title: Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder.
abstract: OBJECTIVE
  To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine and a combination of them in major depression.
  
  
  METHODS
  Sixty outpatients with a diagnosis of major depressive disorder based on DSM-IV criteria and a score >or=15 in the 17-item Hamilton Depression Rating Scale (HDRS) were randomly allocated to receive daily either 1000 mg EPA or 20 mg fluoxetine, or their combination for 8 weeks. Double dummy technique was used to double blind the study. Patients were assessed at 2 week intervals. Change in HDRS was the primary outcome measure.
  
  
  RESULTS
  Analysis of covariance for HDRS at week 8 across treatment groups was performed in 48 patients who completed at least 4 weeks of the study, with the last observation carried forward. Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8. EPA + fluoxetine combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment. Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms. Response rates (>or=50% decrease in baseline HDRS) were 50%, 56% and 81% in the fluoxetine, EPA and combination groups, respectively.
  
  
  CONCLUSIONS
  In the present 8 week trial EPA and fluoxetine had equal therapeutic effects in major depressive disorder. EPA + fluoxetine combination was superior to either of them alone.
authors.affiliation: Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Jazayeri
authors.forename: Mehdi
authors.initials: M
authors.lastname: Tehrani-Doost
authors.forename: Seyed A
authors.initials: SA
authors.lastname: Keshavarz
authors.forename: Mostafa
authors.initials: M
authors.lastname: Hosseini
authors.forename: Abolghassem
authors.initials: A
authors.lastname: Djazayery
authors.forename: Homayoun
authors.initials: H
authors.lastname: Amini
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Jalali
authors.forename: Malcolm
authors.initials: M
authors.lastname: Peet
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents; D005473:Fluoxetine; D015118:Eicosapentaenoic Acid