title: Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial.
abstract: BACKGROUND
  Psychological distress (PD) and depressive symptoms are commonly observed during menopausal transition. Studies suggest that omega-3 (n-3) fatty acids may help alleviate depression.
  
  
  OBJECTIVE
  The objective was to compare enriched ethyl-eicosapentaenoic acid (E-EPA) supplementation with placebo for the treatment of PD and depressive symptoms in middle-aged women.
  
  
  METHODS
  Women with moderate-to-severe PD (n = 120) were randomly assigned to receive 1.05 g E-EPA/d plus 0.15 g ethyl-docosahexaenoic acid/d (n = 59) or placebo (n = 61) for 8 wk. The main outcomes were 8-wk changes in PD scores [Psychological General Well-Being Schedule (PGWB)] and depressive scales [20-item Hopkins Symptom Checklist Depression Scale (HSCL-D-20) and the 21-item Hamilton Depression Rating Scale (HAM-D-21)].
  
  
  RESULTS
  At baseline, women with PD were mildly to moderately depressed, and 24% met the major depressive episode (MDE) criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. After 8 wk, outcomes improved in both groups, but no significant differences were noted between them. Stratification analyses for MDE diagnosis at baseline indicated that differences in adjusted 8-wk changes between the E-EPA group without MDE (n = 46) and the placebo group (n = 45) were 8.0 (95% CI: 0.6, 15.3; P = 0.034) for the PGWB, -0.2 (95% CI: -0.01, -0.4; P = 0.040) for the HSCL-D-20, and -2.7 (95% CI: -0.3, -5.1; P = 0.030) for the HAM-D-21. Differences in adjusted 8-wk changes between the E-EPA group with MDE (n = 13) and the placebo group (n = 16) were not significant.
  
  
  CONCLUSIONS
  To our knowledge, this is the first trial of n-3 supplementation in the treatment of PD and depressive symptoms in middle-aged women. In women with PD without MDE at baseline, the 8-wk changes in PD and depressive scales improved significantly more with E-EPA than with placebo. This trial was registered at http://www.controlled-trials.com as ISRCTN69617477.
authors.affiliation: Lucie and André Chagnon Chair for the Teaching of an Integrated Approach in Prevention, Laval University, Saint-François d'Assise Hospital (CHUQ), Quebec, Canada. michel.lucas@crchul.ulaval.ca
authors.forename: Michel
authors.initials: M
authors.lastname: Lucas
authors.forename: Geneviève
authors.initials: G
authors.lastname: Asselin
authors.forename: Chantal
authors.initials: C
authors.lastname: Mérette
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Poulin
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dodin
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008603:Mental Health; D008609:Mental Status Schedule; D008875:Middle Aged; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D010919:Placebos; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid