Docosahexaenoic acid for selective prevention of posttraumatic stress disorder among severely injured patients: a randomized, placebo-controlled trial.
What this study found
No benefit of DHA+EPA over placebo for PTSD prevention at 3 months. CAPS total score at 3 months: 10.78 (DHA) vs 9.22 (placebo); P=0.572 (n=100). PTSD diagnosed in 11.1% of DHA vs 5.5% of placebo. Erythrocyte DHA and EPA increased in the DHA group (P<0.01), confirming adherence. Conclusion: DHA supplementation was not superior to placebo for secondary prevention of PTSD symptoms at 3 months; the optimal DHA:EPA ratio and higher omega-3 doses for PTSD prevention remain to be determined.
- Study & population
- Randomized, double-blind, placebo-controlled trial in accident-injured adults admitted to the ICU at National Disaster Medical Center, Tokyo, Japan; N=110 (53 assigned to DHA, 57 to placebo); treatment began within days after injury; follow-up for 3 months; adherence assessed by erythrocyte fatty acids; PTSD and other psychiatric outcomes assessed at 1 and…
- Intervention
- Seven 300 mg capsules daily of concentrated marine fish oil delivering 1,470 mg DHA and 147 mg EPA for 12 weeks, taken orally; started about 3.4 days after injury; includes 0.3% alpha-tocopherol.
- Key limitation
- Single-center study in Tokyo; high baseline omega-3 status (erythrocyte omega-3 ~7.6%) and seafood intake may cause ceiling effects; excluded frequent fish consumers; planned sample size not reached (110 analyzed vs 140 planned) with ~9% dropout; results may not generalize to other populations or countries; short…
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Open PDFOriginal abstract
OBJECTIVE Docosahexaenoic acid (DHA) might help prevent or attenuate posttraumatic stress disorder (PTSD) symptoms. We examined the efficacy and safety of DHA for preventing PTSD (DSM-IV) after severe accidental injury. METHOD From December 2008 to August 2013, we conducted a randomized, double-blind, placebo-controlled trial of 110 accident-injured patients consecutively admitted to an intensive care unit of the National Disaster Medical Center in Tokyo, Japan. All patients were taught about their psychological reactions to accidental injury for 20 minutes and were randomly assigned to receive 1,470 mg/d of DHA plus 147 mg/d of eicosapentaenoic acid (EPA; n = 53) or placebo (n = 57) for 12 weeks. The primary outcome was total score on the Clinician-Administered PTSD Scale (CAPS) at 3-month follow-up. Secondary outcomes included PTSD diagnosis (full-blown or partial PTSD). Adherence to the interventions was assessed by erythrocyte fatty acid composition. RESULTS At 3 months, the CAPS total score revealed no differences between the 2 groups (10.78 in the DHA group vs 9.22 in the placebo group; n = 100; P = .572). We found that 11.1% of the DHA group and 5.5% of the placebo group developed PTSD. The erythrocyte level of DHA and EPA in the DHA group was significantly elevated compared to the placebo group (P < .01). CONCLUSIONS Docosahexaenoic acid supplementation was not superior to placebo for the secondary prevention of PTSD symptoms at 3 months after severe accidental injury. The efficacy of a different ratio of DHA and EPA and higher doses of omega-3 fatty acids as secondary prevention of PTSD remains to be determined. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00671099.