title: Effects of 1-year treatment with highly purified omega-3 fatty acids on depression after myocardial infarction: results from the OMEGA trial.
abstract: OBJECTIVE
  The effects of supplementation of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on prevalence and severity of depression were evaluated in patients after a myocardial infarction.
  
  
  METHODS
  A cross-sectional evaluation (posttest-only design) within the prospective, randomized, controlled, multicenter OMEGA trial was performed in patients after myocardial infarction at 12 months' follow-up (N = 2,081; age, mean = 64 years; men, 76.7%; women, 21.8%) from April 2005 to June 2007. Patients received supplementation with ethyl esters 90 (460-mg EPA and 380-mg DHA) or placebo for 12 months. Depression was assessed with the Beck Depression Inventory-II (BDI-II); a BDI-II cutoff score of ≥ 14 was used as diagnosis of depression.
  
  
  RESULTS
  When the total population was evaluated, no effects of EPA/DHA supplementation on depressive symptoms according to BDI-II score (mean [SD]) could be demonstrated: EPA/DHA (n = 1,046), 7.1 (6.9); placebo (n = 1,035), 7.1 (7.0); P = .7. The post hoc analyses of depressed patients with and without antidepressants revealed a tendency toward an antidepressant effect in patients with EPA/DHA supplementation as monotherapy: EPA/DHA (n = 125), 19.4 (5.8); placebo (n = 113), 19.9 (5.1); P = .07. However, in depressed patients with EPA/DHA supplementation as adjunctive to conventional antidepressants, a clinically relevant antidepressant effect was demonstrated: EPA/DHA (n = 33), 20.9 (7.1); placebo (n = 29), 24.9 (8.5); P < .05.
  
  
  CONCLUSIONS
  EPA/DHA supplementation in the total sample of patients after myocardial infarction had no effect on depressive symptoms. The clinically relevant antidepressant effect in the subgroup of depressed patients with EPA/DHA supplementation as adjunctive to conventional antidepressants that was revealed in the post hoc analysis might provide a basis for a controlled, prospective trial of omega-3 augmentation of antidepressants in patients after myocardial infarction.
  
  
  BACKGROUND
  ClinicalTrials.gov identifier: NCT00251134.
authors: Department of Psychiatry, Klinikum rechts der Isar, Technical University of Munich, Meisenweg 7, DE-82237 Wörthsee, Germany reinhilde.zimmer@lrz.tu-muenchen.de.
authors: Reinhilde
authors: R
authors: Zimmer
authors: Thomas
authors: T
authors: Riemer
authors: Bernhard
authors: B
authors: Rauch
authors: Steffen
authors: S
authors: Schneider
authors: Rudolf
authors: R
authors: Schiele
authors: Helmut
authors: H
authors: Gohlke
authors: Frank
authors: F
authors: Diller
authors: Gerhard
authors: G
authors: Steinbeck
authors: Hugo
authors: H
authors: Katus
authors: Jochen
authors: J
authors: Senges
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D015118:Eicosapentaenoic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D005231:Fatty Acids, Unsaturated / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D011594:Psychometrics
chemical_list: D005231:Fatty Acids, Unsaturated; D015118:Eicosapentaenoic Acid; C026219:docosapentaenoic acid