Anemia and depression: A report of two clinical cases

This clinical study addresses the association between depression and anemia through two case presentations.   Both instances initially exhibited as treatment-resistant depression but were later identified as having underlying iron deficiency anemia.

 Case 1: A 5-year follow-up of a postpartum woman exhibiting depressive symptoms unresponsive to various antidepressants (maprotiline, escitalopram, sertraline). Laboratory tests showed that the person had iron deficiency anemia because they had thalassemia mild.  Iron supplementation led to significant symptomatic enhancement.

 Case 2: A 4-year follow-up of a patient with depression and significant somatoform symptoms, who was treated ineffectively with maprotiline and fluoxetine.  A physical checkup and blood testing showed that the person had iron deficiency anemia.  The combination of psychiatric and hematological treatment led to significant improvement.

 The paper stresses that somatic comorbidities, especially anemia, go unreported in over half of psychiatric patients, even though they have an impact on clinical outcomes in 50–70% of cases.  Iron deficiency may directly induce depression by inhibiting serotonin synthesis. The authors conclude that seemingly treatment-resistant depression may be sustained by underlying anemia, and early detection using basic laboratory screening can significantly improve therapy response.