Augmenting sertraline present in fish oil for 10 weeks did not result in greater improvement; in depressive symptoms compared with sertraline and corn oil placebo in patients with major depressive disorder and coronary heart disease; according to a study publish in Journal of Clinical Psychiatry.

However, studies of depressed psychiatric patients have suggested that antidepressant efficacy can be increase; by adding eicosapentaenoic acid (EPA); but one of the omega-3 fatty acids found in fish oils. But the purpose of this study was to determine whether the addition of EPA improves the response to sertraline in depressed patients; with or at high risk for coronary heart disease

“However, there is considerable interest in whether treating depression; improved cardiac event-free survival in [coronary heart disease],” Robert M. Carney, PhD, professor of psychiatry at Washington University School of Medicine in St. Louis, and colleagues wrote. “ In addition, few randomized clinical trials have addressed this question; but the interventions tested in these have had relatively small effects on depression.”

Major depressive disorder

However, researchers examined whether adding eicosapentaenoic acid (EPA); but one of the omega-3 fatty acids found in fish oils, can improve the response to sertraline in 144 patients with major depressive disorder; who have and were at high-risk for coronary heart disease (CHD) between May 2014 and June 2018.

However, patients were randomized to receive either 50 mg each day of sertraline plus 2 g each day of EPA; or 50 mg each day of sertraline and corn oil placebo capsules for 10 weeks. Similarly, Carney and colleagues measured change on the Beck Depression Inventory II (BDI-II; primary outcome); as well as on the Hamilton Depression Rating Scale (HDRS-17), response, remission and anxiety levels.

Pathways linking fish oil to improvement

However, the results revealed no differences at post treatment in the adjusted average BDI-II scores between the placebo; and EPA arms (10.3 vs. 12.1; P = .22) after 10 weeks of treatment. But in addition, the investigators found no difference between the placebo and EPA arms on the 17-item Hamilton Depression Rating Scale (7.2 vs. 8; P = .4); the remission rate (50.6% vs. 46.7%; OR = 0.85; 95% CI, 0.43-1.68), treatment response rate (80.5% vs. 73.1%; OR = 0.64; 95% CI, 0.28-1.47) or anxiety levels (between group difference = 1.11; 95% CI, –1.07 to 3.3).

“In other words identifying the characteristics of cardiac patients whose depression may benefit from omega-3; but clarifying the pathways linking omega-3 to improvement in depression symptoms are important directions for future research,” Carney and colleagues wrote. “However, research on variations in the genes involved in the metabolism, synthesis; uptake and utilization of omega-3 may also help to identify patients who will respond to omeda-3 supplements as monotherapy; or as augmentation of standard antidepressants.” said Savannah Demko