Background: The aim of the study was to measure the level of HCY, vitamin B12 and folic acid, in depression in the course of affective disorders as well as HCY level during remission after pharmacological treatment.
Methods: One-hundred and thirty-three patients (29 male, 106 female), mean age 51±14 years, with depression in the course of bipolar I (37 patients), bipolar II (79 patients) and unipolar (17 patients) mood disorder were studied. The duration of illness was 8.2± years, and duration of a depressive episode was 4.6±1.8 months. The intensity of depression, as measured by the 17-item Hamilton Depression Rating Scale (HDRS), was 19.6±9.5 points. The second measurement of HCY was carried out after the treatment with an antidepressant or/and mood-stabilizing drugs, with depression intensity of ≤7 points. Hyperhomocysteinemia (HHCY) was defined as HCY level >15 μM/l.
Results: During a depressive episode, the mean HCY concentration was 14.0±8.2 mM/l, of vitamin B12 342±145 pg/ml, and folic acid 5.79±2.96 ng/ml. Significant negative correlation was found between the levels of HCY and of both vitamins. HHCY before treatment was observed in 38% of patients, significantly more often in men (62%) than in women (32%). During remission, the mean HCY concentration was 13.0±7.5 mM/l, (significant difference in bipolar II) and the percentage of patients with HHCY significantly decreased (23% of patients 38% male, 19% female).
Conclusions: These results point to a significant frequency of HHCY, especially in men, during depression in the course of affective disorders as well as its marked decrease after the treatment. They also confirm a correlation between an increased concentration of HCY and lower level of vitamin B12 and folic acid during a depressive episode. However, further studies are needed to better define a pathogenic role of HCY in affective disorders.