It was depressing (word play intended!) to find out in the last few years how much the major pharmaceutical companies have suppressed or distorted evidence about the effectiveness of prescription antidepressants. These big sellers for the Pharma companies (we’re talking about tradenames like Prozac, Zoloft, Paxil, Lexapro) turn out to be less effective–and less frequently effective–than the massive TV and print advertising campaigns might suggest. Indeed there are many people who receive very limited benefit from taking them, while also enduring side effects ranging from sexual dysfunction to increased risk of suicide.
It’s no wonder, then, that there’s been a steady stream of research in the last few years devoted to identifying non-prescription alternatives and adjunct treatments for depression. One of the most promising choices has turned out to be omega-3 fatty acids, found in fish and now widely available in fish oil supplements. In the past, epidemiological studies found suggestive correlations between high fish consumption and low levels of depression in various communities and populations. But more recently, there have also been controlled trials using omega-3 fatty acid supplements for depression, which provide evidence of effectiveness comparable to that expected for the approval of prescription drugs. Here’s a brief summary of two such trials, which show notably improved results and decreased side effects when omega-3 fatty acid supplements are added to standard antidepressant treatment:
1. Twenty patients with a diagnosis of major depressive disorder participated in a 4-week, parallel-group, double-blind addition of either placebo or an omega-3 fatty acid supplement to ongoing antidepressant therapy. Seventeen of the patients were women, and three were men. RESULTS: Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment. (Nemets et al.)
2. Seventy patients with persistent depression despite ongoing treatment with an adequate dose of a standard antidepressant were randomized on a double-blind basis to placebo or an omega-3 fatty acid supplement at dosages of 1, 2, or 4 g/d for 12 weeks in addition to unchanged background medication. Patients underwent assessment using the 17-item Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale, and the Beck Depression Inventory.
The 1-g/d group showed a significantly better outcome than the placebo group on all 3 rating scales. All of the individual items on all 3 rating scales improved with the 1-g/d dosage of the omega-3 fatty acid supplement vs placebo, with strong beneficial effects on items rating depression, anxiety, sleep, lassitude, libido, and suicidality. (Peet et al.)
A review article on fish oil and other nutrients for treatment of depression: Volker D, Ng J. Depression: Does nutrition have an adjunctive treatment role? Nutrition and Dietetics. 2006 December; 63(4):213
Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Am J Psychiatry. 2002 Mar;159(3):477-9
Peet, M and Horrobin, D. 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. 2002;59:913-919.
NYBC recommends this fish oil supplement: