Omega-3 Fatty Acids to Improve Depression and Reduce Cardiovascular Risk Factors

Depression Clinical Trial

Official title:

Omega-3 for Depression and Other Cardiac Risk Factors

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00116857
• Other study ID #: 186
• Secondary ID: R01HL076808
• Status: Completed
• Phase: Phase 3
• First received: June 30, 2005
• Last updated: September 11, 2012
• Start date: February 2005
• Est. completion date: November 2009

Study information

• Verified date: September 2012
• Source: Washington University School of Medicine
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

This study will determine the effects of omega-3 fatty acid (FA) augmentation of sertraline on depression and cardiac endpoints after myocardial infarction (MI).

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 122
• Est. completion date: November 2009
• Est. primary completion date: June 2009
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Meets the DSM-IV criteria for a current major depressive episode

• Score of 15 or higher on the Beck Depression Inventory II

• History of acute myocardial infarction, unstable angina, or documented coronary disease

Exclusion Criteria:

• Physician or patient refusal

• 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)

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Angina, Unstable
• Cardiovascular Diseases
• Depression
• Depressive Disorder
• Heart Diseases
• Myocardial Infarction

Intervention

Drug:
• Sertraline/omega-3
Sertraline (50 mgs) plus omega-3 (2 grams)
• Sertraline/Corn Oil
Sertraline (50 mgs) plus corn oil (2 grams) (placebo)

Locations

Country	Name	City	State
United States	Washington University	St. Louis	Missouri

Sponsors (2)

Lead Sponsor	Collaborator
Washington University School of Medicine	National Heart, Lung, and Blood Institute (NHLBI)

Country where clinical trial is conducted

United States, 

References & Publications (1)

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 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Beck Depression Inventory-II	Beck Depression Inventory-II scores on a scale of 0 to 63, minimum score equals 0 maximum score equals 63. Higher value represents a worse outcome. Baseline scores are compared to scores after treatment.	Measured at Baseline and 10 weeks	No