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This mechanistic understanding is reflected by clinical studies that show as many as one third of severely depressed patients manifest folate deficiency, and in these people, folate supplementation has been shown to enhance recovery of their mental state.[33] As there are difficulties in interpreting serum and red cell folate assays in some patients, it has been suggested that total plasma homocysteine could be a more sensitive measure of functional folate and vitamin B12 deficiency.[34]A study of homocysteine, folate, and monoamine metabolism was therefore undertaken in patients with severe depression.[35] In 46 in-patients with severe depression, blood counts, serum and red cell folate, serum vitamin B12, and total plasma homocysteine were measured

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