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The role of one-carbon metabolism in schizophrenia and depression.

Abstract

OBJECTIVE

Physicians often check folate and cobalamin levels in patients with schizophrenia and depression. The reasons for this practice are reviewed, as well as implications for treatment.

METHOD

The physiology of the one-carbon cycle, involving folate, cobalamin, homocysteine, S-adenosyl-methionine, and methylene tetrahydrofolate reductase (MTHFR) is first reviewed, and then the particular contributions of folate and B12 are reviewed. PubMed was searched for studies of the association between folate, cobalamin, homocysteine, and MTHFR polymorphisms and schizophrenia and depression.

RESULTS

The recent key studies from the large literature addressing these topics are summarized. Treatment implications are discussed.

CONCLUSION

It is important to check folate and B12 levels in certain situations, such as alcoholism, malnutrition, malabsorption, and the concurrent use of some medications. Checking homocysteine and methylmalonic levels might be useful. With respect to treatment, folate and cobalamin deficiencies should be corrected. Cobalamin supplementation is probably not helpful. Folate supplementation is indicated in pregnancy but may exacerbate the effects of cobalamin deficiency. SAMe may prove to be a useful antidepressant. In the future, screening for MTHFR polymorphisms might be useful.

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  • Authors+Show Affiliations

    Department of Psychiatry, Harvard Medical School, and Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730, USA. frances.frankenburg@med.va.gov

    Source

    MeSH

    Depressive Disorder
    Folic Acid
    Homocysteine
    Humans
    Methylenetetrahydrofolate Reductase (NADPH2)
    One-Carbon Group Transferases
    S-Adenosylmethionine
    Schizophrenia
    Vitamin B 12

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    17687709

    Citation

    Frankenburg, Frances Rachel. "The Role of One-carbon Metabolism in Schizophrenia and Depression." Harvard Review of Psychiatry, vol. 15, no. 4, 2007, pp. 146-60.
    Frankenburg FR. The role of one-carbon metabolism in schizophrenia and depression. Harv Rev Psychiatry. 2007;15(4):146-60.
    Frankenburg, F. R. (2007). The role of one-carbon metabolism in schizophrenia and depression. Harvard Review of Psychiatry, 15(4), pp. 146-60.
    Frankenburg FR. The Role of One-carbon Metabolism in Schizophrenia and Depression. Harv Rev Psychiatry. 2007;15(4):146-60. PubMed PMID: 17687709.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The role of one-carbon metabolism in schizophrenia and depression. A1 - Frankenburg,Frances Rachel, PY - 2007/8/10/pubmed PY - 2007/12/18/medline PY - 2007/8/10/entrez SP - 146 EP - 60 JF - Harvard review of psychiatry JO - Harv Rev Psychiatry VL - 15 IS - 4 N2 - OBJECTIVE: Physicians often check folate and cobalamin levels in patients with schizophrenia and depression. The reasons for this practice are reviewed, as well as implications for treatment. METHOD: The physiology of the one-carbon cycle, involving folate, cobalamin, homocysteine, S-adenosyl-methionine, and methylene tetrahydrofolate reductase (MTHFR) is first reviewed, and then the particular contributions of folate and B12 are reviewed. PubMed was searched for studies of the association between folate, cobalamin, homocysteine, and MTHFR polymorphisms and schizophrenia and depression. RESULTS: The recent key studies from the large literature addressing these topics are summarized. Treatment implications are discussed. CONCLUSION: It is important to check folate and B12 levels in certain situations, such as alcoholism, malnutrition, malabsorption, and the concurrent use of some medications. Checking homocysteine and methylmalonic levels might be useful. With respect to treatment, folate and cobalamin deficiencies should be corrected. Cobalamin supplementation is probably not helpful. Folate supplementation is indicated in pregnancy but may exacerbate the effects of cobalamin deficiency. SAMe may prove to be a useful antidepressant. In the future, screening for MTHFR polymorphisms might be useful. SN - 1067-3229 UR - https://www.unboundmedicine.com/medline/citation/17687709/The_role_of_one_carbon_metabolism_in_schizophrenia_and_depression_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17687709.ui DB - PRIME DP - Unbound Medicine ER -