SYMPOSIA
SYMPOSIA
SYMPOSIA
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Abstracts of the Invited Speakers<br />
Is fish oil promising in the treatment of depression during pregnancy and lactation?<br />
Evrim Özkorumak<br />
Karadeniz Technical University, Psychiatry Department, Trabzon, Turkey<br />
E-mail: evrimozkorumak@yahoo.com<br />
Increasing concerns about neonatal syndromes following antidepressant use in the late phase of pregnancy(1) have caused more<br />
hesitation about their use. Although inadequate data about in utero exposure of antidepressants may present risks, the risks of untreated<br />
maternal depression must be considered as well. One candidate as an antidepressant is fish oil, in light of its omega-3 constituent.<br />
Omega-3 fatty acids are long-chain, polyunsaturated fatty acids found in plant and marine sources and helpful in treating various medical<br />
conditions (2). Omega-3 fatty acids may prove to be efficacious in a number of psychiatric disorders. Evidence suggests that omega-3<br />
fatty acids may have beneficial effects in mood disorders, including bothmajor depression and bipolar disorder, schizophrenia and<br />
dementia. Furthermore, omega-3 fatty acids may prove to be a safe and efficacious treatment for psychiatric disorders during pregnancy<br />
and breastfeeding (2).<br />
Major depressive disorder (MDD) is prevalent among women of childbearing age. Approximately 15% of women experience an episode<br />
of perinatal depression (PND), antenatally and/or postnatally (3). Because there are increasing concerns about possible adverse effects<br />
of antidepressant medication use during pregnancy and in breastfeeding mothers (4), it is important to investigate possible alternative<br />
treatments. Main dietary risk factors of postnatal depression are low riboflavin, low folate, low docosahexaenoic acid, low eicosapantaenoic<br />
acid, low calcium, low magnesium and low zinc. Oil-rich fish are a rich source of n-3 fatty acids, in particular eicosapentaenoic acid (EPA)<br />
and docosahexaenoic acid (DHA) (5). Evidence indicates that these fatty acids may be involved in the synthesis and regulation of brain<br />
neurotransmitters (dopamine, monoamine and serotonin), which are thought to be reduced in cases with depressive symptoms (6). More<br />
specifically, it is thought that high concentrations of DHA located in non-myelin cell membranes of the central nervous system may help<br />
support synaptic transmissions (7). Different human studies were identified investigating dietary and/or supplemental sources of n-3<br />
in relation to the development of postnatal depression. Only two of these trials were randomised controlled trials (8,9). Among others,<br />
three studies support the theory that dietary and supplemental sources of n-3 are associated with fewer postnatal depression symptoms<br />
(8,10,11) and five studies contest this theory (12,13,14).<br />
Key words: Omega-3 fatty acids, depression, perinatal depression<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S64<br />
[PS-08]<br />
Symposium Title: Advances in complementary alternative psychotropic drugs: Fish oil (omega-3 fatty acids), vitamine B12, folate<br />
ve other add-on therapies in psychiatric disorders<br />
Can St. John’s Wort be an alternative treatment for depression?<br />
Çiçek Hocaoğlu<br />
Rize University, Medical School, Department of Psychiatry, Rize, Turkey<br />
E-mail: chocaoglu@superonline.com<br />
The herb St. John’s Wort (Hypericum perforatum) has been used for centuries to treat a variety of medical illnesses. In certain areas of<br />
Europe, St. John’s Wort has been a commonly prescribed treatment for depression. In some countries extracts of the plant Hypericum<br />
perforatum L. (popularly called St. John’s Wort) are widely used for treating patients with depressive symptoms. Extracts of the plant<br />
Hypericum perforatum have been used in folk medicine for a long time for a range of indications including depressive disorders. Some<br />
researchers believe that specific chemical constituents of St. John’s Wort produce changes in depression in a manner similar to that of<br />
antidepressant medications, yet this hypothesis is problematic. In addition, studies that support the efficacy of St. John’s Wwort in patients<br />
with mild-to-moderate depression have limitations that may affect the accuracy of their conclusions. Studies measuring the effect of St.<br />
John’s Wort in major depression have reported conflicting results and need to be reexamined. In patients who meet the criteria for major<br />
depression, several recent placebo-controlled trials suggest that the tested hypericum extracts have minimal beneficial effects while<br />
other trials suggest that hypericum and standard antidepressants have similar beneficial effects. Preliminary data suggest that hypericum<br />
extract is effective in atypical depression based on the reported outcome of an 8-week double-blind, placebo-controlled, randomized<br />
S64 Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org