People taking prescription folate may be at a lower risk of suicidal event, suggests a study published in JAMA Psychiatry. Specifically, the researchers found that each month of being prescribed folic acid was associated with an additional 5% decrease in risk of suicide attempt during the 24-month follow-up period.
“The role of folate in depression and cognition has been recognized for more than a decade, leading to recommendations for folate augmentation in patients with low or normal levels at the start of any depression treatment,” wrote Robert Gibbons, Ph.D., of the University of Chicago and colleagues.
Gibbons and colleagues used data from the MarketScan Commercial Claims and Encounters databases, which include inpatient, outpatient, and prescription claims from more than 100 insurers. The authors identified participants aged 18 and older who filled a folic acid prescription from 2012 to 2017. (Forty-eight percent of folic acid prescriptions were for 1 mg/d). They then used the database to identify if participants attempted suicide or intentionally harmed themselves or had any diagnoses relevant to suicide risk or folate deficiency between 2010 and 2018. They repeated a similar analysis of participants who had filled prescriptions of cyanocabalamin, or vitamin B12. (Folic acid is vitamin B9.)
The authors collected data on 866,586 participants, 81.3% of whom were female. During the period when participants were taking folic acid, there were 261 suicidal events, for a rate of 4.73 per 100,000 person-months, and 895 suicidal events during the months when participants were not taking folic acid, for a rate of 10.61 per 100,000 person-months. In the adjusted analysis, there was a 44% reduction in suicidal events among participants taking folic acid.
The authors noted a similar association in women of childbearing age, and age and sex did not moderate the association. They found no association between vitamin B12 and suicidal events.
“The results warrant the conduct of a randomized clinical trial with suicidal ideation and behavior as outcomes of interest,” the authors concluded. “If confirmed, folic acid may be a safe, inexpensive, and widely available treatment for suicidal ideation and behavior.”
For related information, see the Psychiatric News article “Prenatal Folic Acid Associated With Lower Psychosis Risk.”
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