2.2. Methodology

This study was approved by the Institutional Review Board of the study site (JSSCPM/IHEC/2019/016). Patients satisfying the study criteria were enrolled and categorized into one of the study arms following a simple randomization technique. Patients in Arm-1 consumed omega-3 fatty acid supplementation (500 mg, daily) but no antidepressants; those in Arm-2 took an antidepressant alone (single agent: Escitalopram, 10 mg, daily or sertraline, 100 mg, daily or fluoxetine, 20 mg, daily) but no omega-3 fatty acid supplementation; and the patients in Arm-3 took an antidepressant (single agent: Escitalopram, 10 mg, daily or sertraline, 100 mg, daily or fluoxetine, 20 mg, daily) along with omega-3 fatty acid supplementation (500 mg, daily).

The Hamilton Depression Rating Scale (HDRS) was used to estimate baseline and periodic (once a month for three months) changes in clinical features of depression in study participants. Medication adherence to the prescribed antidepressant medications and omega-3 fatty acid supplements were assessed at first, second, and third follow-ups in all three study arms with the help of the Medication Adherence Rating Scale (MARS) score.