Cited by 404Fatty Acid Research and HealthTryptophan and brain disordersTreatment of Major Depression

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

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Liao, Yuhua, Xie, Bo, Zhang, Huimin, He, Qian, Guo, Lan, Subramanieapillai, Mehala, Fan, Beifang, Lu, Ciyong, McIntyre, Roger S.·2019·Translational Psychiatry

DOI 10.1038/s41398-019-0515-5PMC PMC6683166

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Abstract

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.

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Fig. 1 Flow chart of literature search and study selection. This figure described the route of studies inclusion. Among 204 researches from database and other studies, there are 26 trials were satisfied for the criteria of our study. MDD major depressive disorder, RCT randomized control trialCC BY · PubMed Central

Fig. 2 Forest plot: omega-3 PUFAs vs control. There was significant effect of omega-3 PUFAs therapy for depression compared to placebo using random effect model. There was also significant evidence of heterogeneity between trials. Size of green plot proportional to weight in meta-analysis. Black lines, show confidence intervals. SD standard deviation, Std. Mean difference standardized mean difference, IV. Random Random (inverse variance heterogeneity), CI confidence intervalCC BY · PubMed Central

Fig. 3 Funnel plot of effect sizes for clinical trials included in the meta-analysis. This funnel plot depicts the standardized mean difference of trials versus their standard error. Published trials are depicted as dark circles. The dotted line bracket the 95% CI for the expect results of trials given this estimated underlying effect sizeCC BY · PubMed Central

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Authors: Liao, Y., Xie, B., Zhang, H., He, Q., Guo, L., Subramanieapillai, M., Fan, B., Lu, C., & McIntyre, R. S.
Affiliations: Shenzhen Nanshan Center for Chronic Disease Control (CN)
Sun Yat-sen University (CN)
University Health Network (CA)
Corresponding author: Fan, Beifang
Lu, Ciyong
ORCID: Liao, Yuhua
Zhang, Huimin
He, Qian
Guo, Lan
Fan, Beifang
Lu, Ciyong
McIntyre, Roger S.
Venue: Translational Psychiatry
Publisher: Springer Science and Business Media LLC
Published: 2019-08-05
Volume: 9
Issue: 1
Pages: 190-190
ISSN: 2158-3188 (ISSN-L)
DOI: 10.1038/s41398-019-0515-5
PMC: PMC6683166
OpenAlex: W2965334743
Cited by: 404
References: 55
Citations by year: 2026: 35 · 2025: 62 · 2024: 75 · 2023: 77 · 2022: 65 · 2021: 52 · 2020: 35 · 2019: 2
FWCI: 5.23
Type: journal article
Language: en
Update notices: correction (2021-09-07)
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Translational Psychiatry (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders: National Natural Science Foundation of China
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Keywords: omega-3 polyunsaturated fatty acids, depression, docosahexaenoic acid, eicosapentaenoic acid, DHA supplementation, dietary supplementation, depressive symptoms, dose-response relationship
MeSH terms: Depressive Disorder, Double-Blind Method, Humans, Fatty Acids, Omega-3, Randomized Controlled Trials as Topic, Treatment Outcome

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

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