Outcomes in depression do not seem to be improved by adding omega-3 fatty acids to sertraline in patients with coronary heart disease (CHD) according to a controlled trial.

There is evidence that omega-3 fatty acids influence depressive illness, and some trial data to suggest that omega-3 fatty acid augmentation can improve response to antidepressive drugs. This study aimed to determine whether augmentation with omega-3 fatty acids improved response to sertraline in patients with CHD and major depression. Participants were patients with CHD and major depression according to current diagnostic criteria. After a pre-randomisation phase of 2.5 to 3.5 weeks during which they were given sertraline 25mg daily plus placebo omega-3 fatty acid capsules, they were re-interviewed to confirm the diagnosis of major depression and randomised to sertraline 50mg daily, plus omega-3 fatty acid 2gm daily or placebo. Primary outcome was weekly score on the Beck Depression Inventory (BDI-II), a recognised measure of depression, with score on the Hamilton Rating Scale for Depression (HAM-D) as a secondary outcome. Study duration was 10 weeks.

There were 178 eligible patients of 941 expressing initial interest in the study; 122 patients remained eligible after the pre-randomisation stage and received study treatment. Adherence to medication was good for both treatment groups, and only 7 patients dropped out of the study (3 active, 4 placebo). There were no significant differences between the two groups in the primary outcome, either at the 10-week endpoint or at any point in-between, neither were there any significant differences in any of the secondary outcomes studied.

Study treatments were well tolerated, with no significant differences between the group in reported adverse effects or serious adverse effects.

The authors conclude that they found no evidence that addition of omega-3 fatty acids improves response to sertraline 50mg daily in this study population.