Eicosapentaenoic acid in treatment-resistant depression associated with symptom remission, structural brain changes and reduced neuronal phospholipid turnover.
The n-3 essential fatty acid eicosapentaenoic acid (EPA) was added to the conventional antidepressant treatment of a treatment-resistant severely depressed and suicidal male patient with a seven-year history of unremitting depressive symptoms. The niacin skin flush test and cerebral magnetic resonance scanning were carried out at baseline and nine months later. The addition of ethyl-EPA led to a dramatic and sustained clinical improvement in all the symptoms of depression, including a cessation of previously unremitting severe suicidal ideation, within one month. Symptoms of social phobia also improved dramatically. During the nine-month period the volumetric niacin response increased by 30%, the relative concentration of cerebral phosphomonesters increased by 53%, and the ratio of cerebral phosphomonesters to phosphodiesters increased by 79%, indicating reduced neuronal phospholipid turnover. Registered difference images showed that the EPA treatment was accompanied by structural brain changes including, in particular, a reduction in the lateral ventricular volume.
Puri
B K
BK
MRI Unit, Imperial College School of Medicine, Hammersmith Hospital, London, W12 0HS, UK.
Counsell
S J
SJ
Hamilton
G
G
Richardson
A J
AJ
Horrobin
D F
DF
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000473:pathology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D009474:Neurons / Q000378:metabolism; D009525:Niacin; D010743:Phospholipids / Q000378:metabolism
D000928:Antidepressive Agents; D010743:Phospholipids; D009525:Niacin; D015118:Eicosapentaenoic Acid