SYMPOSIA

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