The addition of eicosapentaenoic acid (EPA) to sertraline showed no antidepressant effects in patients with comorbid depression and coronary heart disease (CHD), according to study results published in the Journal of Clinical Psychiatry.
Between May 2014 and June 2018, researchers conducted a placebo-controlled randomized study of 144 patients with major depressive disorder and had or were at high risk for coronary heart disease (CHD). Study participants were randomly assigned to receive either EPA and sertraline (n=71) or corn oil placebo and sertraline (n=73) for a total of 10 weeks. Patients received 2 g/d of EPA in addition to 50 mg/d of sertraline or placebo plus 50 mg/d of sertraline. The primary outcome measured was the change in depressive symptom score using the Beck Depression Inventory II from start of therapy to 10 weeks.
After analysis, the researchers found no statistically significant difference between patients given EPA vs placebo (Beck Depression Inventory score, 12.1 vs 10.3; P =.22). With respect to safety, mild gastrointestinal concerns were the most commonly reported adverse event (49.3% vs 45.2%; P =.62; EPA and placebo arms, respectively) in the study.
One key limitation of the study was the short duration of omega-3 treatment. “It is also possible that an effect of EPA augmentation would have been detectable had we chosen another antidepressant or administered a higher dose of sertraline,” the researchers acknowledged.
“Identifying the characteristics of cardiac patients whose depression may benefit from omega-3 and clarifying the pathways linking omega-3 to improvement in depression symptoms are important directions for future research,” they concluded.
Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, Harris WS. A randomized placebo-controlled trial of omega-3 and sertraline in depressed patients with or at risk for coronary heart disease. J Clin Psychiatry. 2019;80(4):19m12742.