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Omega-3 showed no benefit for depression in patients with CHD
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Despite previous studies showing otherwise, the addition of omega-3 fatty acids with sertraline did not improve depression outcomes in patients with coronary heart disease and depression.
Researchers enrolled 122 patients from St. Louis, Mo., who had major depression and CHD in a randomized, controlled trial. All patients received 50 mg per day of sertraline and were randomized to also receive either 2 g per day of omega-3 acid ethyl esters (n=62), including 930 mg of eicosapentaenoic acid and 750 mg of docosahexaenoic acid, or to corn oil placebo capsules (n=60).
The researchers reported that 97% of patients adhered to the treatment regimen. After 10 weeks, they observed no differences between the two groups in weekly or pre-post Beck Depression Inventory II scores (P=.91 and P=.44) or in the Hamilton Rating Scale for Depression scores (P=.90).
The two groups also did not differ based on predefined indicators of depression remission or response. Researchers defined depression remission as a Beck Depression Inventory II score of ≤8; 27.4% of patients assigned to placebo met this indicator vs. 28.3% of those assigned omega-3. Depression response was defined as a >50% reduction in the Beck Depression Inventory II scale — an indicator 49% of the placebo group and 47.7% of the omega-3 group met.
The researchers pointed out that it remains to be seen whether higher doses of omega-3 or sertraline, a different ratio of eicosapentaenoic acid to docosahexaenoic acid, longer treatment or omega-3 monotherapy could improve depression in patients with CHD.
“Efforts should be made to identify the characteristics of depressed patients who may benefit from omega-3 depression monotherapy or augmentation of standard antidepressants,” the researchers wrote. “Confirmatory, prospective clinical trials should then be undertaken in these subgroups. To this end, exploratory analyses are currently being conducted to determine whether any subgroups in this study benefited from omega-3.” – by Tina DiMarcantonio
Carney RM. JAMA. 2009;302:1651-1657.