Omega-3 Fatty Acids to Improve Depression and Reduce Cardiovascular Risk Factors
NCT ID: NCT00116857
Last Updated: 2012-09-12
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE3
122 participants
INTERVENTIONAL
2005-02-28
2009-11-30
Brief Summary
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Detailed Description
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Depression is a risk factor for morbidity and mortality following an acute MI and unstable angina. Two recent studies (sertraline versus placebo and sertraline plus cognitive therapy versus usual care) reported only modest reductions in depression following an acute MI or unstable angina, and many treated patients remained depressed. Neither study reported better medical outcomes in the treated patients. Earlier studies found that even subclinical depression increases the risk of mortality in cardiac patients. Thus, more effective treatments are needed to eliminate depression and improve medical outcomes in patients following an acute MI or unstable angina. Omega-3 FAs have been shown to augment the efficacy of antidepressants for major depression and to improve several cardiac risk factors. However, these findings have been shown in separate lines of research. No previous study has investigated whether omega-3 FAs can simultaneously improve depression and reduce cardiovascular risk factors in post-MI patients.
DESIGN NARRATIVE:
One hundred fifty patients who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for a current major depressive episode and who score 15 or higher on the Beck Depression Inventory II with a history of acute MI, unstable angina, or other cardiac event will be enrolled in a randomized, double-blind, placebo-controlled trial of omega-3 augmentation of sertraline. The participants will be randomly assigned to receive either sertraline plus omega-3 or sertraline plus placebo for 10 weeks. At baseline and again after ten weeks, the subjects will complete the following: 1) assessments of depression and psychosocial functioning; 2) 24-hour electrocardiogram monitoring for heart rate variability analysis; and 3) blood draws to measure procoagulant and proinflammatory markers, and plasma levels of sertraline and omega-3. If this study shows that omega-3 reduces depression and improves cardiovascular disease markers, there will be a basis for proposing a larger clinical trial to determine whether it can also improve survival after hospitalization for acute MI or unstable angina.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
QUADRUPLE
Study Groups
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Sertraline/omega-3 supplement
Sertraline/omega-3
Sertraline (50 mgs) plus omega-3 (2 grams)
Sertraline/corn oil
Sertraline/Corn Oil
Sertraline (50 mgs) plus corn oil (2 grams) (placebo)
Interventions
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Sertraline/omega-3
Sertraline (50 mgs) plus omega-3 (2 grams)
Sertraline/Corn Oil
Sertraline (50 mgs) plus corn oil (2 grams) (placebo)
Eligibility Criteria
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Inclusion Criteria
* Score of 15 or higher on the Beck Depression Inventory II
* History of acute myocardial infarction, unstable angina, or documented coronary disease
Exclusion Criteria
* Lives far away from study site
* Current alcohol or drug abuse
* Psychosis, dementia, or bipolar disorder
* Already taking Omega-3
* Medically ill or disabled such that patient is unable to participate
* Comorbid illness likely to be fatal within 1 year of study entry
* Seizure disorder or takes anticonvulsants
* Pregnant or breast feeding
* Liver or kidney disease
* Severe hypertriglyceridemia (greater than 400 mg/dL)
* Bleeding or clotting disorder
* Type 2 diabetes with a hemoglobin A1c (HbA1c) level greater than 10
* Taking lithium or monoamine oxidase inhibitor (MAO-I)
18 Years
ALL
No
Sponsors
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National Heart, Lung, and Blood Institute (NHLBI)
NIH
Washington University School of Medicine
OTHER
Responsible Party
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Robert Carney
Professor
Principal Investigators
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Robert M. Carney, PhD
Role: STUDY_CHAIR
Washington University School of Medicine
Locations
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Washington University
St Louis, Missouri, United States
Countries
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References
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Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, Harris WS. Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial. JAMA. 2009 Oct 21;302(15):1651-7. doi: 10.1001/jama.2009.1487.
Appleton KM, Voyias PD, Sallis HM, Dawson S, Ness AR, Churchill R, Perry R. Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2021 Nov 24;11(11):CD004692. doi: 10.1002/14651858.CD004692.pub5.
Carney RM, Steinmeyer BC, Freedland KE, Rubin EH, Rich MW, Harris WS. Baseline blood levels of omega-3 and depression remission: a secondary analysis of data from a placebo-controlled trial of omega-3 supplements. J Clin Psychiatry. 2016 Feb;77(2):e138-43. doi: 10.4088/JCP.14m09660.
Bot M, Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, Mann DL. Inflammation and treatment response to sertraline in patients with coronary heart disease and comorbid major depression. J Psychosom Res. 2011 Jul;71(1):13-7. doi: 10.1016/j.jpsychores.2010.11.006. Epub 2011 Jan 15.
Other Identifiers
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186
Identifier Type: -
Identifier Source: org_study_id