Efficacy of omega-3 PUFAs in depression: A meta-analysis

• Published in: Translational psychiatry Vol. 9; no. 1; pp. 190 - 9
• Main Authors: Liao, Yuhua, Xie, Bo, Zhang, Huimin, He, Qian, Guo, Lan, Subramanieapillai, Mehala, Fan, Beifang, Lu, Ciyong, McIntyre, Roger S.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 05.08.2019; Nature Publishing Group
• Subjects: 631/154/436/108; 692/699/476/1414; Behavioral Sciences; Biological Psychology; Depressive Disorder - drug therapy; Double-Blind Method; Fatty acids; Fatty Acids, Omega-3 - therapeutic use; Fish oils; Humans; Medicine & Public Health; Meta-analysis; Neurosciences; Pharmacotherapy; Polyunsaturated fatty acids; Psychiatry; Randomized Controlled Trials as Topic; Review; Review Article; Treatment Outcome
• ISSN: 2158-3188; 2158-3188
• DOI: 10.1038/s41398-019-0515-5

We conducted this meta-analysis of double-blind randomized placebo-controlled trials to estimate the efficacy of omega-3 polyunsaturated fatty acids (PUFAs), especially docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), in the improvement of depression. We applied a systematic bibliographic search in PubMed and EMBASE for articles published prior to 20 December 2017. This meta-analysis was performed using RevMan 5.3 and R 3.4.3, and means and standard deviations were calculated in fixed- or random-effects models based on the results of the Q-test. A sensitivity analysis was also conducted to evaluate the stability of the results, and publication bias was evaluated by a funnel plot and Egger’s linear regression analysis. Our search resulted in 180 articles; we analyzed 26 studies, which included 2160 participants. The meta-analysis showed an overall beneficial effect of omega-3 polyunsaturated fatty acids on depression symptoms (SMD = −0.28, P  = 0.004). Compared with placebo, EPA-pure (=100% EPA) and EPA-major formulations (≥60% EPA) demonstrated clinical benefits with an EPA dosage ≤1 g/d (SMD = −0.50, P  = 0.003, and SMD = −1.03, P  = 0.03, respectively), whereas DHA-pure and DHA-major formulations did not exhibit such benefits. Current evidence supports the finding that omega-3 PUFAs with EPA ≥ 60% at a dosage of ≤1 g/d would have beneficial effects on depression. Further studies are warranted to examine supplementation with omega-3 PUFAs for specific subgroups of subjects with inflammation, severity of depression, and the dose response for both EPA and DHA supplementation.