If you are one of the many people who suffer from depression or are a clinician that treats depression, you know how hard this can be to treat effectively. More than 70% of those treated for depression do not feel they are getting significant symptom relief. There are many things that contribute to depression. Stressful and traumatic life events, poor diet, lack of sleep, and genetics are all known risks factors for depression. If you seek help from your health care provider, you will often be offered an antidepressant medication and if that does not work another one will be tried or a combination of antidepressants. Yet still you do not get relief.
The ideal approach to treating depression would be to identify the root cause and address it at its source. Depression can result from neurotransmitter dysfunction or imbalance. Measuring neurotransmitter function and treating neurotransmitter imbalances with their precursors in the form of B vitamins and amino acids would be ideal. However, this option is not available to most people, nor is there an awareness that this option exists. Another root cause of depression most certainly is hidden in the digestive tract and is often referred to as the second brain. I think in many ways it is our brain’s brain. It is reported that anywhere from 70-95% of our serotonin is produced within the gut. If you are eating a poor diet devoid of vital amino acids, vitamins, and minerals, there is a greater probability you will suffer from some degree of depression. Throw in genetics and situational stressors and your odds of suffering from depression are even higher.
What if there was a simple missing link that could help turn on the switch to alleviating symptoms in those individuals who have a genetic glitch? Recently there was a very promising study done that showed that treatment resistant depression may improve significantly with the addition of Vitamin B9 in the form of L-methylfolate. L-methyfolate is important to the synthesis of cofactor tetrahydrobiopterin or BH4 activating amino acids involved in the synthesis and production of the neurotransmitters serotonin, norepinephrine, and dopamine. However if a key and critical enzyme, known as methylene tetrahydrofolate reductase (MTHFR) that activatesBH4 is lacking, this conversion does not happen thereby blocking the production of these key neurotransmitters passage across the blood-brain-barrier to the brain. So if you are taking an antidepressant to slow the uptake of any one of these key neurotransmitters and you lack MTHFR, you may well have little or no effect from your antidepressant.
Research presented at the European Congress of Psychiatry in 2011 (Papakostas GI et al, EPA 2011, Vienna, Austria; 13 March 2011) showed that when L-methylfolate (Deplin) was given to patients with hard to treat depression, there was a 50% reduction in depressive symptoms based on HAM-D score. Deplin 15mg per day was given to patients in conjunction with their Selective Serotonin Reuptake Inhibitor (SSRI). This was a small study and certainly raises the question, if more patients are offered this treatment with a safe medical food such as L-methylfolate (Deplin), would they benefit? Antidotally, I have had experience with only one patient that I know of who has tried Deplin. This individual felt their life change literally overnight expressing that a fog had been lifted and they felt normal again. It leaves me wondering if this is something that needs to be added to the arsenal to in the treatment of depression.