Upshot: High EPA and DHA content omega 3 supplement reduces depression sx in adult pts with major depression as long as they don't also have an anxiety disorder, and works as well as a pharmaceutical antidepressant. Anxiety pts showed trend toward improvement.
SOURCE: http://www.medscape.com/viewarticle/724130?src=mpnews&spon=12&uac=89474MT
finger prick blood tests for omega 3 status "readily available" (really? where?)
Omega-3 Supplements May Reduce Depressive Symptoms in Patients Without Comorbid Anxiety
Deborah Brauser's article, June 24, 2010
study published online in the Journal of Clinical Psychiatry
Omega-3 supps vs placebo
J Clin Psychiatry. Published online June 15, 2010
lead study author François Lespérance, MD
Department of Psychiatry and Centre de Recherché du Centre Hospitalier
at the Université de Montréal (CRCHUM), Quebec, Canada, and colleagues
n = 432 adult outpatients at 8 Canadian clinics
mean age: 46
68.5% female
all had major depression lasting at least 1 mo
timeframe: 10/05-1/09
inclusive, heterogeneous sample, many difficult-to-treat individuals
over 80% of their study participants "would have been excluded from the usual type of phase 3 trial"
27% chronic depression
53% comorbid ADs
40% taking at least 1 antidepressant
40.3% were on antidepressants at baseline
approximately 15% undergoing some form of psychotherapy
many pts don't get good results with antidepressants or refuse to take them
almost 54% of depressed peeps in US
people with depression in the United States use some form of complementary treatment
randomized 8 week trial
n = 218 got the tx: omega-3 supplements: 1050 mg EPA and 150 mg of DHA /day
n = 214 placebo was sunflower oil plus 2% fish oil to strengthen the double-blind
clinic visits were made by all at weeks 1, 2, 4, and 8
primary outcome measure: self-report score
30-item Inventory of Depressive Symptomatology (IDS-SR30)
secondary measure:
clinician-rated Montgomery-Asberg Depression Rating Scale (MADRS)
subgroup analyses:
presence or absence of comorbid AD at baseline
use of antidepressants
patient sex
number of portions of fish per week during the month before the study's initiation
Only MDE Patients Without ADs Had Significant Improvements
adjusted mean difference between the omega-3 treatment and the placebo treatment was 1.32 points
(95% confidence interval [CI], −0.20 to 2.84; P = .088) on the IDS-SR30
and 0.97 points on the MADRS, neither of which was statistically significant
(95% CI, −0.012 to 1.95; P = .053)
pts with anxiety are harder to treat
no evidence of interactions was found for antidepressant use at baseline, patient sex, or prior fish intake
the interaction of comorbid [ADs] and study group was significant (P = .035)
52.8% of the total patients were found to have comorbid ADs
204 patients without comorbid ADs
fish oil groups had less sx than placebo group
shown by an adjusted mean difference of 3.17 points on the IDS-SR30
(95% CI, 0.89 − 5.45; P = .007) and 1.93 points on the MADRS (95% CI, 0.50 − 3.36; P = .008).
omega-3 supplements "seemed to be more efficacious for patients as a stand-alone treatment in comparison to adjuvant treatment," reported Dr. Lespérance.
46.2% of the patients treated with omega-3 and 53.4% of those treated with placebo
reported no medication-attributed adverse effects
7 serious adverse events in the omega-3 group, 4 in the placebo group
CAPT Joseph R. Hibbeln, MD, acting chief of the Section on Nutritional Neurosciences at the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, in Bethesda, Maryland
not involved with study and disses its design, "no biological validation of compliance"
claims that it was his idea in 1995 to use omega 3's for depression
says we should treat nutrient deficiencies before medicating for depression (duh)
in 2002 the US FDA noticed that benefit of antidepressants in trials depends on how badly depressed pts are
more depressed-->more likely to improve
harder to tx moderately depressed pts
in this trial omega 3 worked as well as antidepressants
in 2006 the APA treatment recommendation committee recommended that all psych pts take at least 1g/day omega3
based on higher risk for cardiovascular disease and metabolic problems
one of the major complications of second-generation antipsychotics: hypertriglyceridemia
fish oil totally works to lower TGs
US dietary guidelines recommended eating fish 2 to 3 times a week for the general population
some pts with major depressive episodes (MDEs) had sig less sx: only pts w/o comorbid anxiety disorders
pts with both depression and anxiety showed "only a trend toward major symptom reduction"