Docosahexaenoic acid for selective prevention of posttraumatic stress disorder among severely injured patients: a randomized, placebo-controlled trial.

The Journal of clinical psychiatry
Q1
Aug 2015
Citations:38
Influential Citations:2
Interventional (Human) Studies
93
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Methods
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 3 months; allocation blinded.
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.
Results
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.
Limitations
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 3-month follow-up; age-related subgroup finding (<40) not robust; DSM-IV PTSD criteria used.

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...