Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial
Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, Harris WS
JAMA · 93 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (R01 HL076808); National Heart, Lung, and Blood Institute (R01 HL076808-01A1)
Según 2 financiadores declarados.
Publicación
- Publicado
- 2009-10-20 · JAMA · vol. 302 · número 15 · pág. 1651
- Editorial
- American Medical Association
- Citado
- 141 citas · más que el 99% de estudios similares · 13.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 42 trabajos
- Acceso
- Acceso abierto (copia en repositorio)
- Áreas de investigación
- Fatty Acid Research and Health · Treatment of Major Depression · Tryptophan and brain disorders
- Palabras clave
- omega-3 fatty acids, sertraline, depression, coronary artery disease, antidepressant augmentation, eicosapentaenoic acid, docosahexaenoic acid, omega-3 acid ethyl esters, major depressive disorder, depression remission, medication adherence, antidepressant efficacy
- MeSH
- humans, coronary disease, sertraline, fatty acids, omega-3, docosahexaenoic acids, eicosapentaenoic acid, antidepressive agents, double-blind method, comorbidity, drug synergism, dietary supplements, middle aged, female, male, major depressive disorder
6 autores
- Robert M. Carney🇺🇸Washington University in St. Louis
- Kenneth E. Freedland🇺🇸Washington University in St. Louis
- Eugene H. Rubin🇺🇸Washington University in St. Louis
- Michael W. Rich🇺🇸Washington University in St. Louis
- Brian C. Steinmeyer🇺🇸Washington University in St. Louis
- William Stephen Harris
Resumen
El texto original del estudio, en el idioma en que se publicó.
Context
Studies of depressed psychiatric patients have shown that antidepressant efficacy can be increased by augmentation with omega-3 fatty acids.
Objective
To determine whether omega-3 improves the response to sertraline in patients with major depression and coronary heart disease (CHD).
Design, setting, and participants
Randomized controlled trial. Between May 2005 and December 2008, 122 patients in St Louis, Missouri, with major depression and CHD were randomized.
Interventions
After a 2-week run-in period, all patients were given 50 mg/d of sertraline and randomized in double-blind fashion to receive 2 g/d of omega-3 acid ethyl esters (930 mg of eicosapentaenoic acid [EPA] and 750 mg of docosahexaenoic acid [DHA]) (n=62) or to corn oil placebo capsules (n=60) for 10 weeks.
Main outcome measures
Scores on the Beck Depression Inventory (BDI-II) and the Hamilton Rating Scale for Depression (HAM-D).
Results
Adherence to the medication regimen was 97% or more in both groups for both medications. There were no differences in weekly BDI-II scores (treatment x time interaction = 0.02; 95% confidence interval [CI], -0.33 to 0.36; t(112) = 0.11; P = .91), pre-post BDI-II scores (placebo, 14.8 vs omega-3, 16.1; 95% difference-in-means CI, -4.5 to 2.0; t(116) = -0.77; P = .44), or HAM-D scores (placebo, 9.4 vs omega-3, 9.3; 95% difference-in-means CI, -2.2 to 2.4; t(115) = 0.12; P = .90). The groups did not differ on predefined indicators of depression remission (BDI-II 50% reduction in BDI-II from baseline: placebo, 49.0% vs omega-3, 47.7%; OR, 1.06; 95% CI, 0.51-2.19; t(112) = 0.15; P = .88).
Conclusions
Treatment of patients with CHD and major depression with sertraline and omega-3 fatty acids did not result in superior depression outcomes at 10 weeks, compared with sertraline and placebo. Whether higher doses of omega-3 or sertraline, a different ratio of EPA to DHA, longer treatment, or omega-3 monotherapy can improve depression in patients with CHD remains to be determined.
Trial registration
clinicaltrials.gov Identifier: NCT00116857.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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