N-3 多不饱和脂肪酸补充剂预防老年期抑郁症患者抑郁复发：一项为期 52 周的双盲、安慰剂对照试验。

The N-3 polyunsaturated fatty acids supplementation to prevent depression recurrence in patients with late-life depression: A 52-week double-blind, placebo-controlled trial.

机构信息

Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taiwan.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Songde Branch, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.

出版信息

J Affect Disord. 2025 Jan 15;369:8-15. doi: 10.1016/j.jad.2024.09.129. Epub 2024 Sep 19.

DOI:10.1016/j.jad.2024.09.129

PMID:39306009

Abstract

BACKGROUND

Reports on the efficacy of omega-3 fatty acids (n-3 PUFAs) for the treatment of late-life depression (LLD) are mixed, and most studies focus on the modification of depressive symptoms rather than depression prevention. The aim of the present study was to investigate the efficacy of n-3 PUFAs in preventing depressive recurrence in patients with late-life depression. In addition, we investigated the effects of n-3 PUFAs on changes in depressive and anxiety symptoms and inflammatory markers in LLD.

METHODS

A 52-week, double-blind, randomized, controlled trial was conducted. We enrolled a total of 39 euthymic patients with LLD. They were randomized to receive either n-3 PUFAs (1.2 g per day of eicosapentaenoic acid and 1 g of docosahexaenoic acid) or placebo for 52 weeks. Recurrence of depression and severity of depression symptoms were assessed at baseline and weeks 4, 8, 16, 24, 32, 40, and 52.

RESULTS

A total of 39 patients completed the trial with 19 in the n-3 PUFAs group and 20 in the placebo group. Cox proportional hazard regression indicated that n-3 PUFAs had significant protective effect on depression recurrence (Hazard Ratio: 0.295, 95 % Confidence Interval: 0.093-0.931, p value =0.037). But n-3 PUFAs intervention had no significant effect in reducing depressive or anxiety symptoms, inflammatory markers over the placebo group.

LIMITATION

The results should be interpreted with consideration of the modest sample size.

CONCLUSION

These findings suggest that n-3 PUFAs may have a prophylactic effect in currently euthymic patients with LLD.

摘要

背景

ω-3 多不饱和脂肪酸（n-3PUFAs）治疗老年期抑郁症（LLD）的疗效报告不一，大多数研究侧重于改善抑郁症状，而不是预防抑郁。本研究旨在探讨 n-3PUFAs 预防老年期抑郁症患者抑郁复发的疗效。此外，我们还研究了 n-3PUFAs 对 LLD 患者抑郁和焦虑症状及炎症标志物变化的影响。

方法

一项为期 52 周的双盲、随机、对照试验。共纳入 39 例心境稳定的老年期抑郁症患者。他们被随机分为 n-3PUFAs 组（每天 1.2g 二十碳五烯酸和 1g 二十二碳六烯酸）或安慰剂组，疗程 52 周。在基线和第 4、8、16、24、32、40 和 52 周评估抑郁复发和抑郁症状严重程度。

结果

共有 39 例患者完成了试验，n-3PUFAs 组 19 例，安慰剂组 20 例。Cox 比例风险回归分析表明，n-3PUFAs 对抑郁复发有显著的保护作用（风险比：0.295，95%置信区间：0.093-0.931，p 值=0.037）。但 n-3PUFAs 干预对降低抑郁或焦虑症状、炎症标志物与安慰剂组相比无显著效果。