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Prediction of Treatment Response in Geriatric Depression From Baseline Folate Level: Interaction With an SSRI or a Tricyclic Antidepressant

Alpert, Murray PhD; Silva, Raul R. MD; Pouget, Enrique R. BA

Journal of Clinical Psychopharmacology: June 2003 - Volume 23 - Issue 3 - p 309-313
doi: 10.1097/
Brief Report

Depressed geriatric patients have lower levels of folate (FOL) than controls. Also, FOL supplement can reduce depressive morbidity. One hypothesis consistent with this is that FOL deficiency causes a lowering of CNS serotonin that contributes to depression. The present report is from one site of a multicenter study that compared an SSRI (sertraline) with a nonspecific tricyclic antidepressant (nortriptyline) in geriatric depressed patients. We added measures of FOL at baseline and outcome for 22 depressed patients older than 60 years. Both treatments were effective. At baseline, FOL levels were within the normal range. Higher FOL levels at baseline predicted greater improvement. Further study of FOL interaction with SSRI is warranted. For the group treated with the SSRI, baseline FOL level was a more efficient predictor of improvement, especially for results on a self-rating depression scale (POMS).

Department of Psychiatry, New York University Medical Center, New York, New York

Received March 22, 2002; accepted September 24, 2002.

This work was supported by a grant from the U.S. Pharmaceuticals Group of Pfizer, Inc.

Address requests for reprints to: Raul R. Silva, MD, Department of Psychiatry, NYU Medical Center, NB21S6, 550 First Avenue, New York, NY 10016. Address e-mail to:

© 2003 Lippincott Williams & Wilkins, Inc.