Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder – Australian and New Zealand Journal of Psychiatry, Mar 2008

Objective: To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine and a combination of them in major depression. [A chief source of EPA is fish oil. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) drug commonly prescribed for clinical depression.]

Method: Sixty outpatients with a diagnosis of major depressive disorder based on DSM-IV criteria and a score >or=15 in the 17-item Hamilton Depression Rating Scale (HDRS) were randomly allocated to receive daily either 1000 mg EPA or 20 mg fluoxetine, or their combination for 8 weeks. Double dummy technique was used to double blind the study. Patients were assessed at 2 week intervals. Change in HDRS was the primary outcome measure.

Results: Analysis of covariance for HDRS at week 8 across treatment groups was performed in 48 patients who completed at least 4 weeks of the study, with the last observation carried forward.


  • Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8.
  • EPA plus fluoxetine combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment.
  • Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms.
  • Response rates (>or=50% decrease in baseline HDRS) were 50%, 56% and 81% in the fluoxetine, EPA and combination groups, respectively.

Conclusions: In the present 8 week trial EPA and fluoxetine had equal therapeutic effects in major depressive disorder. EPA + fluoxetine combination was superior to either of them alone.

Source: The Australian and New Zealand Journal of Psychiatry. March 2008; 42(3):192-8. PMID: 18247193, Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, Jalali M, Peet M. Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Swallownest Court Hospital, Sheffield, UK.

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