Author information
1Department of Psychiatry & Mind-Body Interface Laboratory (K-PS, JP-CC, H-CC); School of Medicine (K-PS); Department of Psychological Medicine (K-PS, H-CC, CMP), Institute of Psychiatry, King's College London, London, United Kingdom.
2Department of Hepatogastroenterology (H-CL, W-PS, C-YP), China Medical University Hospital.
3Department of Nutrition (H-TY), China Medical University, Taichung, Taiwan.
4Department of Psychiatry & Mind-Body Interface Laboratory (K-PS, JP-CC, H-CC).
5Department of Psychiatry & Mind-Body Interface Laboratory (K-PS, JP-CC, H-CC); School of Health Care Administration, Taipei Medical University, Taipei, Taiwan (H-CC).
6Department of Psychological Medicine (K-PS, H-CC, CMP), Institute of Psychiatry, King's College London, London, United Kingdom. Electronic address: carmine.pariante@kcl.ac.uk.
Abstract
BACKGROUND:
Interferon (IFN)-α therapy for chronic hepatitis C virus infection is frequently associated with depression. The routine prophylaxis with antidepressants might expose patients to adverse effects, hence, the need for alternative preventive interventions. Omega-3 polyunsaturated fatty acids are safe and effective essential nutritional compounds used for the treatment of depression, putatively through an anti-inflammatory action. In addition, lower erythrocyte levels of omega-3 polyunsaturated fatty acids have been associated with an increased risk of IFN-induced depression.
METHODS:
We conducted a 2-week, double-blind, placebo-controlled trial comparing eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and placebo for the prevention of IFN-α-induced depression. A total of 162 patients consented to participate and were randomized to the study. All of the patients completed the 2-week trial; 152 participants were followed throughout the 24 weeks of IFN-α treatment and were included in the analysis.
RESULTS:
Compared with placebo, the incident rates of IFN-α-induced depression were significantly lower in EPA-treated but not in DHA-treated patients (10% and 28%, respectively, versus 30% for placebo, p = .037). Both EPA and DHA significantly delayed the onset of IFN-induced depression (week of onset: 12.0 and 11.7, respectively, versus 5.3 for placebo, p = .002). EPA and DHA were both well tolerated in this population. EPA treatment increased both EPA and DHA erythrocyte levels, but DHA only increased DHA erythrocyte levels.
CONCLUSIONS:
EPA is effective in the prevention of depression in hepatitis C virus patients received IFN-α therapy. Our study confirms the notion that anti-inflammatory strategies are effective antidepressants in the context of depression associated with inflammation.