Cytokines, PUFA Tissue Concentrations and Treatment Selection in Antenatal MDD
Status:
Terminated
Trial end date:
2014-05-01
Target enrollment:
Participant gender:
Summary
For a number of reasons women with major depressive disorder often discontinue conventional
antidepressants when they become pregnant and prefer not to take them when depressive illness
develops in the course of pregnancy. There is now considerable evidence that the
administration of the omega-3 polyunsaturated fatty acid, eicosapentaenoic acid (EPA), as
monotherapy has antidepressant effects. If it could be clearly established as effective such
an approach would offer a valuable alternative for woman who are at risk for, or who develop,
depressive disorder during pregnancy. Strongly positive placebo-controlled trials of EPA
supplementation, though, co-exist with entirely negative ones. No clear reasons for these
discrepancies have emerged but one possibility is that the samples studied have differed in
the proportion of individuals likely to benefit from EPA supplementation. As there has been
no effort to identify such individuals we propose to explore two groups of measures, both
relevant to EPA's likely mechanisms of action, as potential tools for identifying individuals
likely to benefit this treatment. Hypothesis: Among women who experience major depressive
episodes during their first two trimesters of pregnancy, baseline measures of cytokine
activity and erythrocyte PUFA concentrations will be associated, in an additive or
interactive fashion, with subsequent improvement in depressive symptoms among women taking
omega-3 PUFA supplementation.