PMID- 20976769
OWN - NLM
STAT- MEDLINE
DCOM- 20101112
LR  - 20101026
IS  - 1531-8249 (Electronic)
IS  - 0364-5134 (Linking)
VI  - 68
IP  - 4
DP  - 2010 Oct
TI  - B-vitamins reduce the long-term risk of depression after stroke: The VITATOPS-DEP 
      trial.
PG  - 503-10
LID - 10.1002/ana.22189 [doi]
AB  - OBJECTIVE: The consumption of certain B-vitamins through diet or supplementation 
      decreases the total plasma concentration of homocysteine (tHcy) and may enhance 
      response to standard antidepressant treatment. It is unclear if treatment with 
      B-vitamins can reduce the long-term prevalence of depression in people at risk, 
      such as stroke survivors. The purpose of this research was to determine if 
      treatment with B-vitamins reduces the hazard of poststroke depression compared 
      with placebo. METHODS: Randomized, double-blind, placebo-controlled trial of 
      tHcy-lowering treatment with daily folic acid (2 mg), vitamin B6 (25 mg), and 
      vitamin B12 (0.5 mg) for 1 to 10.5 years in survivors of stroke. The primary 
      endpoint was the onset of Diagnostic and Statistical Manual of Mental Disorders, 
      4th edition (DSM-IV) major depression after randomization. Secondary outcomes 
      were the prevalence of DSM-IV major or minor depression at the end of treatment. 
      Other measured factors included age, gender, poststroke handicap associated with 
      stroke, recurrence of strokes, cognitive impairment, and use of antidepressants. 
      RESULTS: Among 273 people who completed the final assessment after 7.1 +/- 2.1 
      years (mean +/- standard deviation) of follow up, random assignment to B-vitamins 
      was associated with a lower hazard of major depression compared with placebo 
      (18.4% vs 23.3%, adjusted hazard ratio [HR] = 0.48; 95% confidence interval [CI] 
      = 0.31-0.76) and a trend toward a lower odds of major or minor depression at the 
      end of the trial compared with placebo (19.1% vs 27.7%; adjusted odds ratio [OR] 
      = 0.58; 95%CI = 0.31-1.09). INTERPRETATION: Long-term treatment of poststroke 
      survivors with folic acid, B6, and B12 was associated with a reduction in the 
      hazard of major depression in our patient population. If these findings can be 
      validated externally, B-vitamin supplementation offers hope as an effective, 
      safe, and affordable intervention to reduce the burden of poststroke depression.
FAU - Almeida, Osvaldo P
AU  - Almeida OP
AD  - School of Psychiatry and Clinical Neurosciences, University of Western Australia, 
      Crawley, Perth, WA, Australia. osvaldo.almeida@uwa.edu.au
FAU - Marsh, Kylie
AU  - Marsh K
FAU - Alfonso, Helman
AU  - Alfonso H
FAU - Flicker, Leon
AU  - Flicker L
FAU - Davis, Timothy M E
AU  - Davis TM
FAU - Hankey, Graeme J
AU  - Hankey GJ
LA  - eng
SI  - ClinicalTrials.gov/NCT00097669
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ann Neurol
JT  - Annals of neurology
JID - 7707449
RN  - 12001-76-2 (Vitamin B Complex)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Confidence Intervals
MH  - Depression/blood/*diet therapy/*etiology
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Double-Blind Method
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Stroke/*complications/diet therapy
MH  - Treatment Outcome
MH  - Vitamin B Complex/blood/*therapeutic use
EDAT- 2010/10/27 06:00
MHDA- 2010/11/13 06:00
CRDT- 2010/10/27 06:00
PHST- 2010/10/27 06:00 [entrez]
PHST- 2010/10/27 06:00 [pubmed]
PHST- 2010/11/13 06:00 [medline]
AID - 10.1002/ana.22189 [doi]
PST - ppublish
SO  - Ann Neurol. 2010 Oct;68(4):503-10. doi: 10.1002/ana.22189.