RU2387448C2 - Essential fatty acids for prevention and/or treatment of depression in patients suffering from coronary heart disease or coronary artery disease - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: treatment of depression in the patients suffering from coronary heart disease is ensured by introduction of essential fatty acids or a related drug containing eicosanpentanoic acid ether or docosahexaenoic acid ether, either separately, or mixed in the developed effective doses.

EFFECT: improved cardioprotective and antidepressive action in the given group of patients.

45 cl

Description

FIELD OF THE INVENTION

Essential fatty acids and compositions containing them for preventing and / or treating depression in patients suffering from a cardiovascular disease such as coronary heart disease and / or coronary artery disease or vascular disease.

BACKGROUND

In one embodiment, the present invention relates to the use of a pharmaceutical composition comprising essential fatty acid ethyl esters derived from fish oil, preferably having a high content of a mixture of ethyl esters (20: 5ω-3) eicosanpentanoic acid (EPA) and (22: 6ω- 3) docosanhexanoic acid (DHA), for the prevention and / or treatment of depression in patients suffering from coronary artery disease.

It is well known that some essential fatty acids contained in fish oil have a therapeutic effect that provides prevention and treatment of cardiovascular disorders, such as treatment of hypertension, thrombosis, hypercholesterolemia, arteriosclerosis, cerebral infarction, prevention of sudden death of patients after myocardial infarction, improvement of endothelial function and prevention and treatment of hyperlipidemia.

Examples include US patents US 5502077, US 5656667 and US 5698594. Prevention of cardiovascular events, especially death in patients after the stage of hospitalization for acute myocardial infarction (AMI) is described in International Patent Application WO 00/48592.

In the prior art, in particular, there is evidence of the applicability of fatty acids belonging to the ω-3 group, more preferably (20: 5ω-3) eicosanpentanoic acid (EPA) and (22: 6ω-3) docosanhexanoic acid (DHA) , for the treatment of the above disorders.

EPA fatty acid, a precursor of PGI3 and TxA3, has a platelet aggregation preventing and antithrombotic effect that can be attributed to the inhibition of cyclooxygenase (similar to aspirin) and / or competition with arachidonic acid with respect to this enzyme, followed by a decrease in the amount of PGE2 and TxA synthesized , which are known agents that cause platelet aggregation.

On the other hand, DHA fatty acid is the most important component of cerebral lipids in humans and, in addition, being a structural component of platelets, it directly prevents platelet flow and therefore plays an important role in antithrombotic effects.

In the application for International patent WO 89/11521, the description of which is included in the present invention by reference, in particular, an industrial method for the extraction of mixtures having a high content of polyunsaturated acids, including EPA and DHA and their ethyl esters, from animal and / or vegetable is described oils.

Fatty acid mixtures, in particular EPA / DHA, obtained according to WO 89/11521, are reported to be particularly useful for the treatment of cardiovascular diseases.

However, it is shown that currently used in medicine methods of treatment are ineffective for patients suffering from coronary artery disease.

SUMMARY OF THE INVENTION

In one embodiment, the present invention relates to the use of a pharmaceutical composition comprising essential fatty acid ethyl esters derived from fish oil, preferably a high concentration mixture of ethyl esters (20: 5ω-3) eicosanpentanoic acid (EPA) and (22: 6ω- 3) docosanhexanoic acid (DHA), for the prevention and / or treatment of depression in patients suffering from cardiovascular disease, such as coronary heart disease, coronary artery disease or vascular disease.

In one embodiment, the present invention relates to a new method for the prevention and / or treatment of depression in patients suffering from cardiovascular disease. In another embodiment, in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease. In yet another embodiment, the cardiovascular disease is coronary artery disease or vascular disease. The method of the present invention comprises administering to said patient an effective amount of a medicament containing essential fatty acids, having a high content of eicosanpentanoic acid ethyl ester (EPA), docosanhexanoic acid ethyl ester (DHA) or a high content of eicosanpentanoic acid ethyl ester (EPA) mixture and docosanhexanoic acid ethyl ester (DHA). In one embodiment, the large amount of the mixture is a large amount of a mixture of eicosanpentanoic acid ethyl ester (EPA) and docosanhexanoic acid ethyl ester (DHA).

A high content of EPA ethyl ester or DHA ethyl ester or a large content of their mixture should be understood as a content of not less than 20 wt.% EPA or DHA or not less than 20 wt.% A mixture of EPA and DHA.

In one embodiment, the present invention relates to the use of essential fatty acids, which are a mixture of ethyl ester of eicosanpentanoic acid (EPA) and ethyl ester of docosanhexanoic acid (DHA), for the prevention and / or treatment of depression in patients suffering from cardiovascular disease, in one an example is in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease, in which the content of EPA and DHA in such a mixture is more than 25 wt.%.

In another embodiment, the present invention relates to the use of a therapeutically effective amount of essential fatty acids having a high content of EPA, DHA, or a mixture thereof, for the manufacture of a medicament for the treatment of a cardiovascular disease such as coronary heart disease and / or coronary artery disease or vascular disease.

Other features and advantages of the present invention will be apparent from the following detailed description. However, it should be understood that the detailed description and specific examples, if preferred embodiments of the present invention are indicated therein, are provided for illustration only, since various changes and modifications to the essence and scope should be apparent to those skilled in the art from this detailed description. of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

As used in the present invention, the terms “comprising” and “including” are used interchangeably and not mutually exclusive.

Recently, new risk factors for coronary artery disease, including depression, have been identified. Major depressive disorders, as well as symptoms of depression, are associated with high rates of incidence of cardiovascular diseases and mortality from cardiovascular diseases. In addition, after the occurrence of coronary heart disease, the risk of a fatal heart attack increases. Severe ventricular arrhythmias leading to a sudden rupture of the heart, apparently, are the main cause of death for patients suffering from depression. In addition, it was shown that in patients suffering from anxiety and depressive disorders, heart rate variability decreases. This fact may have great prognostic value, since low heart rate variability is a reliable prognostic factor for sudden heart failure. There is strong evidence that major depression is associated with a change in omega-3 acid status. It was found that with major depression, the content of omega-3 fatty acids in erythrocyte membranes decreases significantly. Another study reports an inverse correlation between the content of omega-3 fatty acids in erythrocyte membranes and the intake of these polyunsaturated fatty acids with food with a severity of depression. It is known that replenishment of the diet with EPA and DHA increases the content of these unsaturated fatty acids in the membranes of red blood cells. Studies of patients after myocardial infarction have shown that supplementing the diet with DHA and EPA increases heart rate variability.

However, currently there are no effective and safe agents for which it would be known that they prevent depression in patients suffering from cardiovascular disease, and there are hardly any other treatments for depression in patients suffering from cardiovascular disease. One study of sertraline showed its beneficial effects in patients after myocardial infarction with concomitant depression. It is well known that for patients suffering from cardiovascular disease and depression, there is a significantly increased risk of cardiovascular disease and death.

Therefore, improved and effective prophylaxis and / or treatment with drugs is still needed, especially to prevent these relapses in patients suffering from both cardiovascular diseases and depression, and an effective treatment for depression in these patients. Therefore, in one embodiment, the present invention relates to such an improved and effective prophylaxis (prevention) and / or treatment of said patients with an effective medicament, in particular the prevention of the above relapses in patients suffering from both cardiovascular diseases and depression, and / or treatment of depression in these patients.

In one embodiment, the present invention relates to a new method for the prevention and / or treatment of depression in patients suffering from cardiovascular disease. In one embodiment, the cardiovascular disease is coronary heart disease and / or coronary artery disease or vascular disease. In another embodiment, the cardiovascular disease is coronary artery disease or vascular disease. In one embodiment, the method comprises administering to said patient an effective amount of a medicament containing essential fatty acids having a high content of ethyl ester of eicosanpentanoic acid (EPA), ethyl ester of docosanhexanoic acid (DHA) or a high content of a mixture of ethyl ester of eicosanpentanoic acid (EPA) and ethyl docosanhexanoic acid ester (DHA). In one embodiment, an agent is administered having a high content of a mixture of eicosanpentanoic acid ethyl ester (EPA) and docosanhexanoic acid ethyl ester (DHA). The present invention also relates to the use of essential fatty acids, such as a large amount of EPA, DHA, or a mixture thereof, for the prevention and treatment of depression in patients suffering from cardiovascular disease.

For ease of description, the terms "EPA ethyl ester" and "DHA ethyl ester" in the present invention will also be referred to as "EPA", "DHA". A high content of EPA ethyl ester or DHA ethyl ester or a large content of their mixture should be understood as a content of not less than 20 wt.% EPA or DHA or not less than 20 wt.% A mixture of EPA and DHA.

In particular, the present invention relates to the use of essential fatty acids containing a mixture of eicosanpentanoic acid ethyl ester (EPA) and docosanhexanoic acid ethyl ester (DHA) for the prevention and / or treatment of depression in patients suffering from cardiovascular disease, preferably in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease, in which the content of EPA and DHA in such a mixture is more than 25 wt.%.

In one embodiment, the essential fatty acid having the high EPA or DHA content of the present invention preferably contains more than 25 wt.%, More preferably from about 60 to about 100% of such an ester. These compounds can be obtained by known methods.

For an essential fatty acid having a high content of a mixture of EPA and DHA, it is preferable that the mixture has a content of EPA and DHA in excess of 25 wt.%, Preferably from about 30 to about 100 wt.%, More preferably about 85 wt.% . For the EPA / DHA mixture, it is preferable that the EPA is contained in an amount of from about 40 to 60 wt.%, And it is preferable that the DHA is contained in an amount of from about 25 to about 45-50%. In any case, the preferred mass ratio of EPA / DHA in such a mixture of EPA / DHA is from about 0.9 to 1.5.

PHARMACOLOGY

Cardiovascular disease is the leading cause of morbidity and disability in the United States, where an estimated 6 million people suffer from symptomatic coronary heart disease. Major depression occurs at an earlier age and with a greater frequency than before. Changes in the content of phospholipids and cholesterol, which are structural components of all cell membranes of the brain, can cause changes in the microviscosity of membranes and, as a result, changes in various neurotransmitter systems that are considered to be associated with the pathophysiology of depression, for example, serotonin and (nor-) adrenaline. Major depression and depressive symptoms, although usually found in sick people, are often not diagnosed and not treated in patients with cardiovascular disease. In patients with coronary heart disease, the prevalence of major depression is almost 20% and the prevalence of minor depression is approximately 27%. Depression (major depressive disorders, as well as depressive symptoms) is associated with indicators of the incidence of cardiovascular disease. For patients suffering from depression, the prognosis after the occurrence of coronary heart disease is worse than for patients not suffering from depression. Depressed patients are less likely to adhere to recommendations for reducing heart risk during recovery from myocardial infarction. With major depression, the content of ω-3 fractions of cholesterol esters was reduced and the ratio C20: 4 ω-6 / C20: 5 ω-3 for cholesterol esters and phospholipids was increased.

Depression is an important independent prognostic factor for death after coronary artery bypass surgery. An analysis of survival taking into account age, gender, number of transplants, the presence of diabetes, smoking, left ventricular ejection fraction and the presence of a previous myocardial infarction shows that for patients with moderate to severe depression after surgery (the adjusted risk score (PR) is 2.4 , p = 0.001) and with mild to moderate depression that persists for up to 6 months after surgery (adjusted PR is 2.2), mortality rates are higher than for those who do not have depression. In addition, mild to moderate symptoms of depression in patients after acute myocardial infarction are associated with reduced survival. The highest mortality rate is observed in patients who manifest the most pronounced symptoms of depression. However, when compared with patients who do not have depression, higher mortality is also observed in those who exhibit very mild symptoms of depression, usually not considered clinically significant. Increased mortality after myocardial infarction is observed in both women and men. In women with depression, mortality during the year after heart disease is about 3 times higher, and in men with depression, it is 2.5 times higher than in the absence of depression in women and men, respectively. Preliminary studies have shown that in addition to the risk of death associated with depression after myocardial infarction, for patients suffering from depression who lived 1 year after myocardial infarction, the cost of medical care associated with both re-hospitalization and outpatient treatment increases. The causes of increased mortality and morbidity in patients with coronary heart disease and depression are not fully understood. However, there is evidence that depression causes abnormalities in the absorption and metabolism of essential fatty acids in combination with reduced formation of cholesterol esters. There is a direct correlation between the ratio of the amount of arachidonic acid to the amount of eicosanpentanoic acid in the blood with the clinical symptoms of depression. A significant inverse correlation of the content of EPA in red blood cells with the severity of depression was also found. Changes in the content of phospholipids and cholesterol, which are structural components of all cell membranes of the brain, can cause changes in the microviscosity of membranes and, as a result, changes in various neurotransmitter systems, such as serotonin and (nor-) adrenaline. It is well known that these neurotransmitters play an important role in the pathophysiology of depression. Finally, a decrease in food intake and a decrease in body weight associated with severe depression can lead to a change in the composition of fatty acids in serum cholesterol phospholipids and esters, which in itself can affect membrane fluidity and the inflammatory response.

The effectiveness of the treatment in the context of the present invention is confirmed by indirect preclinical and clinical data.

1. The consumption of large amounts of fatty ω-3 acids is associated with a general suppression of signaling pathways associated with phosphatidylinositol, arachidonic acid, and other systems.

2. DHA is involved in the metabolism of dopamine and serotonin in the growing brain of rats.

3. Serotonergic and other neurochemical effects of ω-3 fatty acids observed in animals indicate antidepressant activity.

4. Epidemiological data show that differences in the prevalence of major depression and bipolar disorder observed in different countries are directly related to the amount of fish consumed.

5. Epidemiological studies have shown a correlation of the composition of fatty acids in plasma with depression in the elderly.

6. In bipolar disorders, the hyperactivity of cell signal transmission plays a role in pathophysiology.

7. In patients suffering from bouts of major depression, there is a significant decrease in the content of DHA and EPA in the membranes of red blood cells.

8. Fatty omega-3 acids lead to mood stabilization in major depression and other neuropsychiatric disorders.

9. The addition of EPA in the treatment of persistent depression is associated with remission of symptoms, structural changes in the brain and a weakening of the exchange of neural phospholipids.

10. Omacor, a highly concentrated mixture of EPA and DHA, increases the content of EPA and DHA in the membranes of red blood cells.

The above data show that the present invention relates to a new and useful therapeutic method for preventing and / or treating depression in patients suffering from cardiovascular disease, preferably in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease. Accordingly, the present invention relates to a method for the prevention and treatment of depression in patients suffering from coronary artery disease, and preferably in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease, comprising administering to the patient a therapeutically effective amount of a drug containing essential fatty acids, having a high content of EPA ethyl ester or DHA ethyl ester or a high content of their mixture.

The essential fatty acids of the present invention may have a high content, for example, constituting more than 25 wt.%, EPA or DHA, or mixtures thereof. However, it is preferable that the ethyl esters of EPA and DHA are contained as a mixture thereof with an EPA and DHA content of more than 25 wt.%, Preferably from about 30 to about 100 wt.%, In one embodiment, about 80, 81, 82 , 83, 84% or, preferably, about 85 wt.%.

Based on the available data, in a preferred embodiment of the present invention, the dose of an essential fatty acid containing a mixture of EPA and DHA in an amount of 85% by weight for oral administration to a patient can range from about 0.7 to about 6 g per day preferably if it is about 1 g per day.

In one embodiment, an agent having a high content of EPA, DHA or a high content of a mixture thereof is placed in a capsule, such as a gelatin capsule, using techniques known in the art. In one embodiment, the gelatin capsule is a capsule containing 1000 mg. In another embodiment, said capsule comprises 90% by weight of omega-3 fatty acid ethyl esters. In another embodiment, of these 90% by weight in a capsule containing 1000 mg, about 465 mg is EPA and about 375 mg is DHA. In yet another embodiment, said 1000 mg capsule comprises about 4 mg of α-tocopherol in a suitable carrier (such as partially hydrogenated vegetable oils, including soybean oil) and other components of the gelatin capsule, such as gelatin, glycerin and purified water. In one embodiment of the present invention, the administered dose is 4 g per day in capsules containing 1000 mg.

To ensure the necessary blood content, this amount of the drug in the form of a mixture of EPA and DHA (or the amount of EPA only or only DHA) can be administered during the day in several divided doses or, preferably, in a single dose. Obviously, the amount of drug administered is determined by the attending physician in accordance with the age, weight and general condition of the patient. As such, a “therapeutically effective amount” is the amount that, at the dosages and time periods used, is necessary to achieve the desired therapeutic result. It should be understood that this amount can vary depending on factors such as the type of pathological condition, age, gender and weight of the individual, and the ability of the substance to cause the necessary reaction in the individual.

A drug, for example, in the form of a pharmaceutical composition of the present invention, can be prepared using techniques known in the art. The preferred route of administration is oral, but alternative routes of administration are possible, such as the parenteral route, and the decision is made by the physician. The drug or pharmaceutical composition may contain the necessary amount of substance, for example, have a high content of EPA, DHA or a high content of a mixture thereof, proposed in the present invention, and contain a pharmaceutically acceptable solvent, for example, carriers, excipients, excipients and buffers, for example, substances used in pharmaceutical preparations or known in the art, for example, those described in Remington's Pharmaceutical Sciences (Alfonso R. Gennaro ed. 18 ^th edition 1990).

Embodiments of the present invention are further defined in the dependent claims.

The following examples illustrate formulations suitable for oral administration, but in no way limit the present invention.

Gelatin capsules

In accordance with known pharmaceutical technologies, capsules were prepared having the composition below and containing 1 g of the active ingredient (EPA and DHA, 85% content) in each capsule.

Drug 1

EPA ethyl ether 525 mg / capsule DHA ethyl ether 315 mg / capsule d-alpha tocopherol 4 ME / capsule gelatin 246 mg / capsule glycerol 118 mg / capsule red iron oxide 2.27 mg / capsule yellow iron oxide 1.27 mg / capsule

Drug 2

Polyunsaturated Ethyl Esters fatty acids 1000 mg

When containing ethyl
esters of ω-3 polyunsaturated
acids (eicosanpentane EPA, docosanhexane DHA) 850 mg d-1-α-tocopherol 0.3 mg gelatin succinate 233 mg glycerol 67 mg sodium p-hydroxybenzoate 1.09 mg sodium propyl p-hydroxybenzoate 0.54 mg

Although the present invention has been described using what is currently considered a preferred embodiment, it should be understood that the present invention is not limited to the disclosed embodiment. On the contrary, the present invention includes various modifications and equivalent systems included in the essence and scope of the attached claims.

All publications, patents and patent applications in their entirety are included in the present invention by reference to the extent that it would be indicated that each individual publication, patent or patent application in its entirety is incorporated into the present invention by reference .

Claims (45)

1. A method of preventing and / or treating depression in patients suffering from a cardiovascular disease, comprising administering to said patient a therapeutically effective amount of a medicament containing essential fatty acids, which contains:
a) at least 20 wt.% ethyl ester of eicosanpentanoic acid, or
b) at least 20 wt.% ethyl ester of docosanhexanoic acid, or
c) at least 20% by weight of a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester. 2. The method according to claim 1, in which the cardiovascular disease is coronary heart disease and / or coronary artery disease or vascular disease. 3. The method according to claim 2, in which the cardiovascular disease is coronary artery disease or vascular disease. 4. The method according to any one of claims 1 to 3, in which the essential fatty acids contain at least 20 wt.% A mixture of ethyl ester of eicosanpentanoic acid and ethyl ester of docosanhexanoic acid. 5. The method according to any one of claims 1 to 3, in which the essential fatty acids contain at least 20 wt.% Ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid. 6. The method according to claim 4, in which the content of ethyl ester of eicosanpentanoic acid and ethyl ester of docosanhexanoic acid in such a mixture is from about 30 to about 85 wt.%. 7. The method according to claim 4, in which the drug is administered orally. 8. The method according to claim 1, in which the drug is administered orally. 9. The method according to claim 6, in which the drug is administered orally. 10. The method according to claim 7, in which the drug is administered orally at a dose of from about 0.7 to about 6 g per day. 11. The method of claim 8, in which the drug is administered orally at a dose of from about 0.7 to about 6 g per day. 12. The method according to claim 9, in which the drug is administered orally at a dose of from about 0.7 to about 6 g per day. 13. The method of claim 10, wherein the weight ratio of eicosanpentanoic acid ethyl ester to docosanhexanoic acid ethyl ester in a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester is from about 0.9 to 1.5. 14. The method according to claim 11, in which the mass ratio of eicosanpentanoic acid ethyl ester / docosanhexanoic acid ethyl ester in a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester is from about 0.9 to 1.5. 15. The method according to item 12, in which the mass ratio of ethyl ester of eicosanpentanoic acid / ethyl ester of docosanhexanoic acid in a mixture of ethyl ester of eicosanpentanoic acid and ethyl ester of docosanhexanoic acid is from about 0.9 to 1.5. 16. The method according to claim 5, in which the content of ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid is about 60-100 wt.%. 17. The method according to claim 5, wherein the contained eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is administered orally. 18. The method according to claim 5, wherein the contained eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is administered orally. 19. The method according to clause 16, wherein the contained eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is administered orally. 20. The use of a therapeutically effective amount of a medicinal product containing essential fatty acids that contain at least 20 wt.% Ethyl ester of eicosanpentanoic acid or at least 20 wt.% Ethyl ester of docosanhexanoic acid, or at least 20 wt.% A mixture of ethyl eicosanpentanoic acid ester and docosanhexanoic acid ethyl ester and a pharmaceutically acceptable solvent for treating depression in patients with cardiovascular disease. 21. The use according to claim 20, in which the cardiovascular disease is coronary heart disease and / or coronary artery disease or vascular disease. 22. The use of claim 21, wherein the cardiovascular disease is a coronary artery disease or vascular disease. 23. The use according to any one of claims 20 to 22, wherein the essential fatty acids contain at least 20% by weight of a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester. 24. The use according to any one of claims 20 to 22, wherein the essential fatty acids contain at least 20 wt.% Ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid. 25. The application of claim 23, wherein the content of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester in such a mixture is from about 30 to about 85% by weight. 26. The application of item 23, in which the drug is administered orally. 27. The use of claim 25, wherein the drug is administered orally. 28. The use of claim 26, wherein the drug is administered orally at a dose of about 0.7 to about 6 g per day. 29. The use of claim 27, wherein the drug is administered orally at a dose of about 0.7 to about 6 g per day. 30. The use of claim 28, wherein the weight ratio of eicosanpentanoic acid ethyl ester of docosanhexanoic acid ethyl ester in a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester is from about 0.9 to 1.5. 31. The application of clause 29, in which the mass ratio of eicosanpentanoic acid ethyl ester of docosanhexanoic acid ethyl ester in a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester is from about 0.9 to 1.5. 32. The use according to paragraph 24, in which the content of ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid is about 60-100 wt.%. 33. The use of claim 24, wherein the contained eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is administered orally. 34. The use of claim 32, wherein the contained eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is administered orally. 35. Use of essential fatty acids containing at least 20 wt.% Ethyl ester of eicosanpentanoic acid or at least 20 wt.% Ethyl ester of docosanhexanoic acid, or at least 20 wt.% A mixture of ethyl ester of eicosanpentanoic acid and ethyl docosanhexanoic acid it is preferable to use at least 20 wt.% a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester for the preparation of a medicament used for the prevention and / or treatment depression in patients with cardiovascular disease, it is preferable - in patients with coronary heart disease and / or coronary artery disease or cerebrovascular disease, more preferably - in patients with coronary artery disease or cerebrovascular disease. 36. The use of claim 35, wherein the content of eicosanpentanoic acid ethyl ester in docosanhexanoic acid ethyl ester or in a mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester, preferably the content of dicosanhexanoic acid ethyl ester and docosanepanoic acid ethyl ester, more than docosanepentanoic acid ethyl ester and more ethyl ester 25 wt.%. 37. The application of clause 35 or 36, wherein the content of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester in such a mixture is from about 30 to about 100 wt.%. 38. The use according to claim 35 or 36, wherein the content of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester in such a mixture is about 85% by weight. 39. The use according to any one of claims 35-38, wherein the drug is intended for oral administration. 40. The application of clause 38, wherein the drug is intended for oral administration in a dose of from about 0.7 to about 6 g per day. 41. The application of claim 40, wherein the ratio of the eicosanpentanoic acid ethyl ester of docosanhexanoic acid ethyl ester in the mixture of eicosanpentanoic acid ethyl ester and docosanhexanoic acid ethyl ester is from about 0.9 to 1.5. 42. The use of essential fatty acids containing ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid for the manufacture of a medicament used for the prevention and / or treatment of depression in patients suffering from cardiovascular disease, preferably in patients suffering from coronary heart disease and / or coronary artery disease or vascular disease in which the content of ethyl ester of eicosanpentanoic acid or ethyl ester of docosanhexanoic acid is It seems more 25 wt.%. 43. The use of claim 42, wherein the drug is useful for preventing and / or treating depression in patients suffering from coronary artery disease or vascular disease. 44. The application of claim 42 or 43, wherein the content of eicosanpentanoic acid ethyl ester or docosanhexanoic acid ethyl ester is from about 60 to about 100 wt.%. 45. The use according to any one of paragraphs 42-44, wherein the drug is intended for oral administration.