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B vitamins to enhance treatment response to antidepressants in middle-aged and older adults: Results from the B-VITAGE randomised, double-blind, placebo-controlled trial
The British Journal of Psychiatry, 12/10/14
Almeida OP, et al. – The study aimed to determine whether vitamins B6, B12 and folic acid enhance response to antidepressant treatment over 52 weeks. Findings revealed that B vitamins did not increase the 12–week efficacy of antidepressant treatment, but enhanced and sustained antidepressant response over 1 year. Replication of these findings would mandate that treatment guidelines adopt the adjunctive use of B vitamins as a safe and inexpensive strategy to manage major depression in middle–aged and older adults.
  • Randomised, double-blind, placebo-controlled trial of citalopram (20-40 g) together with 0.5 mg of vitamin B12, 2 mg of folic acid and 25 mg of vitamin B6 for 52 weeks (Australian and New Zealand Clinical Trials Registry: 12609000256279).
  • Participants were community-dwelling adults aged 50 years or over with DSM-IV-TR major depression.
  • The authors measured severity of symptoms with the Montgomery-Åsberg Depression Rating Scale (MADRS).
  • The primary outcome was remission of the depressive episode after 12, 26 and 52 weeks.
  • Secondary outcomes included reduction of MADRS scores over time and relapse of major depression after recovery by week 12.

  • In total, 153 people were randomised (76 placebo, 77 vitamins).
  • Remission of symptoms was achieved by 78.1 and 79.4% of participants treated with placebo and vitamins by week 12 (P = 0.840), by 76.5 and 85.3% at week 26 and 75.8 and 85.5% at week 52 (effect of intervention over 52 weeks: odds ratio (OR) = 2.49, 95% CI 1.12-5.51).
  • Group differences in MADRS scores over time were not significant (P = 0.739).
  • The risk of subsequent relapse among those who had achieved remission of symptoms at week 12 was lower in the vitamins than placebo group (OR = 0.33, 95% CI 0.12-0.94).

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