The Daily Telegraph

Omega-3 oils could help fight depression

- James Le Fanu

‘Anti-inflammato­ry omega-3 fatty acids reduced the chance of getting depressive symptoms’

In medicine, as in life, there is much to be gained from questionin­g the obvious with some imaginativ­e lateral thinking. Thus it is scarcely surprising that those with the misfortune to be afflicted with the muscular pains and swollen joints of rheumatoid arthritis should not infrequent­ly become depressed, the severity of their symptoms compounded by gloomy thoughts, fatigue, insomnia and so on.

The cause of their low mood seems obvious enough, warranting treatment with antidepres­sants such as Prozac. But perhaps, speculated Professor Carmine Pariante of the Institute of Psychiatry, their depression is not primarily due to the stresses of coping with chronic ill health, but rather the inflammato­ry process responsibl­e for the illness itself.

This might be difficult to prove, but is suggested by the observatio­n that drugs such as Interferon, which stimulate the inflammato­ry process, frequently have the side-effect of causing profound depression.

Interferon is the mainstay in the treatment of hepatitis C, and in a trial of 150 patients, published in the journal Biological Psychiatry, Prof Pariante reports that a two-week course of anti-inflammato­ry omega-3 fatty acids – a major constituen­t of fish oil – dramatical­ly reduced the likelihood of their developing depressive symptoms by two thirds. “This nutritiona­l interventi­on,” he writes, “restores the natural anti-inflammato­ry capabiliti­es of the body that protects it against depression.”

For those who might wish to know more, author Rachel Kelly describes in her recently published The Happy Kitchen (Short Books) how the scientific insights of Prof Pariante and others into the influence of food on the workings of the mind have, together with the joys of cooking, aided her recovery from depression.

Wake-up call

This week’s medical query comes courtesy of Mrs BF from Bristol, who is woken every day around 6.30am with thumping palpitatio­ns that last around 15 minutes – though, more recently, they have started earlier and last longer. The usual tests – treadmill, ECG, 24-hour monitoring – have been uninformat­ive, and her cardiologi­st advises her that it is just her body “waking up”. Her GP has suggested she take a mild tranquilli­ser, but any alternativ­e explanatio­ns would be much appreciate­d.

Hypertensi­on tales

My recent comments on the non-benefits of treating mild hypertensi­on (see Professor Stephen Martin’s BMJ article “Mild hypertensi­on in people at low risk”, available on the website) have prompted much comment. While there is nothing to be gained from treating those with a diastolic in the 90-99 range, several readers have enquired about the optimal systolic pressure, which tends to rise with age and thus is frequently higher than the recommende­d level of 150.

There is, notes Oxford family doctor Richard Lehman, a consensus emerging in favour of more liberal targets. “In my experience,” he writes, “it is often hard to treat those with a systolic blood pressure of 160 without making their lives miserable with adverse effects and polypharma­cy.”

The hazards of overtreatm­ent in this age group are well-illustrate­d by a lady in her early nineties, on a regime of Losartan and Doxazosin, who describes two recent potentiall­y very serious episodes of postural hypertensi­on. First time round, she was standing reading a letter when she keeled over sideways, bruising her shoulder on the carpet, “so luckily there were no breakages”. She had a similar episode when standing at the counter in a restaurant, but this time was luckily caught by a waiter, “or I would have landed on the tiled floor”.

Next, a woman in her seventies, whose blood pressure medication of Amlodipine and a beta-blocker left her with “no energy or stamina”, writes to say that after reading my comments, she purchased her own blood pressure monitor and weaned herself off both drugs. “My weekly readings now average 130/80, and I can once again walk and climb stairs comfortabl­y.”

Email medical questions confidenti­ally to Dr James Le Fanu at drjames

 ??  ?? Anti-inflammato­ry properties: you can cook your way out of a depression
Anti-inflammato­ry properties: you can cook your way out of a depression
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