Metabolized B Vitamins May Be an Effective Monotherapy for Depression

Once metabolized, B vitamins (i.e., “reduced B vitamins”) are important cofactors in neurotransmitter synthesis. Genetic polymorphisms can impair reduction of B vitamins, and reduced B vitamins (particularly methylfolate) may be effective adjunctively for treatment-resistant depression although the evidence is not strong (NEJM JW Psychiatry Jun 2016 and Am J Psychiatry 2016; 173:575). This manufacturer-sponsored, placebo-controlled study examined the 8-week efficacy of a proprietary formulation of multiple reduced B vitamins (EnLyte) as monotherapy for major depression in medication-free patients who had one of three MTHFR polymorphisms associated with impaired ability to reduce folate.

Compared with placebo, the formula was associated with …