- 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.
- 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.
- 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.
- Small sample size.
Coauthored with Chitra Ravi, MPharm