Omega-3 fatty acids for depression in adults

Appleton, Katherine; Perry, Rachel; Sallis, Hannah M; Ness, Andrew R; Churchill, Rachel

doi:10.1002/14651858.cd004692.pub3

Cited by 36 publications

(65 citation statements)

References 62 publications

(1 reference statement)

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“…Overall, meta-analytic standardized mean differences for omega-3 fatty acids compared to placebo for depression generally range from 0.11 to 0.56 (Appleton et al 2015). However, interestingly, meta-analysis outcomes seem to depend on individual study characteristics: larger effects are seen for studies that supplement EPA to patients with major depressive disorder, as opposed to negligible or absent effect in studies that supplement DHA to subjects with only depressive symptoms or as preventive intervention (Martins 2009;Lin et al 2012;Martins et al 2012).…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…A recent Cochrane meta-analysis of omega-3 fatty acid supplementation for depression observed an overall effect size of 0.30 (95%CI = 0.10-0.50) (Appleton et al 2015). However, the authors conclude that this significant small-to-modest effect size has small clinical significance because the approximate reduction in Hamilton depression rating scale (HDRS)-score of 2.1 points remains under the National Institute for Health and Care Excellence (NICE)-limit of 3 points for clinically meaningful effects.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…Nevertheless, the Cochrane meta-analysis acknowledges that the overall effect size for omega-3 fatty acids is comparable to that of antidepressants (Appleton et al 2015). The authors described that the only available study that directly compared omega-3 fatty acids and antidepressant showed comparable benefit, but that the quality of the evidence is low.…”

Section: Clinical Applicationsmentioning

confidence: 99%

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Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders

Mocking

Assies

Ruhé

et al. 2018

J of Inher Metab Disea

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Continuous research into the pathophysiology of psychiatric disorders, such as major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and schizophrenia, suggests an important role for metabolism. This narrative review will provide an upto-date summary of how metabolism is thought to be involved in the pathophysiology of these psychiatric disorders. We will focus on (I) the important role of fatty acids in these metabolic alterations, (II) whether fatty acid alterations represent epiphenomena or risk factors, and (III) similarities and dissociations in fatty acid alterations between different psychiatric disorders. (Historical) epidemiological evidence links fatty acid intake to psychiatric disorder prevalence, corroborated by altered fatty acid concentrations measured in psychiatric patients. These fatty acid alterations are connected with other concomitant pathophysiological mechanisms, including biological stress (hypothalamic-pituitary-adrenal (HPA)-axis and oxidative stress), inflammation, and brain network structure and function. Metabolomics and lipidomics studies are underway to more deeply investigate this complex network of associated neurometabolic alterations. Supplementation of fatty acids as disease-modifying nutraceuticals has clinical potential, particularly add-on eicosapentaenoic acid (EPA) in depressed patients with markers of increased inflammation. However, by interpreting the observed fatty acid alterations as partly (mal)adaptive phenomena, we attempt to nuance translational expectations and provide new clinical applications for these novel neurometabolic insights, e.g., to predict treatment response or depression recurrence. In conclusion, placing fatty acids in context can contribute to further understanding and optimized treatment of psychiatric disorders, in order to diminish their overwhelming burden of disease.

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Section: Clinical Applicationsmentioning

confidence: 99%

Section: Clinical Applicationsmentioning

confidence: 99%

Section: Clinical Applicationsmentioning

confidence: 99%

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Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders

Mocking

Assies

Ruhé

et al. 2018

J of Inher Metab Disea

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“…Four new meta-analyses [70][71][72][73] and 2 systematic reviews 69,74 have provided updates on the efficacy of o-3 fatty acids in MDD (Suppl . Table S7).…”

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confidence: 99%

“…Table S7). One reported no benefits (13 trials, N ¼ 731), 70 another meta-analysis (25 trials, N ¼ 1438) 72 and 1 review 74 reported equivocal outcomes, 1 meta-analysis (15 trials, N ¼ 916) reported a positive outcome as monotherapy, 73 and 1 meta-analysis (11 trials, N ¼ 418) 69 and 1 review 71 reported a positive outcome as adjunctive therapy. Contradictory findings may be due to differences in study populations, methodology, and intervention parameters.…”

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confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments

Ravindran¹,

Balneaves²,

Faulkner³

et al. 2018

FOC

125

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Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. ''Complementary and Alternative Medicine Treatments'' is the fifth of six sections of the 2016 guidelines. Results: Evidence-informed responses were developed for 12 questions for 2 broad categories of complementary and alternative medicine (CAM) interventions: 1) physical and meditative treatments (light therapy, sleep deprivation, exercise, yoga, and acupuncture) and 2) natural health products (St. John's wort, omega-3 fatty acids; S-adenosyl-L-methionine [SAM-e], dehydroepiandrosterone, folate, Crocus sativus, and others). Recommendations were based on available data on efficacy, tolerability, and safety. Conclusions: For MDD of mild to moderate severity, exercise, light therapy, St. John's wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first-or second-line treatments. Adjunctive exercise and adjunctive St. John's wort are second-line recommendations for moderate to severe MDD. Other physical treatments and natural health products have less evidence

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Supplementation‐induced increase in circulating omega‐3 serum levels is not associated with a reduction in depressive symptoms: Results from the MooDFOOD depression prevention trial

et al. 2020

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Background There is ambiguity on how omega‐3 (n‐3) polyunsaturated fatty acids (PUFAs) are associated with depression, and what the temporality of the association might be. The present study aimed to examine whether (intervention‐induced changes in) n‐3 PUFA levels were associated with (changes in) depressive symptoms. Methods Baseline, 6‐ and 12‐month follow‐up data on 682 overweight and subclinically depressed persons from four European countries that participated in the MooDFOOD depression prevention randomized controlled trial were used. Participants were allocated to four intervention groups: (a) placebos, (b) placebos and food‐related behavioral activation therapy (F‐BA), (c) multinutrient supplements (fish oil and multivitamin), and (d) multinutrient supplements and F‐BA. Depressive symptoms were measured using the inventory of depressive symptomatology. PUFA levels (µmol/L) were measured using gas chromatography. Analyses were adjusted for sociodemographics, lifestyle, and somatic health. Results Increases in n‐3 PUFA, docosahexaenoic acid, and eicosapentaenoic acid levels over time were significantly larger in the supplement groups than in placebo groups. Change in PUFA levels was not significantly associated with the change in depressive symptoms (β = .002, SE = 0.003, p = .39; β = .003, SE = 0.005, p = .64; β = .005, SE = 0.005, p = .29; β = −.0002, SE = 0.0004, p = .69). Baseline PUFA levels did not modify the intervention effects on depressive symptoms. Conclusions In overweight and subclinical depressed persons, multinutrient supplements led to significant increases in n‐3 PUFA levels over time, which were not associated with changes in depressive symptoms. Multinutrient supplements do not seem to be an effective preventive strategy in lowering depressive symptoms over time in these at‐risk groups.

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Omega-3 fatty acids for depression in adults

Cited by 36 publications

References 62 publications

Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders

Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 5. Complementary and Alternative Medicine Treatments

Supplementation‐induced increase in circulating omega‐3 serum levels is not associated with a reduction in depressive symptoms: Results from the MooDFOOD depression prevention trial

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