Folic acid supplementation is linked to a lower likelihood of suicidal thoughts, according to a study.
In 2020, over 46,000 Americans will commit suicide, making it one of the top killers in the country. Supplements containing folic acid are unlikely to be on that list for many people. But a recent, startling study carried out at the University of Chicago could change that.
A recent study found that patients who filled prescriptions for folic acid, generally known as vitamin B9, saw a 44% decrease in suicide episodes. The study was published in JAMA Psychiatry. The popular, affordable vitamin was associated with a 44% decrease in self-harm and suicide attempts.
Data from 866,586 patients’ health insurance claims were used in the study. Over a two-year period, it looked into the connection between folic acid therapy and suicidal thoughts. They discovered that individuals who took folic acid, generally known as vitamin B9, as prescribed saw a 44% decrease in suicidal incidents (suicide attempts and intentional self-harm).
The study’s principal investigator, Robert Gibbons, PhD, is optimistic that these results may enhance efforts to prevent suicide, particularly given how widely available folic acid is. He is the University of Chicago’s Blum-Riese Professor of Biostatistics and Medicine.
“There are no real side effects, it doesn’t cost a lot of money, you can get it without a prescription,” Gibbons said. “This could potentially save tens of thousands of lives.”
Because of a prior study in which his team looked at connections between risk of suicide attempt and 922 different prescribed medicines, Gibbons first became interested in folic acid in the context of suicide. Each substance was simultaneously examined for relationships to both rises and falls in suicide attempts. Contrary to expectations, folic acid and medications known to increase the risk of suicide, such as antidepressants, anxiolytics, and antipsychotics, were both linked to a lower chance of suicide attempt.
This prior study faced a number of difficulties, including the challenging task of analysing the effects of numerous medicines in a sizable data set. Drugs can have distinct effects when taken combined compared to those taken alone, and many people take more than one drug. Occasionally, they are actually connected to a confounding factor that is related to both of them, such as socioeconomic level or health-conscious attitudes, or they are taken for a condition that is linked to suicide (e.g. depression). Instead of comparing patients who did and did not take the treatment to one another, Gibbons and his team were able to partially minimise these problems by comparing subjects to themselves before and after they were administered a drug.
“When we first saw this result, we thought it was pregnancy. Pregnant women take folic acid, and pregnant women tend to have a low suicide rate, so it’s just a false association. So, we just did a quick analysis to restrict it to men. But we saw exactly the same effect in men,” Gibbons said.
Gibbons and his co-authors conducted this new study with a specific focus on folic acid, accounting for many potential confounding factors, such as age, sex, mental health diagnoses, other central nervous system drugs, conditions that affect folic acid metabolism, and more, in order to investigate and further confirm the relationship between folic acid and suicide risk. Filling a prescription for folic acid was still linked to a lower risk of suicidal attempt even after correcting for all of these variables.
Researchers even discovered that folic acid use tended to reduce suicide attempt risk over time. During the 24-month follow-up of their trial, each extra 5% decrease in risk of suicide attempt was connected with being administered folic acid. The scientists also considered that perhaps those who use vitamin supplements generally aim to enhance their health and would be less likely to attempt suicide as a result. They conducted a similar investigation using vitamin B12 as a negative control to address this potential issue. However, there didn’t appear to be any connection between vitamin B12 and suicide risk, unlike folic acid.
Even though Gibbons and his co-authors took care to account for confounding variables, they are unable to determine with certainty whether the link between folic acid and suicidal events is causal. In other words, they are unsure of whether taking folic acid will actually reduce a person’s risk of suicide.
Folic acid would be a secure, affordable, and widely accessible suicide prevention method if the recent research that they conducted supports their findings. The best part is that it might potentially save thousands of lives.
Parvathy Sukumaran 
