# Successful Treatment of Anemia With Ringed Sideroblasts Induced by Antidepressants Through Vitamin B6 Supplementation and Discontinuation of Antidepressants

## TL;DR

A man with anemia caused by antidepressants improved after taking vitamin B6 and stopping the medication.

## Contribution

This case highlights VB6 deficiency as a reversible cause of anemia with ringed sideroblasts.

## Key findings

- The patient's anemia improved significantly with VB6 supplementation.
- Complete resolution occurred after discontinuing the antidepressant amoxapine.

## Abstract

Vitamin B6 (VB6) is a vital coenzyme for δ-aminolevulinic acid synthase (ALAS) in heme biosynthesis. We report a 49-year-old male with severe microcytic anemia and ringed sideroblasts initially diagnosed as myelodysplastic syndrome (MDS). VB6 deficiency, attributed to long-term amoxapine use, was identified. His anemia improved significantly with VB6 supplementation and resolved completely after discontinuing amoxapine. This case highlights the need to consider VB6 deficiency in anemia with ringed sideroblasts.