Addition of omega-3 fatty acid to maintenance medication treatment for recurrent depressive disorder
Nemets B, Stahl Z, Belmaker RH;
Commented by , 2 Jul 2002
Objective
There is an increasing interest in the therapeutic use of omega-3 fatty acids not only in cardiology, but also for psychiatric disorders such as schizophrenia and depressive disorders. Studies have reported that countries with high rates of fish oil consumption seem to have low rates of cardiovascular diseases and a lower incidence of depressions.
The authors studied the use of eicosapentaenoic acid (EPA), a specific omega-3 fatty acid, as an adjunctive in the maintenance treatment of recurrent unipolar depression.
Method
Twenty patients (17 women, 3 men) with a current unipolar major depression who all had experienced one relapse during antidepressive maintenance therapy participated in this 4- week double-blind study with placebo or EPA (2 g/day) as add-on to ongoing stable dose anti-depressant medication.
The patients had been on maintenance treatment for at least three months, and the current therapeutic dose for at least 3 weeks.
The patients`baseline scores on the 24-item Hamilton Depression Rating Scale (HDRS) were 18 or higher. HDRS were rated weekly by a psychiatrist blinded to the treatment.
Results
The addition of the omega-3 fatty acid showed a significant higher improvement on the HDRS score than placebo. This difference was significant at week 2 of the treatment period.
Six of 10 patients recieving EPA but only one of 10 patients recieving placebo achieved a 50% reduction in HDRS score, with an effect on the core depressive symptoms such as depressed mood, guilt feelings, worthlessness and also insomnia.
No clinically relevant side effects were reported.
Discussion
This study is one of the first therapeutic trials of omega-3 fatty acids in unipolar depressive disorder.
It does not say anything about how EPA works as an adjunctive to antidepressants. Does it augment via second messenger systems or does it have an independent antidepressive property ?
This study is preliminary with its low number of participants. It has to be replicated in a larger sample, with a broader range of subtypes of depression, and with a closer look on dose-response curve. A preliminary conclusion is that omega-3 fatty acid is good for the heart and good for the brain.