Date of Award

2014

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not n-3 fatty acids have an effect on depressive symptoms post cardiovascular event in men and women ages 40 and older.

STUDY DESIGN: Systematic review of three English language random controlled trials published between 2011-2012.

DATA SOURCES: Two randomized controlled trials published after 2011 comparing the effects of n-3 fatty acid supplementation on depressive symptoms post cardiovascular event and one randomized controlled trial comparing n-3 fatty acid supplementation effects on depressive symptoms in elderly patients with diagnosed depression. The studies were obtained using the PubMed database.

OUTCOMES MEASURED: Depressive symptoms, assessed using the Geriatric Depression Scale, was the primary outcome measured in all three studies. In all studies patients depressive symptoms were measured with the GDS-15 before the trial of supplementation vs. placebo began, and then after the trial was over. Results were then compared before and after supplementation.

RESULTS: The results of these studies show an insignificant decrease in depressive symptoms of patients supplemented with n-3 fatty acids post cardiovascular event vs. a placebo. However, one study showed the potential for n-3 fatty acid supplementation in depressed elderly patients unrelated to cardiovascular events with a decrease in depressive symptoms after supplementation.6 One subgroup in the study by Andreeva and colleagues reported an increase in depressive symptoms in men who were supplemented n-3 fatty acids for the trial.4

CONCLUSIONS: Based on these studies, the use of n-3 fatty acids for decreasing depressive symptoms in post-cardiovascular events can not be justified. Andreeva and colleagues, as well as Giltay and colleagues, both showed no significant difference in depressive symptoms in patients post-cardiovascular event supplemented with n-3 fatty acids assessed by the GDS-15.4,5 However, Tajalizadekhoob et al. showed n-3 fatty acid supplementation in elderly patients with diagnosed depression does in fact improve their depressive symptoms with a NNT of 8. 6 Although the total patient number of this study was small, further investigation should continue as this proves there is lead way for the use of n-3 fatty acids for their effect in depression.

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