Folic acid treatment reduced rates of suicide attempts

Treatment with folic acid was linked to reduced rates of suicide attempts, researchers reported in JAMA Psychiatry.

“There are no real side effects [with folic acid], it doesn’t cost a lot of money, you can get it without a prescription. This could potentially save tens of thousands of lives,” Robert D. Gibbons, PhD, a professor of public health sciences at the University of Chicago and lead author of the study, said in an article on the university’s website.

Gibbons and colleagues sought to study the association between folic acid prescription fills over a 24-month period and suicide attempts and intentional self-harm. Suicide attempts and incidence of self-harm were defined as a suicidal event.

The researchers collected data from a pharmacoepidemiologic database of United States medical claims for patients with private health insurance who filled a prescription for folic acid from 2012 to 2017. The same process was repeated with a control supplement.

A total of 866,586 patients were included in the analysis, with a majority being female (81.3%), and 10.4% were aged 60 years and older. Overall, there were 261 suicidal events during months covered by a folic acid prescription (5,521,597 person-months) for a rate of 4.73 suicidal events per 100,000 person-months, compared with 895 suicidal events during months without folic acid (8,432,340) for a rate of 10.61 per 100,000.

When adjusted for age and sex, diagnoses related to suicidal behavior, diagnoses related to folic acid deficiency, folate-reducing medications, history of folate-reducing medications and history of suicidal events, the HR for folic acid for suicidal events was 0.56 (95% CI, 0.48-0.65), with similar results for modal dosage of 1 mg of folic acid per day (HR, 0.57; 95% CI, 0.48-0.69).

Additionally, Gibbons and colleagues reported that a duration-response analysis revealed a 5% decrease in suicidal events per month of additional treatment (HR, 0.95; 95% CI, 0.93-0.97).

“The results warrant the conduct of a randomized clinical trial with suicidal ideation and behavior as outcomes of interest,” they wrote. “If confirmed, folic acid may be a safe, inexpensive and widely available treatment for suicidal ideation and behavior.”

Reference:

Study finds folic acid treatment is associated with decreased risk of suicide attempts. https://biologicalsciences.uchicago.edu/news/features/folic-acid-reduces-suicide-attempts. Published Sept. 28, 2022. Accessed Sept. 28, 2022.