Madam, - Dr Killian Kelly (May 6th) and Dr Brenda O'Hanrahan (May 13th) refer, in defence of their respective viewpoints, to the guidelines offered by the National Institute of Clinical Excellence (NICE) for the assisted management of moderate depression.
Dr Kelly correctly says that NICE acknowledges a role for drug treatment in mild depression. However, the NICE guidelines have, in keeping with recognised management protocol, incorporated also the use of exercise and cognitive behaviour therapy (CBT), thereby acknowledging that anti-depressant therapy is neither the sole nor recommended first-line therapy for mental health management.
Unfortunately, NICE omits reference to the vital role that nutrition plays in regulating brain function, thereby ignoring evidence from a plethora of clinical trials conducted over the past decade.
The beneficial effects of PUFA-n3 (Omega 3) at a cellular and genetic level are well documented and clinical comparisons with anti-depressant drugs are more than favourable. A comparison of the therapeutic effects of Omega-3 and Prozac, used separately and in combination, was reported in the Australian Journal of Psychiatry (2008) with the following comparative benefits recorded: combination, 81 per cent, Omega-3 56 per cent, and Prozac 50 per cent.
In a separate trial at Tehran University, using the standard Hamilton Depression Rating Scale (HDRS), the comparative symptom alleviation rate was 64 per cent for Omega-3 and 57 per cent for Prozac.
These results are not highly significant but they are in keeping with positive results for Omega-3 recorded in two psychiatric journals in 2006.
The Irish psychiatrists Syed and Garland have likewise documented the clinical benefits of Pufa-n3, and refer to numerous reports that link low consumption of Omega-3 food sources to the currently high prevalence of depression, bipolar disorder and impulse disorder-related phenomena such as suicide and homicide.
It is unfortunate that Dr Kelly has resorted to personal attacks on respected researchers such as Patrick Holford and Dr Vernon Coleman. These men are well-informed researchers and each has made a significant contribution to current perceptions of health management.
They have provided the necessary impetus for health professionals to test prevailing paradigms and for this they should be respectfully acknowledged. - Yours, etc,
Dr NEVILLE WILSON, The Leinster Clinic, Maynooth, Co Kildare.