Omega-3 Fatty Acids for Depression in Multiple Sclerosis: A Randomized Pilot Study

Abstract

Multiple sclerosis is the most common chronic disabling disease in the central nervous system in young to middle aged adults. Depression is common in multiple sclerosis (MS) affecting between 50–60% of patients. Pilot studies in unipolar depression report an improvement in depression when omega-3 fatty acids are given with antidepressants. The objective of this study was to investigate whether omega-3 fatty acid supplementation, as an augmentation therapy, improves treatment-resistant major depressive disorder (MDD) in people with MS. We performed a randomized, double-blind, placebo-controlled pilot study of omega-3 fatty acids at six grams per day over three months. The primary outcome was a 50% or greater improvement on the Montgomery-Asberg Depression Rating Scale (MADRS). Thirty-nine participants were randomized and thirty-one completed the 3-month intervention. Improvement on MADRS between groups was not significantly different at the 3-month end point with 47.4% in the omega-3 fatty acid group and 45.5% in the placebo group showing 50% or greater improvement (p = 0.30). Omega-3 fatty acids as an augmentation therapy for treatment-resistant depression in MS was not significantly different than placebo in this pilot trial. Omega-3 fatty acid supplementation at the dose given was well-tolerated over 3 months.

Trial registration: ClinicalTrials.gov NCT00122954.

Fig 1. Consort Flow Chart.

Fig 2. MADRS Improvement.

This figure reflects percent of subjects improved by 50% or more from baseline MADRS score. Mixed effects logistic regression model adjusted for age and MS disease duration. No difference between placebo and omega-3 FA was found over 3 months (p = 0.30).

Fig 3. Mean MADRS.

Linear mixed effects model adjusted for age and MS disease duration, error bars indicate standard error of the mean. No difference between placebo and omega-3 FA was found over 3 months (p = 0.23).