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Biol Psychiatry. 2014 Oct 1;76(7):559-66. doi: 10.1016/j.biopsych.2014.01.008. Epub 2014 Jan 24.

Omega-3 fatty acids in the prevention of interferon-alpha-induced depression: results from a randomized, controlled trial.

Author information

1
Department of Psychiatry & Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
2
Department of Hepatogastroenterology, China Medical University Hospital, Taichung, Taiwan.
3
Department of Nutrition, China Medical University, Taichung, Taiwan.
4
Department of Psychiatry & Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan.
5
Department of Psychiatry & Mind-Body Interface Laboratory, China Medical University Hospital, Taichung, Taiwan; School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
6
Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom. Electronic address: carmine.pariante@kcl.ac.uk.

Abstract

BACKGROUND:

Interferon (IFN)-α therapy for chronic hepatitis C virus infection is frequently associated with depression. The routine prophylaxis with antidepressants might expose patients to adverse effects, hence, the need for alternative preventive interventions. Omega-3 polyunsaturated fatty acids are safe and effective essential nutritional compounds used for the treatment of depression, putatively through an anti-inflammatory action. In addition, lower erythrocyte levels of omega-3 polyunsaturated fatty acids have been associated with an increased risk of IFN-induced depression.

METHODS:

We conducted a 2-week, double-blind, placebo-controlled trial comparing eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and placebo for the prevention of IFN-α-induced depression. A total of 162 patients consented to participate and were randomized to the study. All of the patients completed the 2-week trial; 152 participants were followed throughout the 24 weeks of IFN-α treatment and were included in the analysis.

RESULTS:

Compared with placebo, the incident rates of IFN-α-induced depression were significantly lower in EPA-treated but not in DHA-treated patients (10% and 28%, respectively, versus 30% for placebo, p = .037). Both EPA and DHA significantly delayed the onset of IFN-induced depression (week of onset: 12.0 and 11.7, respectively, versus 5.3 for placebo, p = .002). EPA and DHA were both well tolerated in this population. EPA treatment increased both EPA and DHA erythrocyte levels, but DHA only increased DHA erythrocyte levels.

CONCLUSIONS:

EPA is effective in the prevention of depression in hepatitis C virus patients received IFN-α therapy. Our study confirms the notion that anti-inflammatory strategies are effective antidepressants in the context of depression associated with inflammation.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01620502.

KEYWORDS:

Chronic hepatitis C virus (HCV); clinical trial; inflammation; interferon-alpha (IFN-α); major depressive disorder (MDD); omega-3 polyunsaturated fatty acids (n-3 PUFAs)

PMID:
24602409
DOI:
10.1016/j.biopsych.2014.01.008
[Indexed for MEDLINE]

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