Supplementation with B vitamins may help as an adjunctive treatment for schizophrenia, new meta-analysis indicates

Rob Winwood

A new systematic review and meta-analysis (1) reports adjunctive treatment with B vitamins resulted in shorter duration of schizophrenic episodes.  The study covered 18 randomized controlled trials (RCTs) with 832 schizophrenic patients. Vitamins B6 (pyrodoxine), B9 (folic acid) and B12 (cobalamin) supplementation were used in the studies. 

Schizophrenia is a common, costly, long-term illness effecting around 1 percent of the population. Schizophrenia is a type of psychosis. Sufferers have difficulty in distinguishing their own thoughts and ideas from reality. They can suffer from hallucinations, delusions, muddled thoughts and dramatic behavioural changes. Sadly, the symptoms are largely unresponsive to antipsychotic treatments (1). 

A systematic review carried out in 2013 indicated that adjunctive treatment with micronutrients, including minerals and vitamins can be beneficial to people with psychiatric disorders (2). In the case of B vitamins, it is thought their role in the biosynthesis of proteins involved with neuronal growth in repair could be helpful (3). A specific, very recent meta-analysis in patients with depression (4) supported the adjunctive use of methyl folate, EPA/DHA and vitamin D to help reduce depressive symptoms. It has also been suggested that the beneficial effect of certain vitamin and minerals, in terms of reducing neuroinflammation and oxidative stress, may be helpful in delaying the onset and relapse of schizophrenia (5). 

In the new study (1), the combined B vitamins 6, 9 and 12 had a beneficial effect on total schizophrenia symptom scores with the best results obtained in patients who had only recently developed symptoms. Neither anti-oxidant vitamins (C and E) nor minerals showed any significant benefits in comparison with placebo. The results are tempered by the high degree of heterogeneity in the data, but provide a basis for exploring B vitamins as an adjunctive treatment for schizophrenia in future studies. 

1. Firth, J, Stubbs B, Sarris J et al.; “The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis”; Psychological Medicine 2107, 1–13. http://doi.org/10.1017/S0033291717000022
2. Rucklidge JJ & Kaplan BJ; “Broad-spectrum micronutrient formulas for the treatment of psychiatric symptoms: a systematic review”; Expert Review of Neurotherapeutics 2013; 13: 49-73.
3. Kaplan BJ, Rucklidge JJ, Romijn A et al.; “The emerging field of nutritional mental health inflammation, the microbiome, oxidative stress and mitochondrial function”; Clinical Psyschological Science 2015, 3: 964-980.
4. Sarris J, Murphy J, Mischoulen D et al.; “Adjunctive neutraceuticals for depression: a systematic review and meta-analyses”; American Journal of Psychiatry 2016; 173(6): 575-87. doi: 10.1176/appi.ajp.2016.1509122.  
5. Miller BJ, Buckley P, Seabolt W et al; “Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects”; Biological Psychiatrry 2011; 70: 663-671.