Anemia and macrocytosis in the prediction of serum folate and vitamin B12 status, and treatment outcome in major depression.

Abstract

BACKGROUND:

Folate and B12 deficiencies may result in macrocytic anemia, and are common in major depression; hypofolatemia may result in poorer antidepressant response. We wished to determine whether anemia or macrocytosis predict hypofolatemia, low B12, or refractoriness to antidepressants.

METHODS:

After obtaining serum folate, B12, and hematological indices, 213 depressed adults were treated with fluoxetine 20 mg/day. Amelioration of depressive symptoms was measured.

RESULTS:

Neither macrocytosis nor anemia predicted low serum folate/B12, or antidepressant refractoriness. Among 39 patients with hypofolatemia, none had macrocytosis; 28% had low HCT; 41% had low RBC. Among 25 patients with low B12, none had macrocytosis; 24% had low HCT; 28% had low RBC. Among non-responders, 3% had macrocytosis; 24% had low HCT; 25% had low RBC.

CONCLUSION:

Anemia and macrocytosis should not be used to predict folate or B12 deficiencies, or refractoriness to antidepressants. Measurement of folate and B12 should be considered when evaluating treatment refractoriness.

• Authors: D Mischoulon, J K Burger, M K Spillmann, J J Worthington, M Fava, J E Alpert
• Journal: Journal of psychosomatic research (J Psychosom Res) Vol. 49 Issue 3 Pg. 183-7 (Sep 2000) ISSN: 0022-3999 [Print] England
• PMID: 11110989 (Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antidepressive Agents, Second-Generation
• Fluoxetine

Topics

• Adult
• Anemia, Macrocytic (blood, psychology)
• Antidepressive Agents, Second-Generation (therapeutic use)
• Depressive Disorder, Major (blood, drug therapy)
• Drug Tolerance
• Erythrocyte Count
• Female
• Fluoxetine (therapeutic use)
• Folic Acid Deficiency (blood, psychology)
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Psychiatric Status Rating Scales
• Regression Analysis
• Treatment Outcome
• Vitamin B 12 Deficiency (blood, psychology)