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Published in: European Archives of Psychiatry and Clinical Neuroscience 8/2011

01-12-2011 | Original Paper

The effect of low-dose omega 3 fatty acids on the treatment of mild to moderate depression in the elderly: a double-blind, randomized, placebo-controlled study

Authors: Yaser Tajalizadekhoob, Farshad Sharifi, Hossein Fakhrzadeh, Mojde Mirarefin, Maryam Ghaderpanahi, Zohre Badamchizade, Solaleh Azimipour

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 8/2011

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Abstract

Due to the rise in the social and economic costs of depression, new antidepressant medication with fewer side effects should be found. Several studies have shown that an association exists between ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and depression. However, this association has not been clear enough in the elderly with mild to moderate depression. Sixty-six inhabitants of Kahrizak Charity Foundation participated in this double-blind, randomized, placebo-controlled study. Each participant was ≥ 65 years of age, had a Mini Mental State Exam of ≥ 22, and had scores ranging from 5 to 11 on the Geriatric Depression Scale-15 (GDS-15). During the 6 months, the drug group was treated daily with one gram of fish oil capsule containing 300 mg of both eicosapentaenoic acid and docosahexaenoic acid. No significant differences were noted between the groups in regard to level of education, use of antidepressant drugs, alcohol, tobacco use, history of chronic diseases, age, body mass index (BMI), high-sensitive C-reactive protein (hs-CRP), total cholesterol, and GDS-15 scores at baseline. After adjusting for cholesterol, BMI, and history of thyroid dysfunctions, a statistically significant difference was seen in GDS-15 scores between both groups. Furthermore, treatment with ω-3 PUFAs was clinically more effective in treating depression in comparison with the placebo. In this study, low-dose ω-3 PUFAs had some efficacy in the treatment of mild to moderate depression in elderly participants.
Literature
1.
go back to reference Blazer DG, Kessler RC, McGonagle KA et al (1994) The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry 151(7):979–986 (PMID: 8010383)PubMed Blazer DG, Kessler RC, McGonagle KA et al (1994) The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry 151(7):979–986 (PMID: 8010383)PubMed
2.
go back to reference Steffens DC, Skoog I, Norton MC et al (2000) Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry 57(6):601–607 (PMID: 10839339)PubMedCrossRef Steffens DC, Skoog I, Norton MC et al (2000) Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry 57(6):601–607 (PMID: 10839339)PubMedCrossRef
3.
go back to reference Unutzer J, Patrick DL, Simon G et al (1997) Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 277(20):1618–1623 (PMID: 9168292)PubMedCrossRef Unutzer J, Patrick DL, Simon G et al (1997) Depressive symptoms and the cost of health services in HMO patients aged 65 years and older. A 4-year prospective study. JAMA 277(20):1618–1623 (PMID: 9168292)PubMedCrossRef
4.
go back to reference Schoevers RA, Geerlings MI, Beekman AT et al (2000) Association of depression and gender with mortality in old age. Results from the Amsterdam Study of the Elderly (AMSTEL). Br J Psychiatry 177:336–342 (PMID: 11116775)PubMedCrossRef Schoevers RA, Geerlings MI, Beekman AT et al (2000) Association of depression and gender with mortality in old age. Results from the Amsterdam Study of the Elderly (AMSTEL). Br J Psychiatry 177:336–342 (PMID: 11116775)PubMedCrossRef
5.
go back to reference Ziegelstein RC (2001) Depression in patients recovering from a myocardial infarction. JAMA 286(13):1621–1627 (PMID: 11585486)PubMedCrossRef Ziegelstein RC (2001) Depression in patients recovering from a myocardial infarction. JAMA 286(13):1621–1627 (PMID: 11585486)PubMedCrossRef
6.
go back to reference Cui X, Lyness JM, Tu X, King DA et al (2007) Does depression precede or follow executive dysfunction? Outcomes in older primary care patients. Am J Psychiatry 164(8):1221–1228 (PMID: 17671285)PubMedCrossRef Cui X, Lyness JM, Tu X, King DA et al (2007) Does depression precede or follow executive dysfunction? Outcomes in older primary care patients. Am J Psychiatry 164(8):1221–1228 (PMID: 17671285)PubMedCrossRef
7.
go back to reference Steffens DC, Otey E, Alexopoulos GS et al (2006) Perspectives on depression, mild cognitive impairment, and cognitive decline. Arch Gen Psychiatry 63(2):130–138 (PMID: 16461855)PubMedCrossRef Steffens DC, Otey E, Alexopoulos GS et al (2006) Perspectives on depression, mild cognitive impairment, and cognitive decline. Arch Gen Psychiatry 63(2):130–138 (PMID: 16461855)PubMedCrossRef
8.
go back to reference Jackson JL, DeZee K, Berbano E (2004) Can treating depression improve disease outcomes? Ann Intern Med 140(12):1054–1056PubMed Jackson JL, DeZee K, Berbano E (2004) Can treating depression improve disease outcomes? Ann Intern Med 140(12):1054–1056PubMed
9.
go back to reference Krishnan KR (2000) Depression as a contributing factor in cerebrovascular disease. Am Heart J 140(4):S70–S76 (PMID: 11011351)CrossRef Krishnan KR (2000) Depression as a contributing factor in cerebrovascular disease. Am Heart J 140(4):S70–S76 (PMID: 11011351)CrossRef
11.
go back to reference Carnethon MR, Biggs ML, Barzilay JI et al (2007) Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 167(8):802–807 (PMID: 17452543)PubMedCrossRef Carnethon MR, Biggs ML, Barzilay JI et al (2007) Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 167(8):802–807 (PMID: 17452543)PubMedCrossRef
12.
go back to reference Golden SH, Lazo M, Carnethon M et al (2008) Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299(23):2751–2759 (PMID: 18560002)PubMedCrossRef Golden SH, Lazo M, Carnethon M et al (2008) Examining a bidirectional association between depressive symptoms and diabetes. JAMA 299(23):2751–2759 (PMID: 18560002)PubMedCrossRef
13.
go back to reference Gallo JJ, Bogner HR, Morales KH et al (2007) The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med 146(10):689–698 (PMID: 17502629)PubMed Gallo JJ, Bogner HR, Morales KH et al (2007) The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med 146(10):689–698 (PMID: 17502629)PubMed
14.
go back to reference Lavretsky H, Kumar A (2002) Clinically significant non-major depression: old concepts, new insights. Am J Geriatr Psychiatry 10(3):239–255 (PMID: 11994211)PubMed Lavretsky H, Kumar A (2002) Clinically significant non-major depression: old concepts, new insights. Am J Geriatr Psychiatry 10(3):239–255 (PMID: 11994211)PubMed
15.
go back to reference Lyness JM, Heo M, Datto CJ et al (2006) Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Ann Intern Med 144(7):496–504PubMed Lyness JM, Heo M, Datto CJ et al (2006) Outcomes of minor and subsyndromal depression among elderly patients in primary care settings. Ann Intern Med 144(7):496–504PubMed
16.
go back to reference Penninx BW, Geerlings SW, Deeg DJ et al (1999) Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry 56(10):889–895 (PMID: 10530630)PubMedCrossRef Penninx BW, Geerlings SW, Deeg DJ et al (1999) Minor and major depression and the risk of death in older persons. Arch Gen Psychiatry 56(10):889–895 (PMID: 10530630)PubMedCrossRef
17.
go back to reference Williams JW Jr, Barrett J, Oxman T et al (2000) Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA 284(12):1519–1526 (PMID: 11000645)PubMedCrossRef Williams JW Jr, Barrett J, Oxman T et al (2000) Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA 284(12):1519–1526 (PMID: 11000645)PubMedCrossRef
18.
go back to reference National Health Committee (1996) Guidelines for the treatment and management of depression. National Health Committee. Wellington Press, New Zealand National Health Committee (1996) Guidelines for the treatment and management of depression. National Health Committee. Wellington Press, New Zealand
19.
go back to reference McNamara RK, Hahn CG, Jandacek R et al (2007) Selective deficits in the omega-3 fatty acid docosahexaenoic acid in the postmortem orbitofrontal cortex of patients with major depressive disorder. Biol Psychiatry. doi: 10.1016/j.biopsych.2006.08.026 McNamara RK, Hahn CG, Jandacek R et al (2007) Selective deficits in the omega-3 fatty acid docosahexaenoic acid in the postmortem orbitofrontal cortex of patients with major depressive disorder. Biol Psychiatry. doi: 10.​1016/​j.​biopsych.​2006.​08.​026
21.
go back to reference Hibbeln JR, Umhau JC, Linnoila M et al (1998) A replication study of violent and nonviolent subjects: cerebrospinal fluid metabolites of serotonin and dopamine are predicted by plasma essential fatty acids. Biol Psychiatry. doi: 10.1016/S0006-3223(98)001143-7 Hibbeln JR, Umhau JC, Linnoila M et al (1998) A replication study of violent and nonviolent subjects: cerebrospinal fluid metabolites of serotonin and dopamine are predicted by plasma essential fatty acids. Biol Psychiatry. doi: 10.​1016/​S0006-3223(98)001143-7
23.
go back to reference Tanskanen A, Hibbeln JR, Tuomilehto J et al (2001) Fish consumption and depressive symptoms in the general population in Finland. Psychiatr Serv 52(4):529–531 (PMID: 11274502)PubMedCrossRef Tanskanen A, Hibbeln JR, Tuomilehto J et al (2001) Fish consumption and depressive symptoms in the general population in Finland. Psychiatr Serv 52(4):529–531 (PMID: 11274502)PubMedCrossRef
25.
27.
go back to reference Tiemeier H, van Tuijl HR, Hofman A et al (2003) Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr 78(1):40–46 (PMID: 12816769)PubMed Tiemeier H, van Tuijl HR, Hofman A et al (2003) Plasma fatty acid composition and depression are associated in the elderly: the Rotterdam Study. Am J Clin Nutr 78(1):40–46 (PMID: 12816769)PubMed
28.
go back to reference Nemets B, Stahl Z, Belmaker RH (2002) Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 159(3):477–479 (PMID: 11870016)PubMedCrossRef Nemets B, Stahl Z, Belmaker RH (2002) Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry 159(3):477–479 (PMID: 11870016)PubMedCrossRef
29.
go back to reference Peet M, Horrobin DF (2002) A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry 59(10):913–919 (PMID: 12365878)PubMedCrossRef Peet M, Horrobin DF (2002) A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry 59(10):913–919 (PMID: 12365878)PubMedCrossRef
30.
go back to reference Su KP, Huang SY, Chiu CC et al (2003) Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol. doi: 10.1016/S0924-977X(03)00032-4 Su KP, Huang SY, Chiu CC et al (2003) Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol. doi: 10.​1016/​S0924-977X(03)00032-4
32.
go back to reference Frughan M, Jafari Z, Peymaneh S et al (2008) Adapting mini mental state exam of old ages dwelling in Tehran, 2006. J Tazeh-hay-e Oloum Shenaakhti 10(2):29–37 (In Persian) Frughan M, Jafari Z, Peymaneh S et al (2008) Adapting mini mental state exam of old ages dwelling in Tehran, 2006. J Tazeh-hay-e Oloum Shenaakhti 10(2):29–37 (In Persian)
33.
34.
go back to reference Yesavage JA (1988) Geriatric depression scale. Psychopharmacol Bull 24(4):709–711 (PMID: 3249773)PubMed Yesavage JA (1988) Geriatric depression scale. Psychopharmacol Bull 24(4):709–711 (PMID: 3249773)PubMed
35.
go back to reference Malakouti SK, Fatollahi P, Mirabzadeh A et al (2006) Reliability, validity and factor structure of the GDS-15 in Iranian elderly. Int J Geriatr Psychiatry. doi: 10.1002/gps.1533 Malakouti SK, Fatollahi P, Mirabzadeh A et al (2006) Reliability, validity and factor structure of the GDS-15 in Iranian elderly. Int J Geriatr Psychiatry. doi: 10.​1002/​gps.​1533
36.
go back to reference Ghaffarpour M, Hoshiar-Rad A, Kianfar H (1999) The manual for household measures, cooking yield and edible portion of foods. 1 edn. Agriculture Science, Tehran Ghaffarpour M, Hoshiar-Rad A, Kianfar H (1999) The manual for household measures, cooking yield and edible portion of foods. 1 edn. Agriculture Science, Tehran
37.
go back to reference Silvers KM, Woolley CC, Hamilton FC et al (2005) Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. Prostaglandins Leukot Essent Fatty Acids. doi:10.1016/j.plefa.2004.11.004 Silvers KM, Woolley CC, Hamilton FC et al (2005) Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. Prostaglandins Leukot Essent Fatty Acids. doi:10.​1016/​j.​plefa.​2004.​11.​004
38.
go back to reference Astorg P, Couthouis A, Bertrais S et al (2008) Association of fish and long-chain n-3 polyunsaturated fatty acid intakes with the occurrence of depressive episodes in middle-aged French men and women. Prostaglandins Leukot Essent Fatty Acids. doi:10.1016/j.plefa.2008.01.003 Astorg P, Couthouis A, Bertrais S et al (2008) Association of fish and long-chain n-3 polyunsaturated fatty acid intakes with the occurrence of depressive episodes in middle-aged French men and women. Prostaglandins Leukot Essent Fatty Acids. doi:10.​1016/​j.​plefa.​2008.​01.​003
39.
go back to reference Mischoulon D, Best-Popescu C, Laposata M et al (2008) A double-blind dose-finding pilot study of docosahexaenoic acid (DHA) for major depressive disorder. Eur Neuropsychopharmacol 18(9):639–645 (PMID: 18539007)PubMedCrossRef Mischoulon D, Best-Popescu C, Laposata M et al (2008) A double-blind dose-finding pilot study of docosahexaenoic acid (DHA) for major depressive disorder. Eur Neuropsychopharmacol 18(9):639–645 (PMID: 18539007)PubMedCrossRef
41.
go back to reference Polsky D, Doshi JA, Marcus S et al (2005) Long-term risk for depressive symptoms after a medical diagnosis. Arch Intern Med 165:1260–1266 (PMID: 15956005)PubMedCrossRef Polsky D, Doshi JA, Marcus S et al (2005) Long-term risk for depressive symptoms after a medical diagnosis. Arch Intern Med 165:1260–1266 (PMID: 15956005)PubMedCrossRef
42.
go back to reference Eich D, Neuhaus C, Gamma A et al (2007) Is depression a risk factor for heart complaints? Longitudinal aspects in the Zurich study. Eur Arch Psychiatry Clin Neurosci 257:396–401 (PMID: 17902006)PubMedCrossRef Eich D, Neuhaus C, Gamma A et al (2007) Is depression a risk factor for heart complaints? Longitudinal aspects in the Zurich study. Eur Arch Psychiatry Clin Neurosci 257:396–401 (PMID: 17902006)PubMedCrossRef
44.
go back to reference Ladin K (2008) Risk of late-life depression across 10 European Union countries: deconstructing the education effect. J Aging Health 20(6):653–670 (PMID: 18635752)PubMedCrossRef Ladin K (2008) Risk of late-life depression across 10 European Union countries: deconstructing the education effect. J Aging Health 20(6):653–670 (PMID: 18635752)PubMedCrossRef
45.
go back to reference Wu L-T, Anthony JC (1999) Tobacco smoking and depressed mood in late childhood and early adolescence. Am J Public Health 89:1837–1840 (PMID: 10589312)CrossRef Wu L-T, Anthony JC (1999) Tobacco smoking and depressed mood in late childhood and early adolescence. Am J Public Health 89:1837–1840 (PMID: 10589312)CrossRef
46.
go back to reference Goodman E, Capitman J (2000) Depressive symptoms and cigarette smoking among teens. Pediatrics 106:748–755 (PMID: 11015518)PubMedCrossRef Goodman E, Capitman J (2000) Depressive symptoms and cigarette smoking among teens. Pediatrics 106:748–755 (PMID: 11015518)PubMedCrossRef
47.
go back to reference Chaiton M O, Cohen J E, O’Loughlin J et al (2009) A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health. doi: 10.1186/1471-2458-9-356 Chaiton M O, Cohen J E, O’Loughlin J et al (2009) A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health. doi: 10.​1186/​1471-2458-9-356
48.
go back to reference Almeida OP, Calver J, Jamrozik K et al (2009) Obesity and metabolic syndrome increase the risk of incident depression in older men: the health in men study. Am J Geriatr Psychiatry 17(10): 889–898 (PMID: 19910877) Almeida OP, Calver J, Jamrozik K et al (2009) Obesity and metabolic syndrome increase the risk of incident depression in older men: the health in men study. Am J Geriatr Psychiatry 17(10): 889–898 (PMID: 19910877)
49.
go back to reference Koster A, van Gool CH, Kempen GI et al (2010) Late-life depressed mood and weight change contribute to the risk of each other. For the Health ABC Study. Am J Geriatr Psychiatry 18(3):236–244 (PMID: 20224519)PubMed Koster A, van Gool CH, Kempen GI et al (2010) Late-life depressed mood and weight change contribute to the risk of each other. For the Health ABC Study. Am J Geriatr Psychiatry 18(3):236–244 (PMID: 20224519)PubMed
51.
go back to reference Maes M, Scharpe S, Bosmans E et al (1992) Disturbances in acute phase plasma proteins during melancholia: additional evidence for the presence of an inflammatory process during that illness. Prog Neuropsychopharmacol Biol Psychiatry 16:501–515. doi:10.1016/0278-5846(92)90056-K PubMedCrossRef Maes M, Scharpe S, Bosmans E et al (1992) Disturbances in acute phase plasma proteins during melancholia: additional evidence for the presence of an inflammatory process during that illness. Prog Neuropsychopharmacol Biol Psychiatry 16:501–515. doi:10.​1016/​0278-5846(92)90056-K PubMedCrossRef
53.
go back to reference Miller GE, Stetler CA, Carney RM et al (2002) Clinical depression and inflammatory risk markers for coronary heart disease. Am J Cardiol 90:1279–1283PubMedCrossRef Miller GE, Stetler CA, Carney RM et al (2002) Clinical depression and inflammatory risk markers for coronary heart disease. Am J Cardiol 90:1279–1283PubMedCrossRef
54.
go back to reference Luukinen H, Jokelainen J, Hedberg P (2010) The relationships between high-sensitivity C-reactive protein and incident depressed mood among older adults. Scand J Clin Lab Invest 70(2):75–79 ([Epub ahead of print] PMID: 20170291)PubMedCrossRef Luukinen H, Jokelainen J, Hedberg P (2010) The relationships between high-sensitivity C-reactive protein and incident depressed mood among older adults. Scand J Clin Lab Invest 70(2):75–79 ([Epub ahead of print] PMID: 20170291)PubMedCrossRef
55.
go back to reference Appleton KM, Gunnell D, Peters TJ et al (2008) No clear evidence of an association between plasma concentrations of n-3 long-chain polyunsaturated fatty acids and depressed mood in a non-clinical population. Prostaglandins Leukot Essent Fatty Acids 78(6):337–342 (PMID: 18565746)PubMedCrossRef Appleton KM, Gunnell D, Peters TJ et al (2008) No clear evidence of an association between plasma concentrations of n-3 long-chain polyunsaturated fatty acids and depressed mood in a non-clinical population. Prostaglandins Leukot Essent Fatty Acids 78(6):337–342 (PMID: 18565746)PubMedCrossRef
56.
go back to reference Rogers PJ, Appleton KM, Kessler D et al (2008) No effect of n-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial. Br J Nutr 99(2):421–431 (PMID: 17956647)PubMedCrossRef Rogers PJ, Appleton KM, Kessler D et al (2008) No effect of n-3 long-chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomised controlled trial. Br J Nutr 99(2):421–431 (PMID: 17956647)PubMedCrossRef
57.
go back to reference Lam RW, Levitan RD (2000) Pathophysiology of seasonal affective disorder: a review. J Psychiatry Neurosci 25(5):469–480 (PMID: 11109298)PubMed Lam RW, Levitan RD (2000) Pathophysiology of seasonal affective disorder: a review. J Psychiatry Neurosci 25(5):469–480 (PMID: 11109298)PubMed
58.
go back to reference Sohn C-H, Lam RW (2005) Update on the biology of seasonal affective disorder. CNS Spectr 10(8):635–646 (PMID: 16041295)PubMed Sohn C-H, Lam RW (2005) Update on the biology of seasonal affective disorder. CNS Spectr 10(8):635–646 (PMID: 16041295)PubMed
59.
go back to reference Evans M, Mottram P (2000) Diagnosis of depression in elderly patients. Adv Psychiatric Treat 6:49–56. Print ISSN: 1355–5146 Evans M, Mottram P (2000) Diagnosis of depression in elderly patients. Adv Psychiatric Treat 6:49–56. Print ISSN: 1355–5146
60.
go back to reference Gottfries C G (2001) Late life depression. Eur Arch Psychiatry Clin Neurosci 251 (suppl 2): II/57–II/61 (PMID: 11824838) Gottfries C G (2001) Late life depression. Eur Arch Psychiatry Clin Neurosci 251 (suppl 2): II/57–II/61 (PMID: 11824838)
Metadata
Title
The effect of low-dose omega 3 fatty acids on the treatment of mild to moderate depression in the elderly: a double-blind, randomized, placebo-controlled study
Authors
Yaser Tajalizadekhoob
Farshad Sharifi
Hossein Fakhrzadeh
Mojde Mirarefin
Maryam Ghaderpanahi
Zohre Badamchizade
Solaleh Azimipour
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 8/2011
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-011-0191-9

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