Depression is a major cause of disease burden worldwide, affecting approximately 350 million people. Although there are numerous medications for the treatment of depression, less than 50% of patients with depression actually take these medications.

In a new study published last Wednesday in the European Journal of Nutrition, researchers demonstrated that higher red blood cell concentrations of EPA and DHA are associated with a decrease in depressive treatment.

This study was a double-blinded, randomized, controlled trial including 112 individuals. Each participant took a combination product containing 1 gram of EPA and 656 mg of DHA along with other nutrients including SAMe, zinc, 5-HTP, folinic acid and co-factors or placebo for an 8-week period. As a result, brain-derived neurotropic factor (BDNF) and omega-3 fatty acid concentrations were significantly higher in the nutraceutical group. There was also a decrease in omega-6 fatty acid levels and the arachidonic acid to EPA ratio. In addition, there was significant improvement in the Montgomery–Asberg Depression Rating Scale (MADRS) score from baseline to week eight. Overall, greater increases in EPA and DHA concentration were associated with a greater improvement in depressive symptoms.

There are potentially several mechanisms for essential fatty acids in depression. EPA and DHA both influence cell membrane fluidity. In addition, they mitigate oxidative stress and inflammation, which have been linked to depression. This study demonstrated that EPA from fish oil had the strongest antidepressant effect, which has been consistent with previous research.

EPA and DHA have similar effects as compared to previous meta-analyses of those taking antidepressants. This effect is greater in studies where participants were supplementing with higher doses of EPA. The research suggests that it is not the ratio of EPA vs DHA that is important, but the higher EPA dose. It is interesting that EPA seems to be responsible for the beneficial effects of omega fatty acid supplementation while DHA concentrations appear to vary more between patients and controls. We must consider that the beneficial effects of EFA supplementation may not be because the supplementation corrects a membrane DHA insufficiency, but rather they may be due to the anti-inflammatory properties of EPA.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Van der Burg KP, Cribb L, et al. EPA and DHA as markers of nutraceutical treatment response in major depressive disorder. Eur J Nutr. 2019 Sept 25.