Folate as Adjunct Therapy to SSRI/SNRI for Major Depressive Disorder: Systematic Review & Meta-Analysis
Introduction
This systematic review and meta-analysis evaluated the efficacy of folate supplementation (l-methylfolate or folic acid) as adjunct therapy to selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) for major depressive disorder treatment. The study aimed to determine whether folate augmentation improves depression scores, response rates, and remission rates compared to SSRI/SNRI monotherapy.
Background and Rationale
The Challenge of Depression Treatment
Major Depressive Disorder (MDD) affects an estimated 11 million individuals over age 18 annually in the United States and is predicted to become the leading cause of disability within the next 13 years. Current first-line treatments with SSRI/SNRI monotherapy achieve only modest efficacy, with studies like STAR*D showing: