L-methylfolate is as effective as antidepressants.

nbritton · Dec 07, 2014, 01:38 PM

So after looking at this study, I noticed this:

L-methylfolate is as effective as antidepressants.

If you read between the lines it's essentially saying that L-methylfolate (bioactive folate) is as effective as antidepressants. The results show:

Monotherapy with L-methylfolate alone had an improvement of -7.7 with a standard deviation of +/- 5.7. While augmentation (antidepressant + L-methlyfolate) had an improvement of -8.6 with a standard deviation of +/- 6.3. With a standard deviation this wide these could be the same.

Monotherapy with L-methylfolate alone had a treatment response rate of 65.4%, while augmentation (antidepressant + L-methlyfolate) had a treatment response rate of 68.1%. A mere 2.7% difference, easily within the margin of error for this study, these are effectively the same.

Monotherapy with L-methylfolate alone had a remission rate of 51.9%, while augmentation (antidepressant + L-methlyfolate) had a remission rate of 45%. Monotherapy alone has a 6.9% improvement versus augmentation in long term remission rates.

I think the take away of this is to make sure your doctor checks and addresses nutritional deficiencies before beginning treatment with psychotropic medications. Also genetic testing for MTHFR polymorphisms would appear to be worthwhile, the 23andMe SNP DNA test kit that sells for $99 will report if you have a MTHFR mutation.

geis · Dec 07, 2014, 02:11 PM

Medicare covers the test for MTHFR polymorphism, too.

Unfortunately, there are no Medicare Part D plans that cover Deplin (L-methylfolate), although I believe some private insurance plans cover it. I have the homozygous C677T mutation, and Deplin is the only medication that's ever touched my depression. It was a miracle drug for me, but I can't afford it on my extremely limited income.

ETA: If you want to be tested for MTHFR polymorphism, be sure to request that test specifically. Don't let the doc just test your folate level. Assuming you have adequate dietary intake of folate, your blood level will be normal. The problem is that people with the mutation can't process the folic acid and break it down correctly.

Also, 23andme can no longer offer health reports due to an FDA ruling last year. However, they do give you the raw genome data, and there are third-party sites that offer limited health reports. You just can't get it straight from 23andme anymore, and the third-party sites give you a TON of data to sift through, with little indication of what's significant and what's not.

nbritton · Dec 07, 2014, 02:41 PM

Quote:

Originally Posted by geis

Unfortunately, there are no Medicare Part D plans that cover Deplin (L-methylfolate), although I believe some private insurance plans cover it. I have the homozygous C677T mutation, and Deplin is the only medication that's ever touched my depression. It was a miracle drug for me, but I can't afford it on my extremely limited income.

Metafolin is chemically the same stuff as Deplin (i.e. levomefolate calcium) and it's available over the counter in 1000 mcg tablets. It has a half-life of about 3 hours, so I take one tablet twice a day. It only costs me $9.65/month. The RDA for folic acid, in pregnant women, is a mere 600 mcg. I've read that methylfolate has seven times the potency of folic acid, so 2000 mcg a day should be more than sufficient to optimize folate levels.

nbritton · 04:32 AM

Quote:

Originally Posted by geis

Deplin is the only medication that's ever touched my depression. It was a miracle drug for me, but I can't afford it on my extremely limited income.

Also, the BHMT (betaine—homocysteine S-methyltransferase) is a backup pathway to the folate-methionine-homocysteine cycle. Supplementing with trimethylglycine (a/k/a betaine) will activate this pathway, and essentially bypass the need for folate. The reason I mention this is because trimethylglycine can be purchased for as cheap as $0.07 a tablet; it's a by-product of sugar beet processing.

I would recommend tackling the problem from both sides, perhaps 1000 mcg of methylfolate combined with 1000 mg of trimethylglycine, this would get the costs down to $7 a month for you.

In the diagram below betaine is another name for trimethylglycine. DMG is dimethylglycine. BHMT takes trimethylglycine and converts homocysteine back into methionine by taking a methyl group from it. Dimethylglycine is leftover.

L-methylfolate is as effective as antidepressants.

Icare dixit · Dec 05, 2016, 09:36 AM

Quote:

Originally Posted by nbritton

Lamictal interferes significantly with my memory. This drug inhibits the dihydrofolate reductase enzyme, and this enzyme is the first step in a series of enzymes that convert biologically inactive folic acid into biologically active levomefolic acid (L-methylfolate).[1] Most fortified foods and supplements use folic acid. My working hypothesis is that the body can't produce an adequate supply of L-methylfolate, and this in turn reduces methionine production from homocysteine in the brain (methylfolate passes through the blood brain barrier). Methionine is a methyl donor, and methylation is important in the epigenetics of memory. I've also read that high levels of homocysteine can cause memory impairment. It could also be that we suffer from a defective MTHFR polymorphism and lamictal exacerbates the problem.

In theory, if you take supplemental L-methylfolate this might fix the problem. I just pieced this hypothesis together the other day and ordered some levomefolate calcium (Metafolin / Deplin) from amazon.com to test it, but I'm still waiting for it to be delivered. I should know pretty quick if it's going to work, I'll let you know how it works out in a week or so.

You've explained it very well!

fairydustgirl · Dec 05, 2016, 12:15 PM

my psychiatrist did the DNA swab in her office, my insurance paid for the test. I also have the MTHFR issue..and for whatever reason, when I see the letters I see an abbreviation for the curse word mother f...er.
I was prescribed deplin as well, it's expensive as my insurance won't pay for it.

Icare dixit · Dec 05, 2016, 12:36 PM

Quote:

Originally Posted by fairydustgirl

my psychiatrist did the DNA swab in her office, my insurance paid for the test. I also have the MTHFR issue..and for whatever reason, when I see the letters I see an abbreviation for the curse word mother f...er.
I was prescribed deplin as well, it's expensive as my insurance won't pay for it.

You might also try acetylcysteine. Cysteine lowers homocysteine levels somewhat. It's more like treating symptoms and it's not enough on its own, but it may allow you to lower your methylfolate doses.

Anything (else) neuroprotective, protecting your cells, may also help, like vitamin E.

Moose72 · Dec 05, 2016, 12:42 PM

Quote:

Originally Posted by fairydustgirl

my psychiatrist did the DNA swab in her office, my insurance paid for the test. I also have the MTHFR issue..and for whatever reason, when I see the letters I see an abbreviation for the curse word mother f...er.
I was prescribed deplin as well, it's expensive as my insurance won't pay for it.

I do too. (The curse word.)

Icare dixit · Dec 05, 2016, 02:07 PM

MeTHylenetetRahydroFOlate reduCtAse

MTHRFOCA

Unrigged64072835 · Dec 05, 2016, 07:55 PM

I used to take L-Methylfolate. For some reason it increased my anxiety. I stopped taking it. It may work better for other people, though.

Icare dixit · Dec 05, 2016, 08:03 PM

Quote:

Originally Posted by Fharraige

I used to take L-Methylfolate. For some reason it increased my anxiety. I stopped taking it. It may work better for other people, though.

Did you have any reason for taking it (other than that it might work); was there any indication you needed it?

Rudy6897 · May 25, 2017, 02:06 PM

I am on Day 7 of Deplin 15mg daily. I, too, had the testing that shows that I have the MTHFR mutation that prevents my body from producing methylfolate.
Not sure if I'm seeing anything, and hopefully there's still a chance I will see something.
I've read stories where people see almost immediate results within a few days, and I've read it sometimes takes a couple of weeks.
I'm curious to read more personal experiences.

Thanks!
Rudy

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