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.

20 Comments to
Treating Depression and Folate Deficiency With Medical Foods

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  1. 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

  2. This is the first I’ve heard of “medical food.” Why is L-methylfolate classified as a pharmaceutical Rx and not a nutritional supplement?

  3. 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

  4. @ 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.

  5. 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.

  6. 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.

  7. @ 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).

  8. 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.

  9. @ 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)?

  10. 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.

  11. @ 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!

  12. I know this is an old post, but I enjoyed reading it!
    I just wanted to chime in that I’m homozygous for a MTHFR mutation that makes it more difficult for me to convert folate into the brain’s usable form. I’ve had chronic anxiety and mild depression for quite some time, but I don’t respond well to anyi-depressants. A while ago, my doctor gave me a prescription for Deplin and I took it thinking, great. A vitamin.
    Well, hours after taking it…BAM. I was almost euphoric and had tons of energy, and it completely took me by surprise! The high isn’t so extreme now (I was borderline manic that first day), but Deplin really has changed my life. I’m happy. I’m energetic. I’m just…great. :)

    • The MTHFR mutation is super important! I have the 2 types of mutations. Same as Stephanie, have suffered from anxiety and depression for decades. The mutations mean that. I can have Aton of folate in my bloodstream but it cannot cross the blood brain barrier. My experience with Deplin was similar to Stephanie’s – it has been truly transformational for my mental health.

  13. @ Stephanie – Thanks so much for sharing that! No matter when a post was written, it’s always great to hear about someone’s experiences and gain some new insight. I’m glad it works so well for you! :)

  14. I started Deplin as an augmentation to my Effexor XR. It was sort of a last ditch effort to keep from having to cease Effexor and start a different AD. It sounded “easier” than the alternative, so I decided to try it. That was two years ago and I’m glad I did. It made a noticible difference in a short period. With finances getting tight, I stopped it for 2-3 weeks and decided ultimately it is worth every penny & I am back on it regularly now. Regular Folate/Folic acid just isn’t the same. It may not work for you, but for $50 its worth a try, because if folate deficiency is your problem, other ADs won’t be as effective for you either. Don’t give up… Good luck.

  15. I’m just a regular girl. Been on meds for over 20 years. This stuff works. you can email me if you want but I am telling you it works.

    I have tried many things and this is one supplement I am happy to say really is almost a miracle.

  16. I have recently been diagnosed with 2 mutations of the MTHFR gene. I am curious as to trying Deplin. I have always had what I consider to be GAD- anxiety. Now in my 40s it has worsened considerably and developed into a full blown noise phobia.
    Anybody who has tested for mutations of MTHFR and would like to email me, I would greatly appreciate it.

    • Anita, it is worth a try. As a woman who’s had panic/phobias/anxiety, my experience has been positive. I am taking less medication after 6 months and feeling significantly better. I feel like I’m more grounded , rational, not ruminating, not overwhelmed by the thought of an anxious situation. It’s definitely making my meds work better. I don’t see a downside to giving it a try. You notice a difference right away, maybe that levels off, but at 3 months on it, I knew it was transformational for me. At 6 months, I’m convinced.

  17. “…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.”

    L-methylfolate has been around for a long, long time. There are sources for it that are a heck of a lot less expensive than Deplin. Psychiatry again falls for a sales pitch from pharma.

    It makes sense that someone with a folate deficiency, which affects B12 as well, would feel a lot better mentally and physically with proper folate supplementation. These people may have been misdiagnosed with a mental disorder from the very first, and been on psychiatric drugs for years while their vitamin deficiency was neglected.

    Speaking of pharma sales pitches, this article must be quite old, since it refers to the myth that a “chemical imbalance” involving serotonin, dopamine, and norepinephrine is responsible for depression.

    This myth was promulgated to sell antidepressants and has been thoroughly debunked. It’s too bad this misinformation will circulate forever on the Web — here undated, a serious flaw in information on this site.

  18. I have had depression since I was a teenager (I am now 57). I have vigilantly combated a lifetime of depression with exercise/vitamins/nutrition as well as antidepressants. I would get some months of relief from the dysphoria, but never any relief from the fatigue.

    Recently my MD and I decided to try deplin. I have to admit I was not very optimistic, but thought it was worth a try.

    At about the 3 week mark my mood began to lift, and by the 5th week mark I realized that I did not have any fatigue. I have now been on the deplin for 3 months, and I have been fatigue-free and have the best sense of well being. We also have been able to decrease the anti-depressant dosage.

    For me, this has been a life-changing experience.

  19. It’s great that science is now discovering this. We’ve known for a long time about the connection to nutrients and mental health but now science is pin pointing which nutrients play a key role.

  20. I am successfully managing my MTHFR symptoms without medications. I highly recommend Neurofeedback for brain fog, depression, anxiety and chronic pain.

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