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The effects of folic acid supplementation on depression in adults: a systematic review and meta-analysis of randomized controlled trials

Parniyan Khalili (Clinical Psychology Department, Semnan University, Semnan, Iran)

Omid Asbaghi (Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran)

Ladan Aghakhani (Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran)

Cain C.T. Clark (Centre for Intelligent Healthcare, Coventry University, Coventry, UK)

Neda Haghighat (Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran)

Nutrition & Food Science

ISSN: 0034-6659

Article publication date: 29 July 2022

Issue publication date: 28 February 2023

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Abstract

Purpose

This study aims, a systematic review and meta-analysis, to evaluate the effects of folic acid (folate) on patients with depression.

Design/methodology/approach

Related articles were found by searching PubMed, SCOPUS, Web of science and Cochrane’s Library, from inception to January 2022. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.

Findings

Pooled analysis of six randomized controlled trials revealed that folic acid supplementation decreased the depression score in the Beck Depression Inventory (WMD: −3.9; 95% CI: −5.3 to −2.4, p < 0.001) compared with control group, without heterogeneity (I2 = 0.0%, p = 1.000). It also lowered the depression score in the Hamilton (HAM) Depression Inventory (WMD: −3.5 mg/dL; 95% CI: −4.6 to −2.4, p < 0.001) compared with control group, with moderate heterogeneity (I2 = 71.8%, p = 0.007). Moreover, subgroup analysis showed that the folic acid supplementation reduced HAM in all subgroups. Meta-regression analysis demonstrated that there is no evidence of a significant linear relationship between dose and duration of folic acid supplementation and changes in HAM. Also, based on the non-linear dose response, no evidence of a relationship between dose and duration of folic acid supplementation and changes in HAM was found.

Originality/value

Folic acid supplementation could possibly have an effect on lowering depression in patients. However, the clinical trials thus far are insufficient for clinical guidelines and practice.

Keywords

Acknowledgements

The authors thank the Laparoscopy research center of Shiraz University of Medical Sciences.

Citation

Khalili, P., Asbaghi, O., Aghakhani, L., Clark, C.C.T. and Haghighat, N. (2023), "The effects of folic acid supplementation on depression in adults: a systematic review and meta-analysis of randomized controlled trials", Nutrition & Food Science, Vol. 53 No. 3, pp. 521-534. https://doi.org/10.1108/NFS-02-2022-0043

Publisher

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Emerald Publishing Limited