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Folic Acid Associated With Fewer Suicide Attempts, Preliminary Study Finds
Folic acid (vitamin B9) treatment was associated with a lower suicide attempt rate in patients, according to study results published in JAMA Psychiatry.
“These results warrant the conduct of a [randomized clinical trial] with suicidal ideation and behavior as outcomes of interest,” authors noted. “If confirmed, folic acid may be a safe, inexpensive, and widely available treatment for suicidal ideation and behavior.”
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Researchers utilized a within-person exposure-only cohort design to study the connection between folic acid prescription refills and suicide attempts and self-harm over 2 years. Data from 2010 to 2018 was used, collected from MarketScan. Most patients analyzed had a pain disorder. An analysis was also performed on cyanocobalamin (vitamin B12) as a control. Data analysis took place from August 2021 to June 2022.
In total, 866,586 patients were analyzed, 81.3% of whom were female and 10.4% of whom were over the age of 60. In the months with a folic acid prescription, there were 261 suicidal events—a rate of 4.73 per 100,000 person-months. In the months without folic acid, there were 895 suicidal events, or a rate of 10.61 per 100,000 person-months. A duration-response analysis found a 5% decrease in suicidal events with each month of continuing treatment. No association with suicide was found with the control substance cyanocobalamin.
“We believe that these results justify advocating for an RCT to study the effect of folic acid on suicidality,” authors concluded. “That study could be conducted in a high-risk population, which would maximize the number of suicidal events, and could also use longitudinal assessments of suicidal events using previously validated adaptive tests for suicidality.”
