Omega-3 Fatty Acids: Evidence Basis for Treatment and Future Research in Psychiatry
J Clin Psychiatry 2006;67:1954-1967
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To determine if the available data
support the use of omega-3 essential fatty acids (EFA)
for clinical use in the prevention and/or treatment of
Participants: The authors of this article were
invited participants in the Omega-3 Fatty Acids
Subcommittee, assembled by the Committee on
Research on Psychiatric Treatments of the American
Psychiatric Association (APA).
Evidence: Published literature and data
presented at scientific meetings were reviewed. Specific
disorders reviewed included major depressive
disorder, bipolar disorder, schizophrenia, dementia,
borderline personality disorder and impulsivity, and
attention-deficit/hyperactivity disorder. Meta-analyses
were conducted in major depressive and bipolar
disorders and schizophrenia, as sufficient data were
availableto conduct such analyses in these areas of interest.
Consensus Process: The subcommittee
prepared the manuscript, which was reviewed and approved
by the following APA committees: the Committee on Research on Psychiatric Treatments, the Council
on Research, and the Joint Reference Committee.
Conclusions: The preponderance of
epidemiologic and tissue compositional studies supports a
protective effect of omega-3 EFA intake, particularly
eicosapentaenoic acid (EPA) and docosahexaenoic acid
(DHA), in mood disorders. Meta-analyses of randomized
controlled trials demonstrate a statistically
significant benefit in unipolar and bipolar depression
(p=.02). The results were highly heterogeneous, indicating
that it is important to examine the characteristics of
each individual study to note the differences in design
and execution. There is less evidence of benefit in
schizophrenia. EPA and DHA appear to have negligible
risks and some potential benefit in major depressive
disorder and bipolar disorder, but results remain
inconclusive in most areas of interest in psychiatry.
Treatment recommendations and directions for future
research are described. Health benefits of omega-3 EFA
may be especially important in patients with
psychiatric disorders, due to high prevalence rates of
smoking and obesity and the metabolic side effects of
some psychotropic medications.