EPA & Chronic drug resistant depression

[Guest guest]

There have been two important papers on chronic

depression resistant to psychiatric drugs yet

successfully treated with the addition of a specific

omega 3 fatty acid the Eicosapantanoic Acid or EPA.

Now, two questions emerge for discussion among us.

#1. Why was the DHA NOT used? Was there any logical

basis? Certainly DHA cannot be harmful because, in any

case, human body would make DHA out of EPA. Or is it

the cost factor, namely that just EPA is cheaper than

the mixture of EPA and DHA.

The logic that EPA is the true omega 3 because EPA can

convert into DHA but DHA cannot convert into EPA is

too theoretical. Consider the following practical

difficulty:

Just the EPA may not be available in some countries.

Patients in these countries will be unnecessarily

worried by these studies. The mixture of EPA and DHA

is readily available in most countries as EPA 180mg

and DHA 120 mg.

Very high dose of EPA was used in these studies: 4 gm

daily.

 

#2. In one of the two studies evening primrose oil was

also used in addition to EPA. Now, as we all know,

evening primrose oil is omega 6. Again my question is

why to complicate the treatment for depressed

patients? Omega 6 is easily and commonly used as

vegetable oil in most kitchens. For example sunflower

oil has omega 6. So, why to bother about omega 6 and

add to the cost of the treatment? I think we need not

add evening primrose oil as a supplement to EPA.

In fact there may be risk in increasing our intake of

omega 6 as, at least in USA, it is thought to cause

inflammation and blood clotting. We can add some

vitamin K if we need the blood clotting factor at that

high doses of EPA rather than going for omega 6.

 

#3. In one study ethyl-EPA was used. Now, what is the

difference between just EPA and the ethyl-EPA? Does

ethyl-EPA have an advantage over EPA say in terms of

bio-availability?

 

Please comment freely. For those of us who wish to

study the original articles so as to enrich their

scholarly comments, here they are:

- Nemets, B and others: Amerian Journal of Psychiatry,

2002, 159, pp. 477-479.

- Puri, B. and others: Archives of General Psychiatry,

2002, 59 (1).

 

Best wishes to each of your anticipated comments and

to our e-List.

Ratan.