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Efficacy of omega-3 PUFAs in depression: A meta-analysis
Open accessAbstract
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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“DHA-pure and DHA-major formulations, on the contrary, did not exhibit such benefits.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [127]
In the citing paper
“A 2019 meta-analysis of double-blind randomized placebo-controlled trials (including 26 studies; 2,160 participants) showed an overall beneficial effect of n-3 LCPUFA on depression symptoms, and both EPA-pure (= 100% EPA) and EPA-major formulations (≥ 60% EPA) demonstrated clinical benefits at an EPA dosage of ≤ 1 g/day [127].”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [127]
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Molecular recognition of fatty acids by peroxisome proliferator-activated receptors
Xu, H. E., Lambert, M. H., Montana, V. G., Parks, D. J., Blanchard, S. G., Brown, P. J., Sternbach, D. D., Lehmann, J. M., Wisely, G. B., Willson, T. M., et al. (1999) · Molecular Cell · doi:10.1016/s1097-2765(00)80467-0 · Cited by 1,169
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Nemets, B., Stahl, Z., & Belmaker, R. H. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.3.477 · Cited by 627
Omega-3 fatty acids in major depressive disorder
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Meta-Analysis of the Effects of Eicosapentaenoic Acid (EPA) in Clinical Trials in Depression
Sublette, M. E., Ellis, S. P., Geant, A. L., & Mann, J. J. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.10m06634 · Cited by 434
Marangell, L. B., Martinez, J. M., Zboyan, H. A., Kertz, B. L., Kim, H. F. S., & Puryear, L. J. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.5.996 · Cited by 379
Peet, M., & Horrobin, D. F. (2002) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(01)00048-6 · Cited by 329
Mocking, R. J. T., Harmsen, I. M., Assies, J., Koeter, M. W. J., Ruhé, H. G., & Schene, A. H. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.29 · Cited by 284
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Diet and depression: Exploring the biological mechanisms of action
Marx, W., Lane, M., Hockey, M., Aslam, H., Berk, M., Walder, K., Borsini, A., Firth, J., Pariante, C. M., Berding, K., et al. (2021) · Molecular Psychiatry · doi:10.1038/s41380-020-00925-x · Cited by 685
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Metadata
- 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
- Venue
- Translational Psychiatry
- Published
- 2019-08-05
- Volume
- 9
- Issue
- 1
- Pages
- 190-190
- ISSN
- 2158-3188 (ISSN-L)
- 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
- 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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