It has also been demonstrated that the use of antidepressants such as fluoxetine, paroxetine, and venlafaxine for treatment of hot flashes and citalopram for the treatment of hot flashes and mood in perimenopausal women are more effective than placebo. However, antidepressant medications are associated with significant side effects and as of late, have come under increased scrutiny by the U.S. FDA, the psychiatric, and general medical community due to the ongoing controversy regarding a possible increased risk of suicidality after the initiation of antidepressant treatment. While there is not complete agreement on the mechanism of action for omega-3 fatty acids, like antidepressants, overall data suggests that omega-3 fatty acids may be beneficial for treatment of perimenopausal depression. However, unlike antidepressants, omega-3 fatty acids are naturally occurring substances, which may appeal to many individuals suffering from perimenopausal depression. Omega-3 fatty acids have known benefits for cardiovascular health. Therefore, the current study is designed to examine the effectiveness and tolerability of the study drug, Omacor, (omega-3 fatty acid ethyl esters), in the treatment of major depression in perimenopausal women.