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EPA and DHA as markers of nutraceutical treatment response in major depressive disorder

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Abstract

Purpose

Depression clinical trials are increasingly studying biomarkers to predict and monitor response to treatment. Assessment of biomarkers may reveal subsets of patients who are responsive to nutraceutical treatment, which may facilitate a personalized approach to treating depression.

Methods

This is a post hoc analysis of an 8-week, double-blind, randomized, controlled trial (n = 158) investigating a combination nutraceutical comprising Omega-3 (EPA 1 g/DHA 656 mg), SAMe, zinc, 5-HTP, folinic acid, and co-factors versus placebo for the treatment of Major Depressive Disorder. The study explored levels of polyunsaturated fatty acids, folate, vitamin B12, zinc, homocysteine, and BDNF as possible predictors and correlates of response to nutraceutical supplementation.

Results

Concentrations of EPA and DHA in red cell membranes increased in response to treatment and were significantly correlated with a decrease in depressive symptoms during active treatment (p = 0.003 and p = 0.029; respectively). Higher baseline levels of omega-6 fatty acid also correlated with depression reduction in the active treatment group ( p = 0.011). No other biomarkers were associated with a lessening of depressive symptoms.

Conclusion

Changes in fatty acid levels resulting from a nutraceutical combination containing EPA and DHA provide a response biomarker in treating depression.

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Acknowledgements

JS is supported by an NHMRC Clinical Research Fellowship (APP 1125000). JF is supported by a Blackmores Institute Fellowship. MB is supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (APP1059660 and APP1156072). The original study was funded by an Australian National Health and Medical Research Council project grant (APP1048222), and was co-sponsored by FIT-BioCeuticals (who were not involved in any aspect of study design, statistical analysis, or manuscript preparation).

Funding

National Health and Medical Research Council APP1048222; FIT-BioCeuticals (co-sponsor, uninvolved in study design and conduct, data analysis, and manuscript preparation).

Author information

Author notes

  1. Kiki P. van der Burg and Lachlan Cribb are joint first authors.

  2. Chee H. Ng is joint senior author.

Authors and Affiliations

  1. MaSc Medicine at University Medical Center Utrecht (UMCU), Utrecht, The Netherlands

    Kiki P. van der Burg

  2. Professorial Unit, The Melbourne Clinic, Department of Psychiatry, The University of Melbourne, Melbourne, Australia

    Lachlan Cribb, Jenifer Murphy, Georgina Oliver, Chee H. Ng & Jerome Sarris

  3. NICM Health Research Institute, Western Sydney University, Westmead, Australia

    Joseph Firth, Diana Karmacoska & Jerome Sarris

  4. Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

    Joseph Firth

  5. Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    David Mischoulon

  6. Faculty of Medicine, Discipline of Psychiatry, Centre for Clinical Research, Royal Brisbane and Women’s Hospital, The University of Queensland, Herston, Australia

    Gerard J. Byrne

  7. Departments of Medical Genetics, Psychiatry, and Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada

    Chad Bousman

  8. Department of Psychiatry, The University of Melbourne, Melbourne, Australia

    Chad Bousman & Michael Berk

  9. Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia

    Con Stough

  10. IMPACT SRC, Barwon Health, School of Medicine, Deakin University, Geelong, Australia

    Michael Berk

  11. Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia

    Michael Berk

  12. Orygen, The Centre of Excellence in Youth Mental Health, The University of Melbourne, Parkville, Australia

    Michael Berk

Authors
  1. Kiki P. van der Burg
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  2. Lachlan Cribb
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  13. Jerome Sarris
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Contributions

KvdB drafted the initial version of this manuscript. All authors contributed intellectual content to the manuscript and read and approved the final manuscript.

Corresponding author

Correspondence to Jerome Sarris.

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Conflict of interest

JS has received either presentation honoraria, travel support, clinical trial grants, book royalties, or independent consultancy payments from: Integria Healthcare & MediHerb, Pfizer, Scius Health, Key Pharmaceuticals, Taki Mai, FIT-BioCeuticals, Blackmores, Soho-Flordis, Healthworld, HealthEd, HealthMasters, Kantar Consulting, Grunbiotics, Research Reviews, Elsevier, Chaminade University, International Society for Affective Disorders, Complementary Medicines Australia, SPRIM, Terry White Chemists, ANS, Society for Medicinal Plant and Natural Product Research, Sanofi-Aventis, Omega-3 Centre, the National Health and Medical Research Council, CR Roper Fellowship. DM has received research support from Nordic Naturals. He has provided unpaid consulting for Pharmavite LLC and Gnosis USA, Inc. He has received honoraria for speaking from the Massachusetts General Hospital Psychiatry Academy, Blackmores, Harvard Blog, and PeerPoint Medical Education Institute, LLC. He has received royalties from Lippincott Williams & Wilkins for published book “Natural Medications for Psychiatric Disorders: considering the Alternatives.”MB has been a speaker for Lundbeck, Merck, and Servier; has served as a consultant to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Janssen Cilag, Lundbeck Merck, and Servier; and has received Grant/Research Support from the A2 Company, the Meat and Livestock Board, Woolworths, and Avant. CHN had served as a consultant for Grunbiotics, Lundbeck, Servier, Janssen-Cilag, Wyeth, and Eli Lilly, and received research grant support from Wyeth and Lundbeck, and speaker honoraria from Servier, Lundbeck, Bristol-Myers Squibb, Organon, Eli Lilly, GlaxoSmithKline, Janssen- Cilag, Astra-Zenaca, Wyeth, and Pfizer.

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van der Burg, K.P., Cribb, L., Firth, J. et al. EPA and DHA as markers of nutraceutical treatment response in major depressive disorder. Eur J Nutr 59, 2439–2447 (2020). https://doi.org/10.1007/s00394-019-02090-6

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  • DOI: https://doi.org/10.1007/s00394-019-02090-6

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