Clinician Article

Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression.

  • Hallahan B
  • Ryan T
  • Hibbeln JR
  • Murray IT
  • Glynn S
  • Ramsden CE, et al.
Br J Psychiatry. 2016 Sep;209(3):192-201. doi: 10.1192/bjp.bp.114.160242. Epub 2016 Apr 21. (Review)
PMID: 27103682
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  • FM/GP/Mental Health
    Relevance - 6/7
    Newsworthiness - 6/7
  • Family Medicine (FM)/General Practice (GP)
    Relevance - 5/7
    Newsworthiness - 5/7
  • General Internal Medicine-Primary Care(US)
    Relevance - 5/7
    Newsworthiness - 5/7
  • Psychiatry
    Relevance - 5/7
    Newsworthiness - 5/7


BACKGROUND: Trials evaluating efficacy of omega-3 highly unsaturated fatty acids (HUFAs) in major depressive disorder report discrepant findings.

AIMS: To establish the reasons underlying inconsistent findings among randomised controlled trials (RCTs) of omega-3 HUFAs for depression and to assess implications for further trials.

METHOD: A systematic bibliographic search of double-blind RCTs was conducted between January 1980 and July 2014 and an exploratory hypothesis-testing meta-analysis performed in 35 RCTs including 6665 participants receiving omega-3 HUFAs and 4373 participants receiving placebo.

RESULTS: Among participants with diagnosed depression, eicosapentaenoic acid (EPA)-predominant formulations (>50% EPA) demonstrated clinical benefits compared with placebo (Hedge's G = 0.61, P<0.001) whereas docosahexaenoic acid (DHA)-predominant formulations (>50% DHA) did not. EPA failed to prevent depressive symptoms among populations not diagnosed for depression.

CONCLUSIONS: Further RCTs should be conducted on study populations with diagnosed or clinically significant depression of adequate duration using EPA-predominant omega-3 HUFA formulations.

Clinical Comments

General Internal Medicine-Primary Care(US)

Is there anything that omega 3s cannot do? Interesting but not paradigm-changing as depression in Primary Care is such a heterogeneous mix of symptoms and severity. Perhaps anyone with any other co-morbidity should start off with omega 3 fatty acids as first-line therapy for depression.

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