Thanks, that is very interesting. Especially the part about EPA preventing depression during IFN-α treatment.
How much EPA did the mentioned CFS patient take?
While the ultimate goal is finding a cure for ME/CFS, I wish there were also studies that simply attempted to find a few cost effective and relatively safe treatments that improved quality of life.
Study Design and Recruitment
Two hundred seven patients with HCV were screened, 162 of them consented to participate and were randomized to the study, and all of them completed the 2-week trial; 152 participants were followed throughout the 24 weeks of IFN-α treatment and were included in the analysis. For allocation of the participants following simple double-blind randomization procedures, a computer-generated list of random numbers was used. The identical capsules were prepacked in bottles and consecutively numbered according to the randomization schedule by an independent nutritionist.
Figure S1 in
Supplement 1 provides a flow chart summarizing study recruitment. Ten subjects discontinued the IFN-α treatment; they did not differ from the completers in any demographic features, including gender, age, married status, education years, and past history of depression. While the noncompleters did have significantly higher baseline scores than completers in depressive symptoms (Hamilton Rating Scale for Depression [HAMD]: 8.6 ± 3.65 versus 4.5 ± 4.49;
p = .018) and neurovegetative symptoms (Neurotoxicity Rating Scale [NTRS]: 52.9 ± 41.74 versus 26.9 ± 29.58;
p = .010), they were equally distributed among the three groups (EPA,
n = 4; DHA,
n = 3; placebo,
n = 3).
The subjects were randomly assigned in double-blind fashion to EPA, DHA, or placebo, administered for 2 weeks before starting IFN-α therapy. Specifically, 2 weeks before the initiation of IFN-α therapy (week –2), patients started receiving a daily treatment of five identical capsules of EPA (3.5 g/day), DHA (1.75 g/day), or placebo (high oleic oil) in single or divided administration. The experimental capsules contained concentrated EPA (700 mg), DHA (350 mg), or high oleic oil (800 mg); they weighed 1000 mg, were deodorized with orange flavor, and were supplemented with tertiary-butyl hydroquinone (.2 mg/g) and tocopherols (2 mg/g) as antioxidants. The sources of EPA, DHA, and oleic acids were, respectively, anchovy fish body oil (purchased from AK BioTech, Ulsan, Korea), algal vegetable (purchased from DSM Nutritional Products, Basel, Switzerland), and safflower oil (purchased from Aarhus Karlshamn, Hull, England).
The recruited participants were evaluated at weeks –2 (when omega-3 fatty acid prophylactic intervention started) and 0 (when the prophylactic intervention stopped and IFN-α therapy started) and during weeks 2, 4, 6, 8, 12, 16, 20, and 24 of IFN-α therapy to assess the occurrence of major depressive episode with the structured Mini-International Neuropsychiatric Interview. Sociodemographic factors, including gender, age, education, and marital status, as well as the past psychiatric history, substance use history, and family psychiatric history, were recorded at the initial assessment. Severity of depressive symptoms and of neurovegetative symptoms were measured using, respectively, the 21-item HAMD (48), rated by trained psychiatrists, and the self-administered NTRS (49), both administered at weeks –2, 0, 2, 4, 6, 8, 12, 16, 20, and 24. The NTRS is a checklist questionnaire that has been frequently used for the evaluation of neuropsychiatric symptoms related to cytokine therapy; the items are categorized into general symptoms, nonpainful somatic symptoms, and painful somatic symptoms, with each item rated from 0 to 10 on a visual analog scale, and the final score ranging 0 to 390 (15, 49, 50, 51). During IFN-α therapy, allowable concomitant medications included acetaminophen and other nonsteroidal anti-inflammatory agents for pain symptoms and fever; granisetron or ondansetron for nausea; lorazepam for severe anxiety; and zolpidem for insomnia. The results of routine biochemical laboratory examinations, the occurrence of adverse effects, and any reason for IFN-α discontinuation were recorded.