Omega-3 Fatty Acids for Depression in Multiple Sclerosis: A Randomized Pilot Study
What this study found
Omega-3 fatty acid supplementation did not improve depression more than placebo over 3 months. A 50% or greater MADRS improvement occurred in 47.4% of the omega-3 group versus 45.5% of placebo (p = 0.30); BDI improvement was also not significant (p = 0.20), and total BDI was not significant (p = 0.27). Quality of life outcomes were likewise not significant, including PCS (p = 0.10) and MCS (p = 0.06). The intervention was safe and well tolerated, with 11/21 adverse events reported in the omega-3 arm and no clear signal of serious harm.
- Study & population
- This was a randomized, placebo-controlled pilot study in adults with multiple sclerosis and comorbid treatment-resistant major depressive disorder who were already on stable antidepressant therapy.
- Intervention
- The active intervention was oral omega-3 fatty acid capsules for 3 months: six capsules daily providing 1.95 g EPA and 1.35 g DHA total, taken as 3 capsules in the morning and 3 in the afternoon with food.
- Key limitation
- This was a small pilot trial with only 21 participants in the omega-3 arm and 15 completers, limiting power to detect modest effects.
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Open PDFOriginal abstract
Multiple sclerosis is the most common chronic disabling disease in the central nervous system in young to middle aged adults. Depression is common in multiple sclerosis (MS) affecting between 50–60% of patients. Pilot studies in unipolar depression report an improvement in depression when omega-3 fatty acids are given with antidepressants. The objective of this study was to investigate whether omega-3 fatty acid supplementation, as an augmentation therapy, improves treatment-resistant major depressive disorder (MDD) in people with MS. We performed a randomized, double-blind, placebo-controlled pilot study of omega-3 fatty acids at six grams per day over three months. The primary outcome was a 50% or greater improvement on the Montgomery-Asberg Depression Rating Scale (MADRS). Thirty-nine participants were randomized and thirty-one completed the 3-month intervention. Improvement on MADRS between groups was not significantly different at the 3-month end point with 47.4% in the omega-3 fatty acid group and 45.5% in the placebo group showing 50% or greater improvement (p = 0.30). Omega-3 fatty acids as an augmentation therapy for treatment-resistant depression in MS was not significantly different than placebo in this pilot trial. Omega-3 fatty acid supplementation at the dose given was well-tolerated over 3 months. Trial Registration ClinicalTrials.gov NCT00122954