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Research suggests that levomefolic acid (L-methylfolate) taken with a first-line antidepressant [6] provides a modest adjunctive antidepressant effect for individuals who do not respond or have only a partial therapeutic response to SSRI or SNRI medication, [7] [8] and might be a more cost-effective adjunctive agent than second-generation antipsychotics.
Cerefolin is a prescription medication made by Pamlab that contains 5.635 mg of folate as L-methylfolate, 1 mg of vitamin B 12 as methylcobalamin, 50 mg of vitamin B 2 as riboflavin, and 5 mg of vitamin B 6 as pyridoxine. It is approved by the U.S. Food and Drug Administration for the treatment or prevention of vitamin deficiencies. [1]
Metanx is a prescription medical food made by Alfasigma that contains L-methylfolate (as Metafolin, a calcium salt of vitamin B 9), methylcobalamin (vitamin B 12) and pyridoxal 5'-phosphate (vitamin B 6). It is a vitamin B supplement. Metanx is indicated for the dietary management of peripheral neuropathy (i.e. DPN). [1]
The 2013–2014 survey reported that for adults ages 20 years and older, men consumed an average of 249 μg/day folate from food plus 207 μg/day of folic acid from consumption of fortified foods, for a combined total of 601 μg/day of dietary folate equivalents (DFEs because each microgram of folic acid counts as 1.7 μg of food folate).
The antifolate action specifically targets the fast-dividing cells, and tend to have adverse effects on the bone marrow, skin, and hair. As folate is vital in the first trimester of pregnancy for healthy fetal development, the use of antifolates is strongly contraindicated in pregnancy and carries significant teratogenic risk.
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