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Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents with SSRI-Resistant Major Depressive Disorder.
PharmaNutrition 2014; 2(2):38-46P

Abstract

Residual depressive symptoms are commonly observed in adolescents with major depressive disorder (MDD) following treatment with selective serotonin reuptake inhibitors (SSRIs). This study combined a case-control analysis and an open-label fish oil (FO) trial to investigate the relationship between long-chain omega-3 (LCn-3) fatty acid status and residual depressive symptoms in SSRI-resistant adolescent MDD patients. Baseline erythrocyte docosahexaenoic acid (DHA)(-28%, p=0.0003), but not eicosapentaenoic acid (EPA)(-18%, p=0.2), was significantly lower in patients (n=20) compared with healthy controls (n=20). Patients receiving 10-week low-dose (2.4 g/d, n=7) and high-dose (16.2 g/d, n=7) FO exhibited significant increases in erythrocyte EPA and DHA composition. In the intent-to-treat sample, depressive symptoms decreased significantly in the high-dose group (n=7, -40%, p<0.0001), and there was a trend in the low-dose group (n=10, -20%, p=0.06). Symptom remission was observed in 40% of patients in the low-dose group and 100% of patients in the high-dose group. There were no significant changes in vital signs and adverse events were rated as mild or moderate in severity. These preliminary findings demonstrate that adolescents with SSRI-resistant depression exhibit robust DHA deficits, and suggest that adjunctive FO supplementation is well-tolerated and effective for increasing LCn-3 fatty acid status and augmenting SSRI antidepressant effects.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati OH 45219.Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati OH 45219.Department of Pathology, University of Cincinnati, Cincinnati OH 45237.Department of Pathology, University of Cincinnati, Cincinnati OH 45237.Department of Pathology, University of Cincinnati, Cincinnati OH 45237.Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati OH 45219.Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati OH 45219.Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati OH 45219.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24772386

Citation

McNamara, Robert K., et al. "Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents With SSRI-Resistant Major Depressive Disorder." PharmaNutrition, vol. 2, no. 2, 2014, pp. 38-46.
McNamara RK, Strimpfel J, Jandacek R, et al. Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents with SSRI-Resistant Major Depressive Disorder. PharmaNutrition. 2014;2(2):38-46.
McNamara, R. K., Strimpfel, J., Jandacek, R., Rider, T., Tso, P., Welge, J. A., ... Delbello, M. P. (2014). Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents with SSRI-Resistant Major Depressive Disorder. PharmaNutrition, 2(2), pp. 38-46.
McNamara RK, et al. Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents With SSRI-Resistant Major Depressive Disorder. PharmaNutrition. 2014 Apr 1;2(2):38-46. PubMed PMID: 24772386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection and Treatment of Long-Chain Omega-3 Fatty Acid Deficiency in Adolescents with SSRI-Resistant Major Depressive Disorder. AU - McNamara,Robert K, AU - Strimpfel,Jennifer, AU - Jandacek,Ronald, AU - Rider,Therese, AU - Tso,Patrick, AU - Welge,Jeffrey A, AU - Strawn,Jeffrey R, AU - Delbello,Melissa P, PY - 2014/4/29/entrez PY - 2014/4/29/pubmed PY - 2014/4/29/medline KW - Adolescents KW - Docosahexaenoic acid KW - Eicosapentaenoic acid KW - Erythrocyte KW - Major depressive disorder (MDD) KW - Omega-3 fatty acids SP - 38 EP - 46 JF - PharmaNutrition JO - PharmaNutrition VL - 2 IS - 2 N2 - Residual depressive symptoms are commonly observed in adolescents with major depressive disorder (MDD) following treatment with selective serotonin reuptake inhibitors (SSRIs). This study combined a case-control analysis and an open-label fish oil (FO) trial to investigate the relationship between long-chain omega-3 (LCn-3) fatty acid status and residual depressive symptoms in SSRI-resistant adolescent MDD patients. Baseline erythrocyte docosahexaenoic acid (DHA)(-28%, p=0.0003), but not eicosapentaenoic acid (EPA)(-18%, p=0.2), was significantly lower in patients (n=20) compared with healthy controls (n=20). Patients receiving 10-week low-dose (2.4 g/d, n=7) and high-dose (16.2 g/d, n=7) FO exhibited significant increases in erythrocyte EPA and DHA composition. In the intent-to-treat sample, depressive symptoms decreased significantly in the high-dose group (n=7, -40%, p<0.0001), and there was a trend in the low-dose group (n=10, -20%, p=0.06). Symptom remission was observed in 40% of patients in the low-dose group and 100% of patients in the high-dose group. There were no significant changes in vital signs and adverse events were rated as mild or moderate in severity. These preliminary findings demonstrate that adolescents with SSRI-resistant depression exhibit robust DHA deficits, and suggest that adjunctive FO supplementation is well-tolerated and effective for increasing LCn-3 fatty acid status and augmenting SSRI antidepressant effects. SN - 2213-4344 UR - https://www.unboundmedicine.com/medline/citation/24772386/Detection_and_Treatment_of_Long_Chain_Omega_3_Fatty_Acid_Deficiency_in_Adolescents_with_SSRI_Resistant_Major_Depressive_Disorder_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24772386/ DB - PRIME DP - Unbound Medicine ER -