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A: Not necessarily, but screening makes sense: Routine supplementation: High-risk groups: Yes (elderly, vegan, GI disorders, medications) Treatment-resistant depression: Yes All others: Screen first, supplement if low or borderline Cost-benefit: B12 is very safe Inexpensive Potential significant benefit Reasonable to consider broad supplementation THE SCIENTIFIC CONSENSUS What Major Organizations Say: American Psychiatric Association (APA): Recommends screening for B12 in treatment-resistant depression Consider supplementation in deficiency Canadian Network for Mood and Anxiety Treatments (CANMAT): Lists folate/B12 as Level 2 augmentation strategy Recommended for patients with low levels British Association for Psychopharmacology: Check B12 and folate in treatment-resistant cases Supplement if deficient or borderline BOTTOM LINE: Clinical Summary Does B12 Support SSRIs/SNRIs