![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 18 to 42 of 51. Go back in thread:
Posted by Jamal Spelling on January 13, 2008, at 16:10:15
In reply to Re: Deplin is a drug, not a nutritional supplement, posted by Phillipa on January 13, 2008, at 12:29:10
> But shouldn't someone have a side effect profile available to read if it is a drug and what if the person doesn't have a computer.
I think you make a good point, Phillipa. I wonder what the reason was for making methylfolate prescription only, when it used to be an OTC supplement.
It seems like going against public interest to "prescriptionize" a substance like methylfolate, unless they found some medical issue with it that warranted making it prescription only. If there *is* some important side-effect or contra-indication or whatever, then what is it?
If, on the other hand, there are no serious side-effects or contra-indications, which I suspect is the case, then why did methylfolate suddenly become a prescription-only substance?
Who decides which substances are prescription anyway, and what are the criteria?
The only potential issue that I can think of, is that folic acid may mask the signs of vitamin B12 deficiency, so there may possibly be a similar issue with methylfolate, but I'm not sure of that.
Posted by bulldog2 on January 13, 2008, at 16:42:44
In reply to Re: Deplin is a drug, not a nutritional supplement, posted by Jamal Spelling on January 13, 2008, at 16:10:15
> > But shouldn't someone have a side effect profile available to read if it is a drug and what if the person doesn't have a computer.
>
> I think you make a good point, Phillipa. I wonder what the reason was for making methylfolate prescription only, when it used to be an OTC supplement.
>
> It seems like going against public interest to "prescriptionize" a substance like methylfolate, unless they found some medical issue with it that warranted making it prescription only. If there *is* some important side-effect or contra-indication or whatever, then what is it?
>
> If, on the other hand, there are no serious side-effects or contra-indications, which I suspect is the case, then why did methylfolate suddenly become a prescription-only substance?
>
> Who decides which substances are prescription anyway, and what are the criteria?
>
> The only potential issue that I can think of, is that folic acid may mask the signs of vitamin B12 deficiency, so there may possibly be a similar issue with methylfolate, but I'm not sure of that.I've read in the Life Extension Magazine the Pharm companies want to make all vitamins and minerals etc..prescription items..Probably ppl staying well with supps cuts into their profits. So someday we'll have to buy all our supplements from them.
Posted by linkadge on January 13, 2008, at 17:27:06
In reply to Deplin is a drug, not a nutritional supplement., posted by SLS on January 13, 2008, at 8:05:29
>To think of using folic acid as a replacement >does not normally correspond to remission. >Deplin does.
Ok? I don't even know what that means. There are studies suggesting that folic acid added to AD's can improve response rates.
While deplin may have advantages in certain cases, thats no reason to suggest that folic acid is not helpful for many patients.
Again, a "drug"... What's that supposed to mean?
Linkadge
Posted by SLS on January 13, 2008, at 17:46:46
In reply to Re: Deplin is a drug, not a nutritional supplement., posted by linkadge on January 13, 2008, at 17:27:06
> > To think of using folic acid as a replacement does not normally correspond to remission. Deplin does.
> Ok? I don't even know what that means. There are studies suggesting that folic acid added to AD's can improve response rates.
What percentage?
My recommendation is to try Deplin first if you prefer to enhance your chances of responding to it as an augmentor.
> While deplin may have advantages in certain cases,
Exactly which cases, and why?
> thats no reason to suggest that folic acid is not helpful for many patients.
I guess we'll see the clinical separation between these two substances as clinical usage increases.
> Again, a "drug"... What's that supposed to mean?
I think I've addressed this issue in a few of my posts along different threads.
How do *you* define the word "drug"?
For what it is worth, I have tried mega-doses of folic acid before. I experienced only flatulence. I have tried Deplin. I am responding much better 2 months subsequent to its introduction. That's good enough for me to indicate there is something special about taking Deplin over folic acid.
Maybe its just a placebo effect. :-)
- Scott
Posted by Phillipa on January 13, 2008, at 18:55:55
In reply to Re: Deplin is a drug, not a nutritional supplement » Phillipa, posted by SLS on January 13, 2008, at 12:41:51
Scott thanks so far no side effects. Nothing at all I can feel or experience. So we'll see. Phillipa
Posted by Phillipa on January 13, 2008, at 18:59:58
In reply to Re: Deplin is a drug, not a nutritional supplement, posted by bulldog2 on January 13, 2008, at 16:42:44
Bulldog 2 that was going on when I was involved with a vitamin or supplement company. Who knows but a lot of people sure take supplements. Cars in the parking lots and filled baskets with supplemants Phillipa
Posted by clipper40 on January 13, 2008, at 20:37:07
In reply to Re: Deplin is a drug, not a nutritional supplement » bulldog2, posted by Phillipa on January 13, 2008, at 18:59:58
I'm sure there's something very special about it because there are too many wonderful responses for it to be a placebo. Still, that in itself doesn't make it a drug.
As I said in a thread above, it used to be sold in health food stores. In my opinion, calling it a drug is arbitrary in this case.
Whatever you call it, I'm very glad it's out there and that so many people are getting such good results with it!
Posted by linkadge on January 13, 2008, at 20:43:46
In reply to Re: Deplin is a drug, not a nutritional supplement » linkadge, posted by SLS on January 13, 2008, at 17:46:46
>What percentage?
I don't know, but I don't think that data is securely established for deplin either.
>My recommendation is to try Deplin first if you >prefer to enhance your chances of responding to >it as an augmentor.
I'm not saying don't try it. I'm just saying that a number of studies have linked low serum folate to antidepressant resistance. If deplin is not an option for you, it folic acid might be worth a try.
>I guess we'll see the clinical separation >between these two substances as clinical usage >increases.
Well thats the idea. However, the issue of patentability with undoubtedly cloud matters.
>For what it is worth, I have tried mega-doses of >folic acid before. I experienced only >flatulence. I have tried Deplin. I am responding >much better 2 months subsequent to its >introduction. That's good enough for me to >indicate there is something special about taking >Deplin over folic acid.
Perhaps. Deplin also has a name and a specific indication. Folic acid is just a $2 vitamin.
Linkadge
Posted by SLS on January 13, 2008, at 21:13:24
In reply to Re: Deplin is a drug, not a nutritional supplement, posted by linkadge on January 13, 2008, at 20:43:46
> > What percentage?
> I don't know, but I don't think that data is securely established for deplin either.What would you need to see before declaring Deplin something more therapeutic than folic acid?
> >My recommendation is to try Deplin first if you >prefer to enhance your chances of responding to >it as an augmentor.
> I'm not saying don't try it.
>
> I'm just saying that a number of studies have linked low serum folate to antidepressant resistance. If deplin is not an option for you, it folic acid might be worth a try.Why would Deplin not be an option? Is it prohibitively expensive or just certified not to be effective enough as to indicate that folic acid should be the first choice?
I know what I know. Deplin works for me. Folic acid does not. I am somewhat familiar with the bioavailability of L-methylfolate and its participation in methionine metabolic cycles in the brain as well as its pharmacokinetics. If you prefer more detailed explanations as to what are the differences between Deplin and folic acid, Google makes a wonderful resource to find them. Certainly, your own research will be more convincing than my words. I would suggest using Google to learn more about folic acid and L-methylfolate dynamics.
What do you think about the "methyl trap" theory?
> > I guess we'll see the clinical separation >between these two substances as clinical usage increases.
> Well thats the idea. However, the issue of patentability with undoubtedly cloud matters.
Who cares? The stuff exists. I don't care either how or why other than to secure its continued availability.
> > For what it is worth, I have tried mega-doses of >folic acid before. I experienced only >flatulence. I have tried Deplin. I am responding >much better 2 months subsequent to its >introduction. That's good enough for me to >indicate there is something special about taking >Deplin over folic acid.
>
> Perhaps. Deplin also has a name and a specific indication. Folic acid is just a $2 vitamin.Again, I would encourage you to do your own investigation. The answers to your questions are available and quite simple - even for a layman like me.
- Scott
Posted by Phillipa on January 13, 2008, at 23:47:26
In reply to Re: Deplin is a drug, not a nutritional supplement » linkadge, posted by SLS on January 13, 2008, at 21:13:24
Scott. You may not be a scientist but could be but you have studied for so many years for your depression to me you are very knowledgeable about medications. That's how I feel about you. Love Phillipa
Posted by star008 on January 14, 2008, at 7:54:36
In reply to Deplin is a drug, not a nutritional supplement., posted by SLS on January 13, 2008, at 8:05:29
I think it is a matter of how you look at it. I don't think that Deplin is a drug.. Deplin is classifed as a medical food. I guess it depends on what you view a drug as. Folic acid converts to L-methylfolate in the body..Deplin is already converted L-methylfolate.. Matter of opinion.
Deplin doesn't work for me.. I have not noticed any improvement at all with it..It does work well for some people but not me.
Posted by star008 on January 14, 2008, at 8:01:22
In reply to Deplin is a drug, not a nutritional supplement., posted by SLS on January 13, 2008, at 8:05:29
http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1267
check out this article.. the fda classifies dephlin as neither a drug or a supplement.. so according to them we are both wrong
Posted by star008 on January 14, 2008, at 9:30:16
From The INTERNATIONAL JOURNAL OF PHYSICIATRIC MEDICINE MTHF is marketed in the United States as a medical food also called Deplin, which contains 7.5 mg L-methylfolate and is available by prescription only. According to the Food and Drug Administration, a medical food is different both from a drug and from a food, and is defined as a food that is formulated to be consumed orally
...under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.57
Medical foods are required when dietary management cannot achieve the specific nutrient requirements. Treatment with MTHF seems to be safe, apparently has few if any side effects, and is generally less expensive than augmenting with a second antidepressant. Further research is necessary to determine the exact priority this approach should be given in treatment algorithms for major depression. HERE IS THE LINK>>>>>
http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1267
There are more links but they basically say the same thing.
Posted by SLS on January 14, 2008, at 9:35:44
In reply to CNS research Deplin Link » SLS, posted by star008 on January 14, 2008, at 8:01:22
> http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1267
>
> check out this article.. the fda classifies dephlin as neither a drug or a supplement.. so according to them we are both wrong
My motivation for starting this thread was to diffuse the notion that Deplin is nothing more than an expensive folic acid. My calling it a drug would hopefully change people's perspectives regarding the physiological and clinical advantages of Deplin when compared to folic acid supplements. To the best of my knowledge, L-methylfolate is not found in human foodstuffs. I imagine there are good reasons for the FDA to establish the category of "medical food" such that a prescription is required for its dispensation. If someone takes a dozen 7.5mg pills, are there any untoward effects? One 7.5mg pill of Deplin produces many times the biological availability in the brain as folic acid such that one would need to ingest a hundreds of folic acid to equal 1 pill of Deplin. Besides being the biologically active metabolite of folic acid, it readily crosses the blood-brain barrier.Regardless of the semantics, Deplin has pharmacological actions to induce the rate of synthesis of the monoamine neurotransmitters. Folic acid does not do that.
How much different is the relationship between folic acid and Deplin versus primidone and phenobarbital? Both are metabolized by the body before becoming biologically active.
- Scott
Posted by SLS on January 14, 2008, at 9:39:56
In reply to deplin is neither a drug or a supplement, posted by star008 on January 14, 2008, at 9:30:16
Hi star008.
Thanks for this...
- Scott------------------------------------
> From The INTERNATIONAL JOURNAL OF PHYSICIATRIC MEDICINE MTHF is marketed in the United States as a medical food also called Deplin, which contains 7.5 mg L-methylfolate and is available by prescription only. According to the Food and Drug Administration, a medical food is different both from a drug and from a food, and is defined as a food that is formulated to be consumed orally
>
> ...under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.57
>
> Medical foods are required when dietary management cannot achieve the specific nutrient requirements. Treatment with MTHF seems to be safe, apparently has few if any side effects, and is generally less expensive than augmenting with a second antidepressant. Further research is necessary to determine the exact priority this approach should be given in treatment algorithms for major depression. HERE IS THE LINK>>>>>
> http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1267
>
>
> There are more links but they basically say the same thing.
>
Posted by linkadge on January 14, 2008, at 10:54:28
In reply to Re: Deplin is a drug, not a nutritional supplement » linkadge, posted by SLS on January 13, 2008, at 21:13:24
As long as it works for you, thats all that matters.
Linkadge
Posted by linkadge on January 14, 2008, at 10:58:21
In reply to Re: CNS research Deplin Link » star008, posted by SLS on January 14, 2008, at 9:35:44
There are many nutritional supplements that you would get sick if you took a dozen of.
The original point I was trying to make was that the "category" of a particular substance does not equate to how it will help sombody.
I still think omega-3 is the bomb. Hopefully it won't be pulled and called a drug.
Linkadge
Posted by Jamal Spelling on January 14, 2008, at 11:58:19
In reply to Re: CNS research Deplin Link, posted by linkadge on January 14, 2008, at 10:58:21
Just my cynical observation, as a layperson, but it seems as though the psychiatric establishment will only endorse effective non-pharmaceutical treatments as an *adjunct* to standard pharmaceutical treatments. From the way methylfolate works, its therapeutic effect does not necessarily rely on the presence of other ADs, although it is being promoted strictly as an adjunct to prescription ADs.
Posted by Larry Hoover on January 14, 2008, at 12:34:01
In reply to CNS research Deplin Link » SLS, posted by star008 on January 14, 2008, at 8:01:22
> http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=1267
>
> check out this article.. the fda classifies dephlin as neither a drug or a supplement.. so according to them we are both wrongAhhh. Thanks for the link. With it, I was finally able to find an FDA document on the subject. For some reason, keyword searches using 'medical food' on the FDA website had failed to get any hits.
http://www.cfsan.fda.gov/~dms/medfguid.html
The key item in this document, IMHO, is #7. It appears that a manufacturer is free to declare a substance a medical food, without FDA approval being required, provided it meets the criteria in item 2. If that medical food is patented, that effectively restricts the market.
Lar
Posted by star008 on January 14, 2008, at 15:49:34
In reply to Re: CNS research Deplin Link » star008, posted by Larry Hoover on January 14, 2008, at 12:34:01
yes.. all about the money... of course..
Posted by star008 on January 14, 2008, at 15:56:54
In reply to Re: CNS research Deplin Link » star008, posted by SLS on January 14, 2008, at 9:35:44
I did find that the L-methylfolate, (spelling) is found in some leafy green vegetables but i don't know how much you would have to eat. Overdosing would not be cool but that isn't a reason to regulate it..I think it was more about money, myself.. You can overdose on tylenol and lots of ther OTC meds, vitamins, etc..
There was some stuff on alternative where people said they were taking a form of it but it got pulled off the market.
Posted by star008 on January 14, 2008, at 15:58:46
In reply to Re: CNS research Deplin Link, posted by linkadge on January 14, 2008, at 10:58:21
Unfortuantely some company tweaks the product and proves it's uses and they get the patent for it.. money money money
Posted by Phillipa on January 14, 2008, at 19:55:07
In reply to Re: CNS research Deplin Link » linkadge, posted by star008 on January 14, 2008, at 15:58:46
So are you now saying it's really not a med as so far last two days I felt better on half a pill. Getting really confused again???? Phillipa ps what do they mean by a disesase depression? And why feeding tubes? Okay I'm stupid.
Posted by star008 on January 15, 2008, at 0:31:51
In reply to Re: CNS research Deplin Link, posted by Phillipa on January 14, 2008, at 19:55:07
Let me know where you saw the feeding tube thing and the disease depression and maybe i can explain. I will try to explain deplin better for u tomorrow.. it is late and i gotta sleep;)
Posted by Jamal Spelling on January 15, 2008, at 5:08:14
In reply to Re: CNS research Deplin Link » Phillipa, posted by star008 on January 15, 2008, at 0:31:51
Mr Jones: "So, Jeeves, what food will we be serving our guests tonight?"
(enter Jeeves, the middle-aged acerbic English butler)
Jeeves: "For their starters course, I thought we might prepare a platter of Deplin, followed by..."
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.