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Abstract Details

L-Methylfolate Calcium Supplementation in Adolescents and Children: A Retrospective Analysis
General Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)

Folate (vitamin B9) is an essential nutrient required for normal functioning of various biochemical pathways, including neurotransmitter synthesis. Folate deficiency has been linked to neuropsychiatric disorders in adolescents and adults. The 677T and A1298C polymorphisms in this gene lead to a reduced ability to convert dietary folate and folic acid from nutritional supplements into l-methylfolate.  In patients with MTHFR polymorphisms, l-methylfolate calcium may provide more benefit than folic acid supplementation

This study aims to determine the efficacy of l-methylfolate for treatment of depressive symptoms and the roles of methylenetetrahydrofolate reductase (MTHFR) mutations in adolescents.

This retrospective chart review analyzed 146 juvenile patients (ages 7-20) prescribed l-methylfolate calcium at a psychiatry clinic in Amherst, NY, between January 1, 2010 and November 10, 2015. Patients treated with l-methylfolate calcium (Deplin®, USA) 15mg (N=139) or 7.5 mg (N=7) daily were identified, and 44 patients prescribed but not administered l-methylfolate calcium were included as a comparator population.

L-methylfolate calcium was well-tolerated within this pediatric and adolescent population (mean ages =16, 17 for treatment and comparator groups, respectively). With the exception of 5 patients for whom genetic testing results could not be retrieved, all participants had at least one copy of either the A1298C or 677T polymorphisms. The proportion of patients experiencing AEs was significantly higher in the comparator population than the treated population (25.0% vs. 10.3% respectively, p=0.020) as was the overall frequency of AEs (.32 vs. .15 per patient respectively, p=0.015). The most common AEs seen in the treated population were impaired sleep (N=5) and increased anxiety (N=3). There was not a statistically significant difference between patients with 677T and other polymorphisms in terms of adverse event frequency (p>1.00 for treatment group, p=0.30 for control group).

This study reflects a potential place in therapy for l-methylfolate calcium in juvenile patients with MTHFR polymorphisms.

Michelle Rainka, PharmD (Dent Neurologic Institute)
Dr. Rainka has stock in Abbvie. Dr. Rainka has stock in acadia. Dr. Rainka has stock in alon. Dr. Rainka has stock in biogen. Dr. Rainka has stock in bristol myers squib. Dr. Rainka has stock in eisai. Dr. Rainka has stock in Lilly. Dr. Rainka has stock in novartis. Dr. Rainka has stock in pfizer. Dr. Rainka has stock in roche. Dr. Rainka has stock in Sage. Dr. Rainka has stock in alkermes.
Traci Aladeen, PharmD (Dent Neurologic Institute) Dr. Aladeen has nothing to disclose.
Erica S. Westphal (Dent Neurologic Institute) The institution of Ms. Westphal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for McKesson Coorporation. The institution of Ms. Westphal has received research support from Dent Neurologic Institute.
Jessica Greger, PharmD No disclosure on file
No disclosure on file
No disclosure on file
Francis M. Gengo, PharmD (Dent Neurologic Institute) No disclosure on file
Horacio Capote, MD (Dent Neurologic Group, LLP) No disclosure on file