Midweek Mental Greening
First and foremost, I should offer a disclaimer for this post:
The scientific media briefing I watched this morning, “Feeding the Brain to Help Manage Depression: The Role of Medical Foods,” was presented by Rakesh Jain, M.D., M.P.H., the Director of Psychiatric Drug Research at R/D Clinical Research Center in Lake Jackson, TX and Teodoro Bottiglieri, Ph.D. of the Baylor Institute of Metabolic Disease, and sponsored by Pamlab, a pharmaceutical company specializing in prescription medical foods. Neither PsychCentral.com nor myself is affiliated with Pamlab or Deplin, the new medical food discussed during the briefing.
Now that that’s out of the way, on to the more interesting stuff.
“Can we feed the brain to regulate mood disorders?”
If you had no experience with or knowledge of medical foods (meant for nutritional or dietary management of specific diseases), you might’ve thought Jain and Bottiglieri were referring to feeding the brain – and our bodies – with actual food when you heard that question.
Instead, the men were referring to medical foods - more specifically, a new product called Deplin, a medical food that includes L-methylfolate, the only active form of folate that can cross the blood brain barrier and help with the synthesis of the neurotransmitters associated with mood and, consequently, mood disorders such as depression: serotonin, dopamine, and norepinephrine.
Research shows that people with depression and low folate levels are less likely to respond to treatments such as antidepressants and less likely to achieve remission.
(Unfortunately, a smorgasbord of factors can contribute to low folate levels - genetics, age, lifestyle choices like poor diets and smoking, certain medications like anticonvulsants, oral contraceptives, and lithium, and certain illnesses like Crohn’s disease, hypothyroidism, and diabetes, just to name a few.)
Well, that makes sense, right? I mean, if you need folate to help synthesize the neurotransmitters, and you don’t have enough folate, the neurotransmitters won’t be properly synthesized and your depression - even with the assistance of antidepressants - probably won’t get better. Or, at least, the chances of you getting better - and staying better for longer periods of time - will be decreased.
What didn’t make sense to me during most of the briefing was why folic acid and natural forms of folate (the kind you can get from green vegetables, for example) wouldn’t work just as well?
In other words, why do we need yet another pill?
How can you blame me? This column is called “Midweek Mental Greening,” after all.
Well, as it turns out, folic acid (which is a man-made product and can actually block L-methylfolate from crossing the blood brain barrier) has to go through a four-step process throughout our bodies before our brains can use it. Natural folate from green vegetables has to go through a three-step process. When time is of the essence, as it often is in cases of severe depression and other mood disorders, these three- and four-step processes just aren’t quick enough.
Combine the time problem with the fact that many people can’t make the necessary changes in order to increase folate (for example, people taking anticonvulsants aren’t likely to stop just because they need more folate, people with Crohn’s disease and diabetes face nutritional challenges they can manage but not eliminate, and elderly people can’t turn back the clock) and the fact that Deplin is immediately put to use once absorbed, and the “need” for yet another pill might not leave such a bad taste in the mouth.
A recording of the media briefing will be available soon, and in the meantime you can learn more about Deplin and folate deficiency at www.deplin.com. Of course, you shouldn’t use any of this information to diagnosis yourself and/or label Deplin as your wonder drug medical food. If you suffer from depression for which other treatments don’t seem to be working and you fall into one of the categories of folks at risk for folate deficiency, be smart about it: Make an appointment with your doctor.
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11 Comments to
“Treating Depression and Folate Deficiency With Medical Foods”
Hi Alicia,
The folate level link to depression is very interesting but still very complex.
On one hand I agree with you;….” the fact that Deplin is immediately put to use once absorbed…”
Then again on the other hand - Research does show that some treatment trials are encouraging and our awareness of nutritional disorders within the nervous system suggest that prevention of deficiency would be an effectual treatment of folate level deficiency.
Thank you
Regards
Linda Cooper
This is the first I’ve heard of “medical food.” Why is L-methylfolate classified as a pharmaceutical Rx and not a nutritional supplement?
Hi Alicia,
Interesting article;
Although I would like to see research into preventing deficiency instead of treating deficiency. This is better than nothing.
Prevention is still better than cure.
Thank you
Linda Cooper
@ Sandy - I’m really not sure; I don’t have any experience with how they classify these things. I read up on medical foods, and can see the differences between them and “regular foods,” but L-methylfolate sounds almost like it’d fall into a “vitamin” type category. I also read up on L-methylfolate, though, and found that it’s been marketed under other brand names. You can get a quick rundown of it at it’s pages at Drugs.com (http://www.drugs.com/cdi/l-methylfolate.html) and even Wikipedia (http://en.wikipedia.org/wiki/L-methylfolate) - not great for research purposes, but it gives an overall understanding.
@ Linda - I would, too! Also, I was disappointed to hear one of the speakers say that it was impractical for people with the deficiency to get the folate through natural means, because of all the green vegetables that would have to be eaten as well as the “American culture/diet” - I can’t remember is exact words, but that was mentioned. It’s near the end of the briefing, during the Q&A session.
I suffer from bipolar disorder type 2. Deplin has made a big difference for me. I cut down the dosage of psychoactive medicines in half. I have experimented by abstaining from it but the effect is dramatic and unwanted. I tried taking large doses of folic acid but it was not effective. It is obvious that I do not effectively adsorb folate from food.
I suspect that I could not eat enough vegetables to positivly effect the problem if I did nothing but eat folate rich ones all day.
Sounds interesting, especially as augmentation to an AD. I think it’s certainly something I would want to try before being put on Abilify, which is currently being marketed as an AD supplementary drug.
@ Alex - Thanks so much for chiming in with your experiences with Deplin! It’s great to hear from someone who has firsthand experience with it. It’s also great to hear that it works well for you.
@ Meghan - That’s a very good point. I would guess many people might want to try a “medical food” as a supplement to their current medication(s) first, rather than just beginning a new medication (in addition to whatever they’re currently taking).
Deplin has made a huge difference in my life. I now know how ‘normal’ people feel. I have a Major Depressive Disorder which is recurrent. The most dramatic difference is to be present in life instead of constantly ruminating, evaluating and dumping on myself. I hope that this medical food gains acceptance. It is much more acceptable to me than the alternatives for treatment resistant depression.
@ Margaret - I’m so glad to have another person with firsthand experience chime in with her thoughts, and I’m really glad to hear Deplin is working well for you. You mentioned being in the present, and that’s such an important thing to do. Is the ability to do that now something you were missing with any other form of treatment by itself (that you might have been doing/taking before)?
While at the dr’s for an unrelated problem last week, I was offered a trial of Deplin for chronic depression/anxiety.
I was amazed how quickly I felt much better, even without any additional anti-depressant.
Because of a history of symptoms similar to mine, I have told everyone in my family to discuss this topic with their physicians.
I hope many others achieve relief as I have.
@ ann reid - WOW! That’s amazing indeed! I bet knowing that will offer hope to the people out there who might suffer from depression and anxiety but what to try to avoid the typical kinds of medications. Thanks so much for sharing!
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Last reviewed: By John M. Grohol, Psy.D. on 15 Oct 2009
