOS Record]     [Related Records in WOS]
Document TypeJournal article
CollectionUniversity of Macau
Corresponding AuthorZheng,Wei; Xiang,Yu Tao
Affiliation1.The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital),Guangzhou,China
2.Unit of Psychiatry,Institute of Translational Medicine,Faculty of Health Sciences,University of Macau,Macao SAR,China
3.Center for Cognition and Brain Sciences,University of Macau,Macao SAR,China
4.The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University & the Advanced Innovation Center for Human Brain Protection,Capital Medical University,Beijing,China
5.Institute of Mental Health,Buangkok Green Medical Park,Singapore
6.The University of Notre Dame Australia,Fremantle,Australia
7.Division of Psychiatry,School of Medicine,University of Western Australia,Perth,Australia
Corresponding Author AffilicationFaculty of Health Sciences;  University of Macau
Recommended Citation
GB/T 7714
Zheng,Wei,Li,Wen,Qi,Han,et al. Adjunctive folate for major mental disorders: A systematic review[J]. Journal of Affective Disorders,2020,267:123-130.
APA Zheng,Wei,Li,Wen,Qi,Han,Xiao,Le,Sim,Kang,Ungvari,Gabor S.,Lu,Xiao Bin,Huang,Xiong,Ning,Yu Ping,&Xiang,Yu Tao.(2020).Adjunctive folate for major mental disorders: A systematic review.Journal of Affective Disorders,267,123-130.
MLA Zheng,Wei,et al."Adjunctive folate for major mental disorders: A systematic review".Journal of Affective Disorders 267(2020):123-130.
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