Posted by Jakeman on January 18, 2005, at 22:40:29
In reply to Re: pyroluria, methylation, folate » Jakeman, posted by barbaracat on January 18, 2005, at 2:49:37
> Can you send another link to Larry's site? Might be my connection but I got an invalid page error. Have you tried taking antihistamines for any length of time, like more than the course of a cold's duration, and still experienced antidepressant effects? That seems to be a red flag for histadelia from what I've read.
>
> I'm still wondering about all this. I have mixed reations and effects from antihistamines. They sometimes help with my chronic insomnia but I'll feel hungover and slightly depressed the next day if I've taken a strong dose. Other times I'll feel buzzy and kept awake. I also have terrible reactions to antipsychotics that have a strong histamine blockade (especially Seroquel). So, if that's any indication, it suggests that histapenia isn't the problem (although I have other symptoms that would suggest it). But I just don't know. It's getting so that I'm afraid to take any kind of nutritional thing for possibly aggravating the thing I'm trying to help.
>
> Why oh why isn't a panel of metabolic tests given to every person complaining of chronic mood disorders? It would save time and money in the long run. The way psychiatry is currently done is like shooting in the dark, and at best only addresses symptoms.
>
> Please keep me informed of anything new you come across - especially interesting in info that goes beyond typical Pfeiffer/Walsh stuff, which is pretty easy to find and all of it the same. - Barbara
>
I couldn't get that link to work either so I pasted the info at the end of this post. No, I have not tried taking antihistamines for a prolonged period...best I can remember they lose their AD effect over a few days. I do take Trazodone at night for sleep which also has some antidepressant effect, although I don't know if that's due to lowering histamine or its action on other receptors. I know what you mean about indecision about what to take. The articles below suggest that increased folate may alleviate treatment resistant depression, at the same time many sources state histadelia is associated with high levels of folate. I guess it's all a very delicate balancing act and everyone's chemistry is a bit different and a lot of what we know are unfortunately just educated guesses.The complete absence of any real biochemical diagnostic approach in psychiatry is a scandal. Perhaps if insurance companies didn't discourage it things would be different. Good luck and keep me posted.
-Jake
excerpt post (thanks to the contributors)
> >
> > I noticed that you posted some information on Tryptophan above. Between SJW and Tryptophan (and any other non-pharmaceutical treatment), what would you recommend for a very treatment-resistant depression?
> >
> > Thanks
>
> I wish things were so easy to predict.
>
> Your lack of response to antidepressants could be because of nutrient deficiencies. Just consider these following abstracts with respect to folate levels and antidepressant response. People are being snowed by the idea that a "balanced diet", whatever that is, can provide all the nutrition one needs. That idea is demonstrably false, but when was the last time your doctor tested your folate level?
>
> http://lpi.oregonstate.edu/infocenter/vitamins/fa/
>
> ***This article shows that taking folic acid along with fluoxetine (Prozac) not only increased the level of remission, but it also reduced the side-effects dramatically.***
>
>
> J Affect Disord. 2000 Nov;60(2):121-30.
>
> Comment in:
> J Affect Disord. 2002 Dec;72(3):297-8.
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> Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial.
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> Coppen A, Bailey J.
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> MRC Neuropsychiatry Laboratory, West Park Hospital, KT19 8PB, Surrey, Epsom, UK.
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> BACKGROUND: A consistent finding in major depression has been a low plasma and red cell folate which has also been linked to poor response to antidepressants. The present investigation was designed to investigate whether the co-administration of folic acid would enhance the antidepressant action of fluoxetine. METHODS: 127 patients were randomly assigned to receive either 500 microg folic acid or an identical looking placebo in addition to 20 mg fluoxetine daily. All patients met the DSM-III-R criteria for major depression and had a baseline Hamilton Rating Scale (17 item version) score for depression of 20 or more. Baseline and 10-week estimations of plasma folate and homocysteine were carried out. RESULTS: Patients receiving folate showed a significant increase in plasma folate.This was less in men than in women. Plasma homocysteine was significantly decreased in women by 20.6%, but there was no significant change in men. Overall there was a significantly greater improvement in the fluoxetine plus folic acid group. This was confined to women where the mean Hamilton Rating Scale score on completion was 6.8 (S.D. 4. 1) in the fluoxetine plus folate group, as compared to 11.7 (S.D. 6. 7) in the fluoxetine plus placebo group (P<0.001).A percentage of 93. 9 of women, who received the folic acid supplement, showed a good response (>50% reduction in score) as compared to 61.1% of women who received placebo supplement (P<0.005). Eight (12.9%) patients in the fluoxetine plus folic acid group reported symptoms possibly or probably related to medication, whereas in the fluoxetine plus placebo group 19 (29.7%) patients reported such symptoms (P<0.05). LIMITATIONS AND CONCLUSIONS: Folic acid is a simple method of greatly improving the antidepressant action of fluoxetine and probably other antidepressants. Folic acid should be given in doses sufficient to decrease plasma homocysteine. Men require a higher dose of folic acid to achieve this than women, but more work is required to ascertain the optimum dose of folic acid.
>
>
> ***This article shows that in fluoxetine non-responders later given augmentation (either increase in dose, or the addition of another drug along with the fluoxetine), those with normal folate status responded to the augment more than 620% better than those with low folate status.***
>
> J Clin Psychiatry. 2004 Aug;65(8):1090-5.
>
> Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 1: predictors of clinical response in fluoxetine-resistant depression.
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> Papakostas GI, Petersen T, Mischoulon D, Ryan JL, Nierenberg AA, Bottiglieri T, Rosenbaum JF, Alpert JE, Fava M.
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> Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. gpapakostas@partners.org
>
> OBJECTIVE: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels and clinical response in patients with major depressive disorder (MDD) who had previously failed to respond to open treatment with fluoxetine 20 mg/day and were enrolled in a 4-week, double-blind trial of either (1) fluoxetine dose increase, (2) lithium augmentation of fluoxetine, or (3) desipramine augmentation of fluoxetine. METHOD: Fifty-five outpatients (mean +/- SD age = 41.7 +/- 10.6 years; 50.9% women) with MDD as assessed with the Structured Clinical Interview for DSM-III-R who were enrolled in the double-blind trial had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to fluoxetine treatment initiation). Folate levels were classified as either low (< or = 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (< or = 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (> or = 13.2 micromol/L) or normal. With the use of a logistic regression, we then assessed the relationship between (1) low or normal folate levels, (2) normal or low B12 levels, and (3) elevated or normal homocysteine levels and clinical response to double-blind treatment. The study was conducted from November 1992 to January 1999. RESULTS: Low serum folate levels (chi2=3.626, p =.04), but not elevated homocysteine (p >.05) or low vitamin B12 levels (p >.05), were associated with poorer response to treatment. The response rates for patients with (N = 14) and without (N = 38) low folate levels were 7.1% versus 44.7%, respectively. CONCLUSION: Low serum folate levels were found to be associated with further treatment resistance among patients with fluoxetine-resistant MDD.
>
>
>
> ***This article shows that relapse back to depression in fluoxetine monotherapy was over 1340% more likely in those with low folate status.***
>
> J Clin Psychiatry. 2004 Aug;65(8):1096-8.
>
> Serum folate, vitamin B12, and homocysteine in major depressive disorder, Part 2: predictors of relapse during the continuation phase of pharmacotherapy.
>
> Papakostas GI, Petersen T, Mischoulon D, Green CH, Nierenberg AA, Bottiglieri T, Rosenbaum JF, Alpert JE, Fava M.
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> Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. gpapakostas@partners.org
>
> OBJECTIVE: In the present study, we assessed the relationship between serum folate, vitamin B12, and homocysteine levels on the rate of relapse in outpatients with remitted major depressive disorder (MDD) during a 28-week continuation phase of treatment with fluoxetine. METHOD: Seventy-one outpatients (mean +/- SD age = 40.2 +/- 11.1 years; 56.3% women) with MDD (as assessed with the Structured Clinical Interview for DSM-III-R) who had remitted and who were enrolled in the continuation phase of treatment with fluoxetine had serum folate, vitamin B12, and homocysteine measurements completed at baseline (prior to acute-phase treatment). Patients were followed for 28 weeks of continued treatment with fluoxetine 40 mg/day to monitor
> for depressive relapse. Folate levels were classified as either low (< or = 2.5 ng/mL) or normal. Vitamin B12 levels were classified as either low (< or = 200 pg/mL) or normal. Homocysteine levels were classified as either elevated (> or = 13.2 micromol/L) or normal. With the use of separate logistic regressions, we then assessed the relationship between folate, vitamin B12, and homocysteine level status and relapse. The study was conducted from November 1992 to January 1999. RESULTS: The presence of low serum folate levels (p =.004), but not low B12 (p >.05) or elevated homocysteine levels (p >.05), was associated with relapse during continuation treatment with fluoxetine. The relapse rates for patients with (N = 7) and without (N = 64) low folate levels were 42.9% versus 3.2%, respectively. CONCLUSION: Low serum folate levels were found to place patients with remitted MDD at risk for depressive relapse during the continuation phase of treatment with fluoxetine.
>
>
> The bottom line is, you need to ensure that your nutritional status is optimized, or maybe nothing will work.
>
> Lar--------------------------------------
Larry,
Very interesting articles, thanks for posting. What becomes a bit problematic for me is obtaining a real determination of my nutritional status. I wonder if a basic blood test measures levels of folate and/or homocysteine. Below is another article on folate and depression.
JakeDepression, Low Folate Levels Linked
Tufts nutrition experts find that the vitamin folate – found in a variety of foods including vegetables and cereals – may help ease depression and prevent memory loss.
Boston [06-23-03] The food you eat may impact more than just your physical health – it could also play a role in your mental health as well. According to recent studies by Tufts nutrition experts, low levels of the vitamin folate – found in a variety of foods – has been linked with depression, low energy levels and even memory loss.
“[Tufts’ Martha Morris and four colleagues] found that those who had experienced major depression had lower concentrations of folate in their bloodstream and red blood cells than those who had never been depressed,” reported the Hartford Courant. “In addition, those with chronic low-level depression - also known as dysthymia - had lower red blood cell levels than the non-depressed.”
The research team, which conducted their research at Tufts’ Jean Mayer USDA Human Nutrition Research Center on Aging, studied data on nearly 3,000 people ages 15 to 39.
“Supplementation possibly helps by reducing fatigue and improving energy levels,” Morris, an epidemiologist who teaches at Tufts’ Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, told the newspaper. “People who are diagnosed with depression should then find out whether they are folate deficient to determine if a supplement is warranted.”
Morris’ research opens the door for future research to pinpoint exactly why vitamin deficiencies result in different types of medical conditions.
“Clinical studies show that folate supplementation helps depressed people, although we still don’t have a good idea why depressed people have low folate status,” Morris said.
This isn’t the first time that Tufts researchers have further shown the health benefits of folate. In 2001, Morris and her colleagues found that folate helps significantly modify homocysteine levels in the brain. The presence of homocysteine has been associated with cognitive impairment and has been linked to the onset of Alzheimer disease, dementia and strokes. And, Dr. Irwin Rosenberg, dean of the Friedman School of Nutrition Science and Policy, was among the very first worldwide to explore the relationship between folate, homocysteine and cardiovascular disease resulting in landmark publications.
“Researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University were looking for a relationship between blood homocysteine levels and memory loss,” reported the Agriculture Research Service. “Their research had established that homocysteine levels were higher in elderly people with low intakes of B vitamins, especially folate.”
Despite its benefits, Morris and her colleagues caution that people shouldn’t make a significant increase in their folate intake without consulting a doctor.
“While studies on folate and antidepressant treatment are promising, scientists do not yet know which patients should get folate supplements, in what dose or for how long,” reported the Courant. “Furthermore, the safety of high-dosage supplementation has not been established.”
Good sources for folate include vegetables and fruits such as leafy greens, strawberries, and melons, as well as dried beans and cereals, or any multivitamin.
http://enews.tufts.edu/stories/062303Folate.htm
poster:Jakeman
thread:436445
URL: http://www.dr-bob.org/babble/alter/20050101/msgs/444022.html