12.01.09
Indication: Depression in patients with coronary heart disease
Source: JAMA, 2009;302(15):1651-1657.
Research: The objective of this study was to determine whether omega 3 supplementation improves response to the anti-depressant sertraline in patients with major depression and coronary heart disease (CHD). The randomized, controlled trial, which took place between May 2005 and December 2008, involved 122 patients in St. Louis, MO, with major depression and coronary heart disease (CHD). After a 2-week run-in period, all patients were given 50 mg/d of sertraline and randomized in double-blind fashion to receive 2 grams/d of omega 3 acid ethyl esters (930 mg of eicosapentaenoic acid [EPA] and 750 mg of docosahexaenoic acid [DHA]) (n=62) or corn oil placebo capsules (n=60) for 10 weeks. Subjects were evaluated on the Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression (HAM-D).
Results: Adherence to the medication regimen was 97% or more in both groups for both medications. There were no differences in weekly BDI-II scores (treatment x time interaction = 0.02; 95% confidence interval [CI], –0.33 to 0.36; t 112 = 0.11; P = .91), pre-post BDI-II scores (placebo, 14.8 vs. omega 3, 16.1; 95% difference-in-means CI, –4.5 to 2.0; t 116 = –0.77; P = .44), or HAM-D scores (placebo, 9.4 vs. omega 3, 9.3; 95% difference-in-means CI, –2.2 to 2.4; t 115 = 0.12; P = .90). The groups did not differ on predefined indicators of depression remission (BDI-II 8: placebo, 27.4% vs. omega 3, 28.3%; odds ratio [OR], 0.96; 95% CI, 0.43-2.15; t113 = –0.11; P = .91) or response (>50% reduction in BDI-II from baseline: placebo, 49% vs. omega 3, 47.7%; OR, 1.06; 95% CI, 0.51-2.19; t 112 = 0.15; P = .88). Researchers concluded that treatment of patients with sertraline and omega 3 fatty acids did not result in superior depression outcomes at 10 weeks, compared with sertraline and placebo. Whether higher doses of omega 3 or sertraline, a different ratio of EPA to DHA, longer treatment, or omega 3 monotherapy can improve depression in patients with CHD remains to be determined.
Source: JAMA, 2009;302(15):1651-1657.
Research: The objective of this study was to determine whether omega 3 supplementation improves response to the anti-depressant sertraline in patients with major depression and coronary heart disease (CHD). The randomized, controlled trial, which took place between May 2005 and December 2008, involved 122 patients in St. Louis, MO, with major depression and coronary heart disease (CHD). After a 2-week run-in period, all patients were given 50 mg/d of sertraline and randomized in double-blind fashion to receive 2 grams/d of omega 3 acid ethyl esters (930 mg of eicosapentaenoic acid [EPA] and 750 mg of docosahexaenoic acid [DHA]) (n=62) or corn oil placebo capsules (n=60) for 10 weeks. Subjects were evaluated on the Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression (HAM-D).
Results: Adherence to the medication regimen was 97% or more in both groups for both medications. There were no differences in weekly BDI-II scores (treatment x time interaction = 0.02; 95% confidence interval [CI], –0.33 to 0.36; t 112 = 0.11; P = .91), pre-post BDI-II scores (placebo, 14.8 vs. omega 3, 16.1; 95% difference-in-means CI, –4.5 to 2.0; t 116 = –0.77; P = .44), or HAM-D scores (placebo, 9.4 vs. omega 3, 9.3; 95% difference-in-means CI, –2.2 to 2.4; t 115 = 0.12; P = .90). The groups did not differ on predefined indicators of depression remission (BDI-II 8: placebo, 27.4% vs. omega 3, 28.3%; odds ratio [OR], 0.96; 95% CI, 0.43-2.15; t113 = –0.11; P = .91) or response (>50% reduction in BDI-II from baseline: placebo, 49% vs. omega 3, 47.7%; OR, 1.06; 95% CI, 0.51-2.19; t 112 = 0.15; P = .88). Researchers concluded that treatment of patients with sertraline and omega 3 fatty acids did not result in superior depression outcomes at 10 weeks, compared with sertraline and placebo. Whether higher doses of omega 3 or sertraline, a different ratio of EPA to DHA, longer treatment, or omega 3 monotherapy can improve depression in patients with CHD remains to be determined.