Omega-3 fatty acids for major depressive disorder during pregnancy: Results from a randomized, double-blind, placebo-controlled trial

Journal of Clinical Psychiatry

Volumn 69, Issue 4, 2008, Pages 644-651

  Su, Kuan Pin ^a,b,c   Huang, Shih Yi ^b   Chiu, Tsan Hung ^a   Huang, Kuo Cherh ^b   Huang, Chieh Liang ^a   Chang, Hui Chih ^b,c   Pariante, Carmine M ^c  

^a CHINA MEDICAL UNIVERSITY HOSPITAL   (Taiwan)

^b TAIPEI MEDICAL UNIVERSITY   (Taiwan)

^c KING'S COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

OMEGA 3 FATTY ACID; PLACEBO; PSYCHOTROPIC AGENT; TERT BUTYLHYDROQUINONE; TOCOPHEROL DERIVATIVE;

ADULT; ARTICLE; CLINICAL ARTICLE; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DEMOGRAPHY; DIARRHEA; DISEASE ASSOCIATION; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG SAFETY; DRUG TOLERABILITY; FEMALE; HUMAN; INSOMNIA; MAJOR DEPRESSION; MONOTHERAPY; NAUSEA; NEWBORN CARE; PERINATAL PERIOD; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SYMPTOMATOLOGY; TREATMENT OUTCOME; TREATMENT RESPONSE;

EID: 44849092681     PISSN: 01606689     EISSN: None     Source Type: Journal    
DOI: 10.4088/JCP.v69n0418     Document Type: Article

References (68)

1. Wisner KL, Zarin DA, Holmboe ES, et al. Risk-benefit decision making for treatment of depression during pregnancy. Am J Psychiatry 2000;157:1933-1940
2. Lee DT, Chan SS, Sahota DS, et al. A prevalence study of antenatal depression among Chinese women. J Affect Disord 2004;82:93-99
3. Evans J, Heron J, Francomb H, et al. Cohort study of depressed mood during pregnancy and after childbirth. BMJ 2001;323:257-260
4. Kitamura T, Sugawara M, Shima S, et al. Temporal variation of validity of self-rating questionnaires: improved validity of repeated use of Zung's Self-Rating Depression Scale among women during the perinatal period. J Psychosom Obstet Gynaecol 1999;20:112-117
5. Kumar R, Robson KM. A prospective study of emotional disorders in childbearing women. Br J Psychiatry 1984;144:35-47
6. Gaynes BN, Gavin N, Meltzer-Brody S, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ) 2005;119(Feb):1-8
7. Gotlib IH, Whiffen VE, Mount JH, et al. Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. J Consult Clin Psychol 1989;57:269-274
8. O'Hara MW, Neunaber DJ, Zekoski EM. Prospective study of postpartum depression: prevalence, course, and predictive factors. J Abnorm Psychol 1984;93:158-171
9. Hedegaard M, Henriksen TB, Sabroe S, et al. Psychological distress in pregnancy and preterm delivery. BMJ 1993;307:234-239
10. Pagel MD, Smilkstein G, Regen H, et al. Psychosocial influences on new born outcomes: a controlled prospective study. Soc Sci Med 1990;30:597-604
11. Wadhwa PD, Sandman CA, Porto M, et al. The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol 1993;169:858-865
12. Teixeira JM, Fisk NM, Glover V. Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ 1999;318:153-157
13. Cohen LS, Altshuler LL, Harlow BL, et al. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA 2006;295:499-507
14. Moses-Kolko EL, Bogen D, Perel J, et al. Neonatal signs after late in utero exposure to serotonin reuptake inhibitors: literature review and implications for clinical applications. JAMA 2005;293:2372-2383
15. Chambers CD, Johnson KA, Dick LM, et al. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 1996;335:1010-1015
16. Suri R, Altshuler L, Hellemann G, et al. Effects of antenatal depression and antidepressant treatment on gestational age at birth and risk of preterm birth. Am J Psychiatry 2007;164:1206-1213
17. Freeman MP. Antenatal depression: navigating the treatment dilemmas. Am J Psychiatry 2007;164:1162-1165
18. Rubin R. The baby or the drug? it's a choice that many pregnant women often face - but shouldn't. US News and World Report Mar 27, 1995:59
19. Torpy JM, Lynm C, Glass RM. JAMA patient page. Eating fish: health benefits and risks. JAMA 2006;296:1926
20. Akabas SR, Deckelbaum RJ. Summary of a workshop on n-3 fatty acids: current status of recommendations and future directions. Am J Clin Nutr 2006;83:1536S-1538S
21. Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA 2006;296:1885-1899
22. Burr GO, Burr MM. A new deficiency disease produced by the rigid exclusion of fat from the diet. J Biol Chemistry 1929;82:345-367
23. Hornstra G. Essential fatty acids in mothers and their neonates. Am J Clin Nutr 2000;71:1262S-1269S
24. Al MD, van Houwelingen AC, Hornstra G. Long-chain polyunsaturated fatty acids, pregnancy, and pregnancy outcome. Am J Clin Nutr 2000;71:285S-291S
25. Horrobin DF, Bennett CN. Depression and bipolar disorder: relationships to impaired fatty acid and phospholipid metabolism and to diabetes, cardiovascular disease, immunological abnormalities, cancer, ageing and osteoporosis: possible candidate genes. Prostaglandins Leukot Essent Fatty Acids 1999;60:217-234
26. Tanskanen A, Hibbeln JR, Tuomilehto J, et al. Fish consumption and depressive symptoms in the general population in Finland. Psychiatr Serv 2001;52:529-531
27. Tanskanen A, Hibbeln JR, Hintikka J, et al. Fish consumption, depression, and suicidality in a general population. Arch Gen Psychiatry 2001;58:512-513
28. Hibbeln JR. Fish consumption and major depression. Lancet 1998;351:1213
29. Peet M, Murphy B, Shay J, et al. Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Biol Psychiatry 1998;43:315-319
30. Adams PB, Lawson S, Sanigorski A, et al. Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression. Lipids 1996;31(suppl):S157-S161
31. Edwards R, Peet M, Shay J, et al. Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord 1998;48:149-155
32. Maes M, Smith R, Christophe A, et al. Fatty acid composition in major depression: decreased omega 3 fractions in cholesteryl esters and increased C20: 4 omega 6/C20:5 omega 3 ratio in cholesteryl esters and phospholipids. J Affect Disord 1996;38:35-46
33. Maes M, Christophe A, Delanghe J, et al. Lowered omega3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients. Psychiatry Res 1999;85:275-291
34. Logan AC. Neurobehavioral aspects of omega-3 fatty acids: possible mechanisms and therapeutic value in major depression. Altern Med Rev 2003;8:410-425
35. Freeman MP, Hibbeln JR, Wisner KL, et al. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry 2006;67:1954-1967
36. Lin PY, Su KP. A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry 2007;68:1056-1061
37. Su KP, Huang SY, Chiu CC, et al. Omega-3 fatty acids in major depressive disorder: a preliminary double-blind, placebo-controlled trial. Eur Neuropsychopharmacol 2003;13:267-271
38. 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;159:477-479
39. Peet M, Horrobin DF. A dose-ranging study of the effects of ethyleicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Arch Gen Psychiatry 2002;59:913-919
40. Frangou S, Lewis M, McCrone P. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Br J Psychiatry 2006;188:46-50
41. Nemets H, Nemets B, Apter A, et al. Omega-3 treatment of childhood depression: a controlled, double-blind pilot study. Am J Psychiatry 2006;163:1098-1100
42. Chiu CC, Huang SY, Shen WW, et al. Omega-3 fatty acids for depression in pregnancy. Am J Psychiatry 2003;160:385
43. Su KP, Shen WW, Huang SY. The use of omega-3 fatty acids for the management of depression and psychosis during pregnancy and breast-feeding. In: Peet M, Glen I, Horrobin DF, eds. Phospholipid Spectrum Disorder in Psychiatry and Neurology. 2nd ed. Carnforth, United Kingdom: Marius Press; 2003:391-399
44. Freeman MP, Hibbeln JR, Wisner KL, et al. An open trial of omega-3 fatty acids for depression in pregnancy. Acta Neuropsychiatrica 2006;18:21-24
45. Olsen SF, Sorensen JD, Secher NJ, et al. Randomised controlled trial of effect of fish-oil supplementation on pregnancy duration. Lancet 1992;339:1003-1007
46. McNamara RK, Carlson SE. Role of omega-3 fatty acids in brain development and function: potential implications for the pathogenesis and prevention of psychopathology. Prostaglandins Leukot Essent Fatty Acids 2006;75:329-349
47. Cohen JT, Bellinger DC, Connor WE, et al. A quantitative analysis of prenatal intake of n-3 polyunsaturated fatty acids and cognitive development. Am J Prev Med 2005;29:366-374
48. Uauy R, Hoffman DR, Mena P, et al. Term infant studies of DHA and ARA supplementation on neurodevelopment: results of randomized controlled trials. J Pediatr 2003;143:S17-S25
49. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(suppl 20):22-33
50. Su KP, Chiu TH, Huang CL, et al. Different cutoff points for different trimesters? the use of Edinburgh Postnatal Depression Scale and Beck Depression Inventory to screen for depression in pregnant Taiwanese women. Gen Hosp Psychiatry 2007;29:436-441
51. Chiu CC, Huang SY, Su KP, et al. Polyunsaturated fatty acid deficit in patients with bipolar mania. Eur Neuropsychopharmacol 2003;13:99-103
52. Delion S, Chalon S, Guilloteau D, et al. Age-related changes in phospholipid fatty acid composition and monoaminergic neurotransmission in the hippocampus of rats fed a balanced or an n-3 polyunsaturated fatty acid-deficient diet. J Lipid Res 1997;38:680-689
53. Delion S, Chalon S, Guilloteau D, et al. Alpha-linolenic acid dietary deficiency alters age-related changes of dopaminergic and serotoninergic neurotransmission in the rat frontal cortex. J Neurochem 1996;66:1582-1591
54. Delion S, Chalon S, Herault J, et al. Chronic dietary alpha-linolenic acid deficiency alters dopaminergic and serotonergic neurotransmission in rats. J Nutr 1994;124:2466-2475
55. Rapoport SI, Bosetti F. Do lithium and anticonvulsants target the brain arachidonic acid cascade in bipolar disorder? Arch Gen Psychiatry 2002;59:592-596
56. Noponen M, Sanfilipo M, Samanich K, et al. Elevated PLA2 activity in schizophrenics and other psychiatric patients. Biol Psychiatry 1993;34:641-649
57. Chang MC, Contreras MA, Rosenberger TA, et al. Chronic valproate treatment decreases the in vivo turnover of arachidonic acid in brain phospholipids: a possible common effect of mood stabilizers. J Neurochem 2001;77:796-803
58. Rintala J, Seemann R, Chandrasekaran K, et al. 85 kDa cytosolic phospholipase A2 is a target for chronic lithium in rat brain. Neuroreport 1999;10:3887-3890
59. Chang MC, Jones CR. Chronic lithium treatment decreases brain phospholipase A2 activity. Neurochem Res 1998;23:887-892
60. Ghelardoni S, Tomita YA, Bell JM, et al. Chronic carbamazepine selectively downregulates cytosolic phospholipase A2 expression and cyclooxygenase activity in rat brain. Biol Psychiatry 2004;56:248-254
61. Lamberg L. Risks and benefits key to psychotropic use during pregnancy and postpartum period. JAMA 2005;294:1604-1608
62. Einarson A, Selby P, Koren G. Abrupt discontinuation of psychotropic drugs during pregnancy: fear of teratogenic risk and impact of counselling. J Psychiatry Neurosci 2001;26:44-48
63. Freeman MP. Omega-3 fatty acids and perinatal depression: a review of the literature and recommendations for future research. Prostaglandins Leukot Essent Fatty Acids 2006;75:291-297
64. Blanchard DS. Omega-3 fatty acid supplementation in perinatal settings. MCN Am J Matern Child Nurs 2006;31:250-256
65. Hsu CS, Liu PL, Chien LC, et al. Mercury concentration and fish consumption in Taiwanese pregnant women. BJOG 2007;114:81-85
66. Huang SY, Yang HT, Chiu CC, et al. Omega-3 fatty acids on the forced-swimming test. J Psychiatr Res 2008;42:58-63
67. Arterburn LM, Hall EB, Oken H. Distribution, interconversion, and dose response of n-3 fatty acids in humans. Am J Clin Nutr 2006;83:1467S-1476S
68. Hampton T. Antidepressants and pregnancy: weighing risks and benefits no easy task. JAMA 2006;295:1631-1633