The VITATOPS-DEP study was a randomized, double-blind, placebo-controlled trial of daily folic acid (2 mg), vitamin B6 (25 mg), and vitamin B12 (0.5 mg) for 1 to 10.5 years in stroke survivors. The primary endpoint was the onset of major depression, as defined by the DSM-IV, after randomization. Secondary outcomes were the prevalence of DSM-IV major or minor depression at the end of treatment. Among 273 people who completed the final assessment after 7.1 ± 2.1 years (mean ± standard deviation) of follow up, B-vitamins were associated with a significantly lower risk of major depression compared with placebo (18.4% vs 23.3%, adjusted hazard ratio 0.48, 95% CI 0.31-0.76). There was also a trend toward a lower risk of major or minor depression at the end of the trial compared with placebo (19.1% vs 27.7%; adjusted odds ratio 0.58; 95%CI 0.31-1.09). Long-term treatment of poststroke survivors with B-vitamin supplementation may be an effective, safe, and affordable intervention to reduce the burden of poststroke depression. (Ann Neurol. 2010 Oct;68(4):503-10.) PMID: 20976769.
