Fatty acid metabolism and its longitudinal relationship with the hypothalamic-pituitary-adrenal axis in major depression: Associations with prospective antidepressant response

摘要: Summary Background Metabolism of dietary fatty acids (FAs), and its relationship with the hypothalamic–pituitary–adrenal (HPA)-axis, have been found to be altered in major depressive disorder (MDD). Moreover, indications exist that these factors are associated antidepressant-response. If we better understand associations, might identify novel targets for add-on therapy increase antidepressant-response, and/or early indicators improve response prediction. Objective To determine whether alterations FA-metabolism, their HPA-axis, prospective antidepressant paroxetine MDD. Design We first compared 70 initially unmedicated MDD-patients 51 age- gender-matched controls at study-entry, regarding salivary cortisol erythrocyte membrane FAs [omega-3 docosahexaenoic acid (DHA), eicosapentaenoic (EPA), FA-chain length, -unsaturation -peroxidizability]. Subsequently, treated patients 6 weeks 20 mg/day selective serotonin reuptake inhibitor paroxetine. After weeks, continued this treatment responders (i.e. showing ≥50% decrease Hamilton depression rating scale-score), randomized non-responders a 6-week, double-blind, placebo-controlled dose-escalation up 50 mg/day. repeated FA-measures after 12 weeks. Results Compared controls, showed higher FA-unsaturation FA-peroxidation, more negative relationships FA-peroxidation cortisol. were nonresponse. Nonresponse was also low DHA, which related fish intake. Furthermore, initial EPA increased during study, while exhibited opposite patterns. Conclusions FA-metabolism alterations, cortisol, MDD, may therefore form an indicator effectiveness. intake through effect on FA-metabolism.