Schizophrenia: folic acid supplementation may improve negative symptoms

  • Sakuma K & al.
  • Psychopharmacology (Berl)
  • 22 May 2018

  • curated by Jim Kling
  • Clinical Essentials
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Takeaway

  • A meta-analysis shows that folic acid combined with antipsychotics has a small effect on improving negative symptoms and is well-tolerated.
  • Folic acid is not associated with improvement in positive, general, or depressive symptoms.

Why this matters

  • Epidemiological, biochemical, and genetic studies have suggested that folic acid deficiency may play a role in schizophrenia, but evidence for efficacy has remained inconclusive, possibly because of low statistical power in clinical trials.

Study design

  • Systematic review and meta-analysis of 7 double-blind, placebo-controlled, randomized clinical trials analyzing folic acid + antipsychotic treatment for schizophrenia (n=789).
  • Funding: None disclosed.

Key results

  • Folic acid combined with antipsychotics was more effective than placebo for negative symptoms (5 studies; n=281; P=.04).
  • Improvement in total symptoms was not significantly different between the groups (7 studies; n=340; P=.08).
  • Folic acid treatment was associated with lower incidences of serious adverse events than placebo (P=.02; number needed to harm, not significant).
  • No significant differences in other safety outcomes between the 2 groups.

Limitations

  • Small sample size.

Coauthored with Chitra Ravi, MPharm

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