No abstract

BackgroundOmega-3 polyunsaturated fatty acids (n-3 PUFAs) augmentation of antidepressants has shown great potential in the prevention and treatment of major depressive disorders (MDD).ObjectiveTo investigate the effect of n-3 PUFAs plus venlafaxine in patients with first-diagnosed, drug-naïve depression.MethodA total of 72 outpatients with first-diagnosed depression were recruited. The daily dose of 2.4 g/day n-3 PUFAs or placebo plus venlafaxine was used for over 12 weeks. The outcomes were assessed by the Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), Beck depression inventory (BDI), and Self-rating anxiety scale (SAS).ResultsBoth groups exhibited improvement on clinical characteristics at week 4 and week 12 compared with baseline. The rate of responders for anxiety in n-3 PUFAs group (44.44%) was significantly higher than that in placebo group (21.21%) at week 4 (χ2 = 4.182, p = 0.041), while week 12 did not show a difference (χ2 = 0.900, p = 0.343). The rate of responders for depression at both week 4 (χ2 = 0.261, p = 0.609) and week 12 (χ2 = 1.443, p = 0.230) showed no significant difference between two groups. Further analysis found that Childhood Trauma Questionnaire (CTQ) had positive correlation with HAMA (r = 0.301, p = 0.012), SAS (r = 0.246, p = 0.015), HAMD (r = 0.252, p = 0.038) and BDI (r = 0.233, p = 0.022) with Pearson correlation analysis. Social Support Rating Scale (SSRS) had negative correlation with SAS (r = −0.244, p = 0.015) and BDI (r = −0.365, p = 0.000).ConclusionThis trial found that n-3 PUFAs supplementation in favor of venlafaxine alleviated the anxiety symptoms rather than depressive symptoms at the early stage of treatment (4 weeks) for first-diagnosed, drug-naïve depressed patients. However, the advantage disappeared in long-term treatment. Furthermore, childhood abuse and social support are closely related to the clinical and biological characteristics of depression. Both childhood trauma and lack of social support might be predictors of poor prognosis in depression.Clinical Trial Registration[clinicaltrials.gov], identifier [NCT03295708].

Background Major Depressive Disorders is a chronic and severe psychiatric disorder with poor prognosis and quality of life. Abnormal erythrocyte fatty acid composition in the depressed patients were found in our previous study, but the relationship between erythrocyte membrane fatty acid levels and different severity of depressive and anxiety symptoms remains to be explored. Methods This cross-sectional study included 139 patients with first-diagnosed, drug-naïve depression and 55 healthy controls whose erythrocyte fatty acid composition was analyzed. Subjects with depression was divided into severe depression and mild to moderate depression, or depression with severe anxiety and mild to moderate anxiety. Then the differences of fatty acid levels among different groups were analyzed. Finally, the ROC analysis was applied to identify potential biomarkers in distinguishing the severity of depressive symptoms. Results Levels of erythrocyte membrane fatty acid were elevated among patients with severe depression compared to healthy controls or patients with mild to moderate depression in almost all kinds. While C18:1n9t (elaidic acid, EA), C20:3n6 (eicosatrienoic acid, EET), C20:4n6 (arachidonic acid, AA), C22:5n3 (docosapentaenoic acid, DPA), total fatty acids (FAs), and total monounsaturated fatty acids (MUFAs) were elevated in patients with severe anxiety compared with patients with mild to moderate anxiety. Furthermore, the level of AA, C22:4n6 (docosatetraenoic acid, DTA), EA, and combination of all three were associated with the severity of depressive symptoms. Conclusions The results suggested that erythrocyte membrane fatty acid levels have the potential to be the biological indicator of clinical characteristics for depression, such as depressive symptoms and anxiety. In the future, more research is needed to explore the causal association between fatty acid metabolism and depression.