Depression Clinical Trial
Official title:
Omega-3 for Depression and Other Cardiac Risk Factors
This study will determine the effects of omega-3 fatty acid (FA) augmentation of sertraline on depression and cardiac endpoints after myocardial infarction (MI).
BACKGROUND:
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.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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