[S21.007] Omega-3 Fatty Acids as an Adjunct Therapy for Depression in Multiple Sclerosis: A Randomized, Double-Blind Placebo-Controlled Pilot Trial

Lynne Shinto, Gail Marracci, Lauren Stuber, Dennis Bourdette, Portland, OR

OBJECTIVE: To determine if omega-3 fatty acids (omega-3 FA) is an effective and safe adjunct therapy for depression in multiple sclerosis (MS). BACKGROUND: Depression is common in MS. Pilot studies in unipolar depression report an improvement in depression with omega-3 FA plus antidepressants. This is the first study to evaluate omega-3 FA as an adjunct therapy for depression in MS. DESIGN/METHODS: We conducted a randomized double-blind, placebo-controlled pilot study. Subjects were in included who met the following criteria: age 18-85 yrs;definite diagnosis of MS (MacDonald criteria); mild to moderate depression; stable antidepressant dose > 3 months; not cognitively impaired. Treatment was given for 3 months. Omega-3FA was dosed at 6 g/day containing 1350 mg docosahexaenoic acid(DHA) and 1950 mg eicosapentaenoic acid (EPA). Placebo was soybean oil (6g/day). The primary outcome was the Montgomery-Asberg Depression Rating Scale (MADRS). Secondary outcome measures included Beck's Depression Inventory, Quality of Life (SF-36), Multiple Sclerosis Functional Composite (MSFC), and red blood cell membrane FA levels. Linear mixed model was used to analyze all outcomes. Analysis was adjusted for age and MS disease severity. RESULTS: Thirty-nine subjects were randomized and thirty-one completed the 3-month intervention. Both groups improved on the MADRS score from baseline at 3-months (p< 0.001), although there was no significant difference between groups (p=0.32). Compared to placebo, the group receiving omega-3 FA showed an improvement in Paced Auditory Serial Addition Test (PASAT) score (p=0.03). No serious adverse events occurred. CONCLUSIONS/RELEVANCE: Omega-3 FA as an adjunct therapy for depression is not significantly different than placebo in MS. A significant placebo effect in depression measures was noted. Omega-3 FA was well-tolerated over 3-months. Improvement in PASAT score in subjects taking omega-3 FA warrants further investigation. Supported by: NIH/NCCAM K23AT002155, NIH/NCRRUL1RR024140, Nancy Davis Center Without Walls, Department of Veterans Affairs, Nordic Naturals, Watsonville, CA, USA.
Category - MS and Related Diseases - Clinical Science

Wednesday, April 14, 2010 3:30 PM

Scientific Sessions: Multiple Sclerosis: Clinical Trials II (2:00 PM-4:00 PM)