Omega-3 fatty acids for major depressive disorder associated with the menopausal transition

Abstract

Objectives We sought to obtain preliminary data regarding the efficacy of omega-3 fatty acids for major depressive disorder associated with the menopausal transition. Secondary outcomes were assessed for vasomotor symptoms (or hot flashes). Methods After a single-blind placebo lead-in, participants received 8 weeks of treatment with open-label omega-3 fatty acid capsules (eicosapentaenoic acid and docosahexaenoic acid, 2 g/d). The Montgomery-Asberg Depression Rating Scale (MADRS) was the primary outcome measure. Hot flashes were monitored prospectively using daily diaries and the Hot Flash Related Daily Interference Scale. Blood samples for plasma pretreatment and post treatment essential fatty acid assays were obtained. Because of the small sample size, data were analyzed using nonparametric techniques. Results Of 20 participants treated with omega-3 fatty acids, 19 (95%) completed the study. None discontinued because of adverse effects. The pretreatment and final mean MADRS scores were 24.2 and 10.7, respectively, reflecting a significant decrease in MADRS scores (P G 0.0001). The response rate was 70% (MADRS score decrease of Q50%), and the remission rate was 45% (final MADRS score of e7). Responders had significantly lower pretreatment docosahexaenoic acid levels than nonresponders did (P = 0.03). Hot flashes were present in 15 (75%) participants. Among those with hot flashes at baseline, the number of hot flashes per day improved significantly from baseline (P = 0.02) and Hot Flash Related Daily Interference Scale scores decreased significantly (P = 0.006). Conclusions These data support further study of omega-3 fatty acids for major depressive disorder and hot flashes in women during the menopausal transition.

Omega‐3 fatty acid biomarkers and subsequent depressive symptoms

“…While RBC omega-3 levels were not associated with depressive symptoms, the reduced odds of new depression at follow-up in those with dietary DHA+EPA in the highest tertile of intake relative to the lowest tertile would be consistent with that of previous studies in a variety of populations (Ali et al , 2009, Amin et al , 2008, Baghai et al , 2011, Freeman et al , 2011, Park et al , 2012, Pottala et al , 2012b). The Freeman et al trial supplemented with EPA and DHA at 2 g/day, which although somewhat higher, corresponds to the third tertile of dietary DHA+EPA intake noted in our study (0.12g – 2.03g).…”

Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: A randomized, double-blind, placebo-controlled study

“…Results from PP participants suggest effects on night sweating, but this was not significant among the primary ITT population. Previously, long-chain n-3 fatty acids have shown alleviation of symptoms of depression and/or hot flashes among peri-and postmenopausal women, possibly via modulation of neurotransmitters involved in thermoregulation [26,27]. Among breast cancer survivors, vitamin E slightly decreased frequency of hot flashes [28].…”

(N-3) Fatty Acids: Molecular Role and Clinical Uses in Psychiatric Disorders

“…Even though well conducted, there should be certain reservations when interpreting their results, mainly because of disagreement in the literature concerning the appropriate therapeutic daily dose of these substances, and the appropriate DHA:EPA ratio that should be prescribed for these patients (56)(57)(58)(59)(60)(61)(62), making administrations unique. One example is Rogers et al (63), who could not find any correlation between supplementation and improvement, although there were reservations about their use of oleic acids as an appropriate placebo, and their preparations with low concentrations of EPA, which is thought to be the most active component in relieving mood symptoms.…”

“…Peet et al (54) conducted a study that showed improvement in the patients treated with E-EPA, and who were refractory to selective serotonin uptake inhibitor monotherapy for major depression. Other clinical trials have found positive correlations between an increase in (n-3) fatty acid concentrations and improvement in symptoms, whether in major isolated depression (54)(55)(56)(57), pediatric unipolar depression (58), and depression associated with Parkinson's disease (59), with menopausal transition (60), and with aging in women (61).…”