Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder
Mocking RJ, Harmsen I, Assies J, Koeter MW, Ruhé HG, Schene AH
Translational psychiatry · 210 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- ZonMw
- University or hospital
- Universiteit van Amsterdam
- Government
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Government
- Dutch Research Council (NWO)
- Grants
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (016.126.059;); ZonMw (016.126.059)
Based on 4 listed funder(s).
Publication
- Published
- 2016-03-15 · Transl Psychiatry · vol. 6 · issue 3 · p. e756
- Publisher
- Springer Nature
- Cited
- 282 citations · more than 100% of similar papers · 28.6× the field average
- Impact
- Top 10% most cited in its field
- References
- 60 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Fatty Acid Research and Health · Diet and metabolism studies · Alcoholism and Thiamine Deficiency
- Keywords
- Major depressive disorder, Meta-analysis, Eicosapentaenoic acid, Internal medicine, Polyunsaturated fatty acid, Docosahexaenoic acid, Placebo, Antidepressant, Strictly standardized mean difference, Medicine, Psychiatry, Fatty acid, Biology, Pathology
- MeSH
- humans, fatty acids, omega-3, docosahexaenoic acids, eicosapentaenoic acid, antidepressive agents, regression analysis, depression, dietary supplements, randomized controlled trials as topic, major depressive disorder
6 authors
From NL
- Roel J. T. Mocking · correspondingAmsterdam UMC Location University of Amsterdam; University of Amsterdam
- Iris M HarmsenAmsterdam UMC Location University of Amsterdam; University of Amsterdam
- Johanna AssiesAmsterdam UMC Location University of Amsterdam; University of Amsterdam
- Maarten W.J. KoeterAmsterdam UMC Location University of Amsterdam; University of Amsterdam
- Henricus Gerardus RuhéUniversity Medical Center Groningen; University of Groningen; Amsterdam UMC Location University of Amsterdam; University of Amsterdam
- Aart H. ScheneRadboud University Nijmegen; Radboud University Medical Center; Donders Institute for Brain, Cognition and Behaviour
Abstract
Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as (adjuvant) treatment for major depressive disorder (MDD). In the present meta-analysis, we pooled randomized placebo-controlled trials assessing the effects of omega-3 PUFA supplementation on depressive symptoms in MDD. Moreover, we performed meta-regression to test whether supplementation effects depended on eicosapentaenoic acid (EPA) or docosahexaenoic acid dose, their ratio, study duration, participants' age, percentage antidepressant users, baseline MDD symptom severity, publication year and study quality. To limit heterogeneity, we only included studies in adult patients with MDD assessed using standardized clinical interviews, and excluded studies that specifically studied perinatal/perimenopausal or comorbid MDD. Our PubMED/EMBASE search resulted in 1955 articles, from which we included 13 studies providing 1233 participants. After taking potential publication bias into account, meta-analysis showed an overall beneficial effect of omega-3 PUFAs on depressive symptoms in MDD (standardized mean difference=0.398 (0.114-0.682), P=0.006, random-effects model). As an explanation for significant heterogeneity (I(2)=73.36, P<0.001), meta-regression showed that higher EPA dose (β=0.00037 (0.00009-0.00065), P=0.009), higher percentage antidepressant users (β=0.0058 (0.00017-0.01144), P=0.044) and earlier publication year (β=-0.0735 (-0.143 to 0.004), P=0.04) were significantly associated with better outcome for PUFA supplementation. Additional sensitivity analyses were performed. In conclusion, present meta-analysis suggested a beneficial overall effect of omega-3 PUFA supplementation in MDD patients, especially for higher doses of EPA and in participants taking antidepressants. Future precision medicine trials should establish whether possible interactions between EPA and antidepressants could provide targets to improve antidepressant response and its prediction. Furthermore, potential long-term biochemical side effects of high-dosed add-on EPA supplementation should be carefully monitored.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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