Depression

Depression

Omega-3 Fats: Powerful Adjunctive Weapons In The Fight Against Depression

May Improve Antidepressant Effects In Patients With Relapse & Treatment Resistance

Fatty acids seem to help the brain "think" better. They may also help it maintain emotional balance, providing a potentially powerful boost to antidepressant therapy in patients with chronic mood disorders.

Supplementation with an omega-3 fatty acid, commonly found in fish oil, significantly reduces symptoms in patients being treated for recurrent unipolar depression, according to a recent report in the American Journal of Psychiatry.

Previous intervention trials have produced strong evidence that omega-3 fatty acid supplementation may help prevent bipolar depression in susceptible patients.

This latest trial, a four-week, double-blind trial conducted on twenty-three patients experiencing a relapse of unipolar depression, investigated whether supplementing patients’ antidepressant medications with 2 grams of ethyl-eicosapentaenoic acid (E-EPA) stabilized with vitamin E each day would elicit a positive effect on their treatment outcomes.

The answer, researchers found, was a resounding "yes." After four weeks, the average reduction in depression (based on the Hamilton scale) in the patients taking the EPA was 12.4 - compared to just 1.6 in the patients who receiving a placebo supplement with their antidepressants. "This reduction was clinically meaningful," the researchers reported. "6 of 10 patients receiving E-EPA but only 1 of 10 patients receiving placebo achieved a 50% reduction in Hamilton depression score."

This trial was the first to examine the effects of omega-3 fatty acid therapy in a group of patients with unipolar depression. It used a lower dose of EPA than other fatty acid intervention trials, and patients were unable to distinguish the "fish oil" supplement from the placebo.

A recent case study involving a 21-year-old man with treatment-resistant depression, reported in a letter to the Archives of General Psychiatry, seems to back these preliminary findings. After suffering escalating symptoms of depression for seven years with no clinical response to a wide range of antidepressants, hypnotics, and antipsychotic medications, the young man was supplemented with 4 grams per day of E-EPA. (He took the fatty acid in addition to 20-30 mg/d of paroxetine hydrochloride, which he had already been taking for 10 months with no significant effect on increasing suicidal urges and other depressive symptoms.) After just one month of E-EPA supplementation, the man’s condition rapidly improved, with suicidal tendencies and social phobia declining dramatically. After nine months, all of his previous depressive symptoms disappeared completely. He experienced no side effects from the supplements and, more than one year later, is still in complete recovery.

Source: Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder [brief report]. Am J Psychiatry 2002;159:477-479.