Eicosapentaenoic acid in treatment-resistant depression associated with symptom remission, structural brain changes and reduced neuronal phospholipidturnover

The n-3 essential fatty acid eicosapentaenoic acid (EPA) was added to the c onventional antidepressant treatment of a treatment-resistant severely depr essed and suicidal male patient with a seven-year history of unremitting de pressive symptoms. The niacin skin flush test and cerebral magnetic resonan ce scanning were carried out at baseline and nine months later. The additio n of ethyl-EPA led to a dramatic and sustained clinical improvement in all the symptoms of depression, including a cessation of previously unremitting severe suicidal ideation, within one month. Symptoms of social phobia also improved dramatically During the nine-month period the volumetric niacin r esponse increased by 30%, the relative concentration of cerebral phosphomon esters increased by 53%, and the ratio of cerebral phosphomonesters to phos phodiesters increased by 79%, indicating reduced neuronal phospholipid turn over. Registered difference images showed that the EPA treatment was accomp anied by structural brain changes including, in particular, a reduction in the lateral ventricular volume.