Effect of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy to sertraline in controlling suicidal ideation in patients with depression: A comparative study

Background: Omega-3 fatty acids and 5-hydroxytryptophan have been gaining attention as promising alternative treatment for depressive illness. These agents are given as as add on treatment to conventional antidepressant drugs. The present study was carried out to evaluate efficacy of omega-3 fatty acids versus 5-hydroxytryptophan as add on therapy in controlling suicidal ideation in depressive patients on sertraline. Methods: This was a prospective, open label, randomized, parallel group study conducted in department of Psychiatry. Ninety treatment nae patients (18-65 years age) were divided into 3 groups of 30 each. Group I: Sertraline, Group II: Sertraline plus omega-3 fatty acids, Group III: Sertraline plus 5-hydroxytryptophan. Suicidal ideations were assessed with Becks scale for suicidal ideation (BSI) at weeks 0, 4 and 8. Data were analyzed using repeated measures ANOVA (SPSS version 20.0). Post hoc analysis was done using Bonferroni test. Results: Baseline parameters in patients of all groups were comparable. Administration of sertraline resulted in reduction of Becks scale for suicidal ideation scores as compared to baseline. Addition of omega-3 fatty acids and 5-hydroxytryptophan also showed reduction in BSI scores. Effect of sertraline monotherapy was more as compared to omega-3 fatty acids or 5-hydroxytryptophan as add on therapy, which was statistically significant (p value < 0.05). Conclusion: Both omega-3 fatty acids and 5-hydroxytryptophan produce significant effect in controlling suicidal ideations in patients with depression