Evidence map›Paper›PMID 40200764›Full record

Trial reportBrain and behavior2025

Short-Term Effects of Folate Supplementation in Combination With Vitamin B6 for Treating Acute Manic Episodes in Bipolar I Disorder: A Randomized Controlled Trial.

Farzad Akbarzadeh, Andisheh Talaei, Mohsen Nematy, Dina Ganji, Alireza Ebrahimi, Ali Talaei

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Brain and behavior, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Farzad AkbarzadehPsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Andisheh TalaeiFaculty of Biotechnology, Tehran University, Tehran, Iran.
Mohsen NematyDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Dina GanjiPsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Alireza EbrahimiPsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.ORCID https://orcid.org/0000-0002-5904-5743
Ali TalaeiPsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Funding

Mashhad University of Medical Sciences 89827
6 · The paper itself

Abstract

backgroundDrug resistance poses a formidable challenge in managing acute manic episodes in bipolar I disorder, leading to suboptimal treatment outcomes. This study investigates the efficacy of folate and vitamin B6 supplementation as an adjunct to sodium valproate in improving treatment responses for patients experiencing acute mania.

methodsIn a randomized, double-blind, placebo-controlled trial, 43 patients diagnosed with bipolar I disorder presenting with acute manic episodes were enrolled. Participants were randomly assigned to three groups: one receiving folate (5 mg/day) plus vitamin B6 (80 mg/day), a second group receiving folate alone (5 mg/day), and a third group receiving placebo. Evaluations were conducted at baseline and after 3 and 6 weeks using the Mini-Mental State Examination (MMSE) and the Young Mania Rating Scale (YMRS).

resultsAll groups demonstrated significant clinical improvements after the treatment period; however, the trends in MMSE scores showed no significant differences (p = 0.068). Notably, the reduction in YMRS scores significantly varied across groups (p < 0.001, effect size = 0.342), with the folate group demonstrating a significantly greater decrease compared to both the folate/B6 (p = 0.003) and placebo groups (p < 0.001). Recovery rates revealed that 80% of patients receiving folate showed over a 50% decrease in YMRS scores after 3 weeks, markedly higher than the other groups (p = 0.001).

conclusionsOur findings support the short-term use of folate as a beneficial adjunct in treating acute manic episodes in bipolar I disorder. However, the addition of vitamin B6 did not yield additional advantages. These results may inform future treatment guidelines targeting acute mania in bipolar disorder, advocating for folate supplementation as a potential strategy to enhance therapeutic outcomes.

Indexed as

Bipolar DisorderFolic AcidManiaValproic AcidVitamin B 6AdultAntimanic AgentsDietary SupplementsDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMaleTreatment OutcomeYoung AdultAntimanic AgentsFolic AcidValproic AcidVitamin B 6bipolar I disorderfolatemaniasodium valproatevitamin B6

Identifiers

PMID40200764
PMCPMC11979356

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.