Gram Research analysis of five studies suggests folate supplementation may reduce suicidal thoughts and behaviors, with one study showing a 44% lower risk of suicide-related emergency visits after taking folic acid. However, evidence remains mixed—two studies, including the most rigorous randomized controlled trial, found no significant benefit. While folate shows promise as a potential complementary tool for suicide prevention, current evidence is insufficient to recommend it as a standalone treatment, and anyone with suicidal thoughts should seek immediate professional help.
A new review of research studies examined whether taking folate (vitamin B9) supplements might help reduce suicidal thoughts and behaviors. Researchers looked at five studies involving hundreds of thousands of people and found some promising results: three studies showed that folate supplements appeared to lower suicide risk, while two studies didn’t find a clear benefit. The most striking finding came from one study showing a 44% reduction in suicide-related emergency visits after taking folic acid. However, scientists say more large-scale studies are needed before we can be confident about folate’s role in suicide prevention.
Key Statistics
A 2026 scoping review of five studies found that one cohort study showed a 44% lower hazard of suicide-related emergency or hospital visits after treatment with folic acid (hazard ratio = 0.56), though two other studies including a randomized controlled trial reported no significant benefit.
According to research reviewed by Gram, three of five studies examining folate supplementation reported significant reductions in suicidal outcomes, while two studies found no benefit, indicating promising but mixed evidence for folate’s role in suicide prevention.
A case-control study of 800,000 adults with a history of suicidal behavior found significantly lower suicidal ideation questionnaire scores in patients taking folinic acid (P < 0.01), suggesting potential benefit in high-risk populations.
The randomized controlled trial of 475 participants examining folic acid supplementation for suicide prevention reported no significant benefit for suicide-related endpoints, highlighting the gap between observational evidence and controlled trial results.
The Quick Take
- What they studied: Whether taking folate (a B vitamin) supplements could reduce suicidal thoughts and suicide attempts in people
- Who participated: Five different research studies involving approximately 800,475 adults total. Studies included people with and without mental health conditions, and some focused specifically on people with a history of suicidal behavior
- Key finding: Three out of five studies found that folate supplements reduced suicide-related outcomes. One study showed a 44% lower risk of suicide-related emergency room visits or hospitalizations after taking folic acid supplements
- What it means for you: While folate supplementation shows promise for potentially reducing suicide risk, the evidence is still early and mixed. This is not yet a proven treatment, and anyone having suicidal thoughts should talk to a mental health professional immediately. Folate may be one tool doctors consider as part of comprehensive suicide prevention, but it shouldn’t replace standard mental health care
The Research Details
Researchers conducted a ‘scoping review,’ which means they searched multiple medical databases (PubMed, Cochrane Library, psychology databases, and clinical trial registries) from the beginning of records through February 2025 to find all studies that tested whether folate supplements affected suicide-related outcomes. They only included studies that used rigorous scientific methods: randomized controlled trials (where people are randomly assigned to get folate or a placebo), cohort studies (where researchers follow groups of people over time), and case-control studies (where they compare people with suicidal behavior to those without).
The researchers found five studies that met their strict criteria. These studies tested different types of folate supplements (folic acid or folinic acid) at various doses, ranging from 1 to 5 milligrams per day. The studies tracked different outcomes, including suicidal thoughts, suicide attempts, and emergency visits or hospitalizations related to suicide.
This approach is valuable because it brings together all the best available evidence on one topic, making it easier to see what we know and what we still need to learn. By reviewing multiple studies together, researchers can spot patterns and identify gaps in the research.
A scoping review is the right approach for this question because folate and suicide prevention is a relatively new research area with only a handful of studies. This type of review helps scientists understand what evidence exists, how strong it is, and what questions still need answers. It’s especially important for mental health topics where people are looking for any potential help, so we need to be honest about what we actually know versus what we hope might work
The review was thorough—researchers searched multiple databases and used clear criteria for which studies to include. However, the five studies they found were quite different from each other in important ways: they used different types of folate, different doses, different study designs, and measured different outcomes. This ‘heterogeneity’ (variety) makes it harder to draw firm conclusions. Additionally, only one study was a randomized controlled trial (the gold standard), and that one didn’t find a benefit. The other positive findings came from observational studies, which are less reliable because they can’t prove cause-and-effect as clearly. The largest studies involved hundreds of thousands of people, which is a strength, but the randomized trial was smaller with only 475 participants
What the Results Show
Three of the five studies reported that folate supplements reduced suicide-related outcomes. The most striking finding came from a within-person cohort study (where researchers tracked the same people before and after treatment): people who took folic acid had a 44% lower risk of suicide-related emergency room visits or hospitalizations compared to when they weren’t taking it. This is measured as a ‘hazard ratio’ of 0.56, which means the risk dropped to about half.
A second study, which was a case-control study of people with a history of suicidal thoughts and behaviors, found that those taking folinic acid (another form of folate) had significantly lower scores on a suicidal ideation questionnaire, meaning they reported fewer suicidal thoughts. This difference was statistically significant, meaning it was unlikely to be due to chance.
However, two studies—including the randomized controlled trial, which is typically the most reliable type of study—did not find that folate supplements reduced suicide-related outcomes. This mixed evidence is why researchers emphasize that while the findings are ‘promising,’ they’re not yet conclusive.
Interestingly, when researchers looked at vitamin B12 (another B vitamin) in one of the studies, they found no benefit for suicide prevention, suggesting that the potential benefit might be specific to folate rather than B vitamins in general.
One important secondary finding was that the potential benefit of folate appeared in both people with and without psychiatric histories. This suggests that if folate does help reduce suicide risk, it might work across different groups of people, not just those with diagnosed mental health conditions. The studies tested different folate formulations—some used folic acid (a synthetic form) and others used folinic acid (a naturally occurring form)—at doses ranging from 1 to 5 milligrams per day, but the review didn’t identify clear differences in effectiveness between these different types or doses
This is one of the first comprehensive reviews of folate supplementation specifically for suicide prevention. Previous research has shown that folate plays important roles in brain chemistry and mood regulation, and some studies have linked low folate levels to depression and suicidal behavior. This review builds on that foundation by asking whether actually giving people folate supplements can reduce suicide risk. The findings align with emerging ‘real-world evidence’ (observations from actual clinical practice) suggesting folate might help, but the controlled research evidence is still limited. The review authors note that this is an area where real-world observations are ahead of rigorous clinical trial evidence
The biggest limitation is that only five studies met the inclusion criteria, and they were quite different from each other. Three used different study designs, different folate formulations, and different ways of measuring outcomes, making it hard to combine the results. The randomized controlled trial—which is the most reliable type of study—didn’t find a benefit, which raises questions about whether the positive findings from the other studies might be due to bias or chance. The studies also varied widely in sample size, from 475 people in the randomized trial to hundreds of thousands in the large cohort studies. Additionally, none of the studies were specifically designed to test folate for suicide prevention; most were looking at other health outcomes and happened to measure suicide-related endpoints. The review authors emphasize that we need larger, well-designed studies that specifically test folate for suicide prevention before we can be confident in the results
The Bottom Line
Based on current evidence, folate supplementation shows promise but is not yet proven as a suicide prevention treatment. Confidence level: LOW to MODERATE. If you’re experiencing suicidal thoughts, talk to a mental health professional immediately—don’t rely on supplements alone. If you’re working with a doctor or psychiatrist, you could discuss whether folate supplementation might be appropriate as part of your overall treatment plan, but it should complement, not replace, standard mental health care like therapy or medication. General folate supplementation (400-800 micrograms daily) is safe for most adults and supports overall health, but taking higher doses specifically for suicide prevention should only be done under medical supervision
This research is most relevant to: people with suicidal thoughts or a history of suicide attempts, mental health professionals treating suicidal patients, psychiatrists considering complementary approaches to standard treatments, and researchers studying nutrition and mental health. People should NOT use this as a reason to avoid standard suicide prevention treatments like therapy, medication, or crisis support. This research is NOT a substitute for emergency help—if you’re having suicidal thoughts, call 988 (Suicide & Crisis Lifeline) or go to an emergency room immediately
If folate supplementation does help reduce suicide risk, the benefit appeared relatively quickly in the studies reviewed—within weeks to months of starting supplementation. However, this is not a fast-acting emergency treatment. The full effects on mood and mental health typically take several weeks to develop, similar to how antidepressant medications work. Anyone considering folate supplementation should continue working with their mental health provider and not expect it to work as a standalone solution
Frequently Asked Questions
Can folate supplements prevent suicide?
Folate shows promise in some studies—one found a 44% reduction in suicide-related emergency visits—but evidence is mixed. Three of five studies showed benefit while two didn’t. It may help as part of comprehensive treatment, but it’s not a proven prevention method and shouldn’t replace professional mental health care.
What dose of folate should I take for suicidal thoughts?
Studies tested 1-5 mg daily of folic acid or folinic acid, but dosing for suicide prevention isn’t established. Never self-treat suicidal thoughts with supplements. Talk to a mental health professional or doctor who can recommend appropriate doses as part of your overall treatment plan.
Is folate better than antidepressants for suicide prevention?
No. Antidepressants have much stronger evidence for reducing suicide risk. Folate may potentially complement standard treatments, but it shouldn’t replace proven therapies like medication, therapy, or crisis support. Always work with a mental health professional.
How long does it take for folate to help with suicidal thoughts?
If folate helps, benefits likely appear within weeks to months, similar to antidepressants. However, this isn’t a fast-acting emergency treatment. Anyone having suicidal thoughts needs immediate professional help, not just supplements.
Who should take folate for suicide prevention?
Current evidence doesn’t support recommending folate specifically for suicide prevention to any group. Only consider it under medical supervision as part of comprehensive treatment. General folate supplementation (400-800 mcg daily) is safe for most adults and supports overall health.
Want to Apply This Research?
- Track daily folate intake (in micrograms) and correlate with weekly mood scores and suicidal ideation ratings using a standardized scale like the Columbia-Suicide Severity Rating Scale (C-SSRS). Record the specific folate formulation and dose being taken
- If working with a healthcare provider who recommends folate supplementation, set a daily reminder to take your supplement at the same time each day (such as with breakfast). Log your intake in the app to maintain consistency and track whether you notice changes in mood or suicidal thoughts over 4-8 weeks
- Establish a baseline of suicidal ideation, mood, and energy levels before starting folate. Then track these weekly using the app’s mood and ideation logging features. Compare trends month-to-month to see if there are patterns. Share this data with your mental health provider to help them assess whether folate is helping as part of your overall treatment plan
This article reviews research on folate supplementation and suicide-related outcomes. The evidence is promising but limited and mixed—not all studies showed benefit. Folate supplementation is not a proven suicide prevention treatment and should not replace standard mental health care including therapy, medication, or crisis support. If you are having suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline (call or text 988), go to your nearest emergency room, or call emergency services immediately. Any decisions about folate supplementation should be made in consultation with your doctor or mental health professional. This information is for educational purposes only and is not medical advice.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.