Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study.
BACKGROUND
Perinatal major depressive disorder (MDD), including antenatal and postpartum depression, is common and has serious consequences. This study was designed to investigate the feasibility, safety, and efficacy of omega-3 fatty acids for perinatal depression in addition to supportive psychotherapy.


METHODS
Perinatal women with MDD were randomized to eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), 1.9g/day, or placebo for 8weeks. A manualized supportive psychotherapy was provided to all subjects. Symptoms were assessed with the Hamilton Rating Scale for Depression (HAM-D) and Edinburgh Postnatal Depression Scale (EPDS) biweekly.


RESULTS
Fifty-nine women enrolled; N = 51 had two data collection points that allowed for evaluation of efficacy. Omega-3 fatty acids were well tolerated. Participants in both groups experienced significant decreases in EPDS and HAM-D scores (p<.0001) from baseline. We did not find a benefit of omega-3 fatty acids over placebo. Dietary omega-3 fatty acid intake was low among participants.


CONCLUSIONS
The ability to detect an effect of omega-3 fatty acids may have been limited by sample size, study length, or dose. The benefits of supportive psychotherapy may have limited the ability to detect an effect of omega-3 fatty acids.


CONCLUSIONS
There was no significant difference between omega-3 fatty acids and placebo in this study in which all participants received supportive psychotherapy. The manualized supportive psychotherapy warrants further study. The low intake of dietary omega-3 fatty acids among participants is of concern, in consideration of the widely established health advantages in utero and in infants.
Freeman
Marlene P
MP
Women's Mental Health Center, University of Texas Southwestern Medical Center, Dallas TX, USA. marlene.freeman@utsouthwestern.edu
Davis
Melinda
M
Sinha
Priti
P
Wisner
Katherine L
KL
Hibbeln
Joseph R
JR
Gelenberg
Alan J
AJ
D003131:Combined Modality Therapy; D019052:Depression, Postpartum / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D010919:Placebos; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief; D011644:Puerperal Disorders / Q000188:drug therapy; D012107:Research Design / Q000592:standards; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D010919:Placebos