Omega-3 Fatty Acid Supplementation for Perinatal Depression

Abstract

Objective: Several randomized controlled trials (RCTs) investigated omega-3 polyunsaturated fatty acids (PUFAs) (ie, fish oil) in perinatal depression, but their efficacy remains unclear. We performed a meta-analysis of RCTs on omega-3 PUFAs for perinatal depression, comparing a priori defined subgroups: pregnant women vs postpartum women and prevention vs treatment of perinatal depression. Methods: We searched Web of Science, Embase, PsycINFO, and the Cochrane Library, combining omega-3 PUFAs and perinatal depression terms and including publications up to February 18, 2019, for RCTs on omega-3 PUFAs compared to placebo or any active comparator. Results: Data from 18 RCTs on 4,052 participants showed an overall significant small beneficial effect of omega-3 PUFAs on depressive symptoms compared to placebo (−0.236 standardized difference in means [SDM]; 95% CI = −0.463 to −0.009; P = .042). Heterogeneity was considerable (I 2 = 88.58; P < .001), with significant subgroup differences explaining 55% of between-study variance (P = .001). In depressed women, omega-3 PUFAs showed a medium effect (SDM = −0.545; 95% CI = −1.182 to 0.093; P = .094) vs no effect in nondepressed women (SDM = −0.073). Moreover, the effect was medium to large in postpartum women (SDM = −0.656; 95% CI = −1.690 to 0.378; P = .214) compared to a negligible effect during pregnancy (SDM = −0.071). RCTs specifically studying postpartum depression showed the largest effect (SDM = −0.886; 95% CI = −2.088 to 0.316; P = .149). Conclusions: Omega-3 PUFAs have an overall significant small beneficial effect on perinatal depression, with important subgroup differences. We advise against prescribing omega-3 PUFAs for the treatment or prevention of depressive symptoms during pregnancy, given a lack of effect with low heterogeneity. In contrast, omega-3 PUFA supplementation may be a promising (add-on) treatment for postpartum depression.

Bibliometrics and Visual Analysis of the Research Status and Trends of Postpartum Depression From 2000 to 2020

“…At present, the physiological causes of PPD are mainly neuroendocrine factors, which are considered to be abnormal central neurotransmitter metabolism and changes in related receptor functions, such as 5-hydroxytryptamine (5-HT), dopamine, and norepinephrine. In recent years, studies have focused on W-3 unsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Markhus et al, 2015;Hsu et al, 2018;Mocking et al, 2020). Pawluski et al (2017) also found through functional magnetic resonance imaging (fMRI) that the connections between the amygdala, anterior cingulate gyrus, dorsolateral prefrontal cortex, and hippocampus in PPD patients are significantly reduced, and the activity of the left amygdala is significantly reduced.…”

New Insights into Depressive Disorder with Respect to Low-Grade Inflammation and Fish Oil Intake

“…Moderate intake of n-3 PUFAs (approximately 0.5-1 g/day) was significantly associated with a lower prevalence of depression 31) . EPA may exert anti-inflammatory benefits in women with perinatal depression 32) . The treatment efficacy of n-3 PUFA supplementation depends on the proportion and dose of EPA and DHA 33) .…”

Nontraditional therapies for treatment-resistant depression: Part 2

“…Rare: More serious injuries SAMe 8 Nausea, mild insomnia, dizziness, irritability, anxiety Vitamin D [1][2][3][4][5] Toxicity (uncommon), which may include weakness, fatigue, sleepiness, headache, dry mouth, metallic taste, loss of appetite, nausea, vomiting Probiotics [10][11][12] May trigger allergic reactions or cause mild stomach upset, diarrhea, flatulence, or bloating Mindfulness-based interventions 31,32 May negatively affect emotions, sensory perception, social interactions, sense of self Essential fatty acids [5][6][7] Accumulates in adipose tissue. In this context, omega-6 rich diets can increase oxidized low-density lipoprotein levels…”

“…6 Furthermore, omega-3 fatty acids may be helpful as an add-on agent for postpartum depression. 7 Be aware that a diet rich in omega-6 greatly increases oxidized low-density lipoprotein levels in adipose tissue, potentially posing a cardiac risk factor. Clinicians need to be aware that self-prescribed use of essential fatty acids is common, and to ask about and monitor their patients' use of these agents.…”