Novel Adjunctive Therapy Shows Rapid Results in MDD

March 29, 2018

A novel adjunctive treatment for major depressive disorder (MDD) which has showed promise in animal models exhibited rapid symptom improvement in a trial with 58 people.

In a study published online in the Journal of Affective Disorders, researchers aimed to examine the efficacy and tolerability of add-on palmitoylethanolamide (PEA) in the treatment of MDD. PEA is an endogenous fatty acid amide shown to have anti-inflammatory properties.

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In a randomized, double-blind study, 58 patients were assigned to receive either 600 mg of PEA or placebo twice daily, in addition to the antidepressant citalopram, for 6 weeks. The participants, who had a baseline score of 19 or higher on the Hamilton Depression Rating Scale (HAM-D), were assessed at weeks 2, 4, and 6. Of the 58 patients who began the study, 54 completed it.

After 2 weeks, patients in the PEA group had a significantly greater reduction in HAM-D scores, compared with the placebo group. Throughout the trial, the PEA group also experienced significantly greater improvement in depressive symptoms, in comparison with the placebo group. After 6 weeks, all participants in the PEA group had a 50% or more reduction in their HAM-D score, vs 74% of the placebo group.

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“Palmitoylethanolamide adjunctive therapy to citalopram can effectively improve symptoms of patients (predominantly male gender) with major depressive disorder,” the study team, from Iran, wrote. “PEA showed rapid-onset antidepressant effects which need further investigation.”

Side effects were not any more frequent in the treatment group, according to the study abstract.

Researchers noted study limitations included the small size of the population in the study and the relatively short duration of the follow-up period.

—Terri Airov


Ghazizadeh-Hashemi M, Ghajar A, Shalbafan M, et al. Palmitoylethanolamide as adjunctive therapy in major depressive disorder: a double-blind, randomized and placebo-controlled trial. Journal of Affective Disorders. 2018;232:127-133