A Revision on the Effectiveness of Omega-3 Polyunsaturated Fatty Acids As Monotherapy in the Treatment of Major Depressive Disorder

Overview

Journal Int J Clin Pract

Publisher Wiley

Specialty General Medicine

Date 2022 Dec 7

PMID 36474548

Authors

Tommaso Accinni

Matteo Panfili

Lorenzo Tarsitani

Massimo Biondi

Massimo Pasquini

Annalisa Maraone

Affiliations

Soon will be listed here.

Abstract

Background: Insufficient effectiveness and a difficult tolerability profile of antidepressant drugs for the treatment of major depressive disorder (MDD) have been reported, and polyunsaturated fatty acids (PUFAs) have been posited as reliable therapeutic alternatives. The present study investigated the efficacy of omega-3 PUFAs as monotherapy for MDD.

Methods: Two well-trained reviewers independently looked at the most significant randomized clinical trials (RCTs) from the PubMed database regarding PUFAs' employment in MDD compared to placebo; "major depressive disorder" and "omega-3 fatty acids," or "omega-6 fatty acids," or "polyunsaturated fatty acids (PUFA)," or " - 3 polyunsaturated fatty acids," or "eicosapentaenoic acid (EPA)," or "docosahexaenoic acid (DHA)" were used as the medical subject keywords.

Results: Of the initial 96 potential RCTs based on titles and abstracts, 82 studies did not meet the inclusion criteria and were excluded. Six studies were excluded from the remaining 14 after full text revision. Eight RCTs met all the inclusion/exclusion criteria without reporting clear evidence of PUFAs' effectiveness in the treatment of MDD.

Conclusion: At present, there is no opportunity to recommend the use of omega-3 PUFAs monotherapy for the treatment of MDD, although their supplementation may be useful in some specific populations.

Citing Articles

The metabolome-wide signature of major depressive disorder.

Jansen R, Milaneschi Y, Schranner D, Kastenmuller G, Arnold M, Han X Mol Psychiatry. 2024; 29(12):3722-3733.

PMID: 38849517 DOI: 10.1038/s41380-024-02613-6.

Oleaginous Microbial Lipids' Potential in the Prevention and Treatment of Neurological Disorders.

Alhattab M, Moorthy L, Patel D, Franco C, Puri M Mar Drugs. 2024; 22(2).

PMID: 38393051 PMC: 10890163. DOI: 10.3390/md22020080.

The Metabolome-Wide Signature of Major Depressive Disorder.

Jansen R, Milaneschi Y, Schranner D, Kastenmuller G, Arnold M, Han X Res Sq. 2023; .

PMID: 37790319 PMC: 10543022. DOI: 10.21203/rs.3.rs-3127544/v1.

References

Lee S, Lee S, Han C, Patkar A, Masand P, Pae C . Oxidative/nitrosative stress and antidepressants: targets for novel antidepressants. Prog Neuropsychopharmacol Biol Psychiatry. 2012; 46:224-35. DOI: 10.1016/j.pnpbp.2012.09.008. View

Beck A, Ward C, Mendelson M, Mock J, ERBAUGH J . An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4:561-71. DOI: 10.1001/archpsyc.1961.01710120031004. View

Appleton K, Voyias P, Sallis H, Dawson S, Ness A, Churchill R . Omega-3 fatty acids for depression in adults. Cochrane Database Syst Rev. 2021; 11:CD004692. PMC: 8612309. DOI: 10.1002/14651858.CD004692.pub5. View

McNamara R, Jandacek R, Rider T, Tso P, Cole-Strauss A, Lipton J . Omega-3 fatty acid deficiency increases constitutive pro-inflammatory cytokine production in rats: relationship with central serotonin turnover. Prostaglandins Leukot Essent Fatty Acids. 2010; 83(4-6):185-91. PMC: 2993848. DOI: 10.1016/j.plefa.2010.08.004. View

Chalon S, Vancassel S, Zimmer L, Guilloteau D, Durand G . Polyunsaturated fatty acids and cerebral function: focus on monoaminergic neurotransmission. Lipids. 2001; 36(9):937-44. DOI: 10.1007/s11745-001-0804-7. View

Dyall S . Long-chain omega-3 fatty acids and the brain: a review of the independent and shared effects of EPA, DPA and DHA. Front Aging Neurosci. 2015; 7:52. PMC: 4404917. DOI: 10.3389/fnagi.2015.00052. View

Edwards R, Peet M, Shay J, Horrobin D . Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients. J Affect Disord. 1998; 48(2-3):149-55. DOI: 10.1016/s0165-0327(97)00166-3. View

Li F, Liu X, Zhang D . Fish consumption and risk of depression: a meta-analysis. J Epidemiol Community Health. 2015; 70(3):299-304. DOI: 10.1136/jech-2015-206278. View

Marangell L, Martinez J, Zboyan H, Kertz B, Kim H, Puryear L . A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Am J Psychiatry. 2003; 160(5):996-8. DOI: 10.1176/appi.ajp.160.5.996. View

10.

Appleton K, Woodside J, Yarnell J, Arveiler D, Haas B, Amouyel P . Depressed mood and dietary fish intake: direct relationship or indirect relationship as a result of diet and lifestyle?. J Affect Disord. 2007; 104(1-3):217-23. DOI: 10.1016/j.jad.2007.03.012. View

11.

Rush A, Trivedi M, Ibrahim H, Carmody T, Arnow B, Klein D . The 16-Item Quick Inventory of Depressive Symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol Psychiatry. 2003; 54(5):573-83. DOI: 10.1016/s0006-3223(02)01866-8. View

12.

Levant B, Ozias M, Davis P, Winter M, Russell K, Carlson S . Decreased brain docosahexaenoic acid content produces neurobiological effects associated with depression: Interactions with reproductive status in female rats. Psychoneuroendocrinology. 2008; 33(9):1279-92. PMC: 2582014. DOI: 10.1016/j.psyneuen.2008.06.012. View

13.

Gabbay V, Freed R, Alonso C, Senger S, Stadterman J, Davison B . A Double-Blind Placebo-Controlled Trial of Omega-3 Fatty Acids as a Monotherapy for Adolescent Depression. J Clin Psychiatry. 2018; 79(4). PMC: 6625364. DOI: 10.4088/JCP.17m11596. View

14.

Tajalizadekhoob Y, Sharifi F, Fakhrzadeh H, Mirarefin M, Ghaderpanahi M, Badamchizade Z . The effect of low-dose omega 3 fatty acids on the treatment of mild to moderate depression in the elderly: a double-blind, randomized, placebo-controlled study. Eur Arch Psychiatry Clin Neurosci. 2011; 261(8):539-49. DOI: 10.1007/s00406-011-0191-9. View

15.

Lange K . Lack of evidence for efficacy of omega-3 fatty acids in depression. Acta Psychiatr Scand. 2021; 144(4):415-416. DOI: 10.1111/acps.13357. View

16.

Pasquini M, Berardelli I, Cabra A, Maraone A, Matteucci G, Biondi M . Core Depressive Symptoms In Depressed Cancer OutpatientsB. Clin Pract Epidemiol Ment Health. 2012; 7:178-81. PMC: 3249640. DOI: 10.2174/1745017901107010178. View

17.

Kawakita E, Hashimoto M, Shido O . Docosahexaenoic acid promotes neurogenesis in vitro and in vivo. Neuroscience. 2006; 139(3):991-7. DOI: 10.1016/j.neuroscience.2006.01.021. View

18.

Berg K, Maayani S, Clarke W . 5-hydroxytryptamine2C receptor activation inhibits 5-hydroxytryptamine1B-like receptor function via arachidonic acid metabolism. Mol Pharmacol. 1996; 50(4):1017-23. View

19.

Sanchez-Villegas A, Henriquez P, Figueiras A, Ortuno F, Lahortiga F, Martinez-Gonzalez M . Long chain omega-3 fatty acids intake, fish consumption and mental disorders in the SUN cohort study. Eur J Nutr. 2007; 46(6):337-46. DOI: 10.1007/s00394-007-0671-x. View

20.

Kodas E, Galineau L, Bodard S, Vancassel S, Guilloteau D, Besnard J . Serotoninergic neurotransmission is affected by n-3 polyunsaturated fatty acids in the rat. J Neurochem. 2004; 89(3):695-702. DOI: 10.1111/j.1471-4159.2004.02401.x. View