title: Omega-3 fatty acids and supportive psychotherapy for perinatal depression: a randomized placebo-controlled study.
abstract: 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.
authors.affiliation: Women's Mental Health Center, University of Texas Southwestern Medical Center, Dallas TX, USA. marlene.freeman@utsouthwestern.edu
authors.forename: Marlene P
authors.initials: MP
authors.lastname: Freeman
authors.forename: Melinda
authors.initials: M
authors.lastname: Davis
authors.forename: Priti
authors.initials: P
authors.lastname: Sinha
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Wisner
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Hibbeln
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Gelenberg
mesh_terms: 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
chemical_list: D015525:Fatty Acids, Omega-3; D010919:Placebos