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Omega-3 Fatty Acids for Psychiatric Illness Presented By : Amin Younis Uniwersytet Medyczny w Łodzi


Introduction Omega-3 fatty acids (ω −3 fatty acids) are fats commonly found in marine and plant oils. They are polyunsaturated fatty acids with a double bond (C=C) at the third carbon atom from the end of the carbon chain. The fatty acids have two ends, the acid (-COOH) end, which is considered the beginning of the chain, thus "alpha", and the methyl (CH3) end, which is considered the "tail" of the chain, thus "omega".


Introduction O mega-3 fatty acids, include eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha- linolenic acid (ALA). ALA is a metabolic precursor to EPA and DHA . Omega-3 FA are thought to contribute to cell membrane fluidity, modulation of neurotransmitters, and signal transduction pathways. Omega-3 FA concentration may impact serotonin and dopamine transmission. Therefore , decreased intake may increase the risk of several psychiatric disorders.

Mechanism of Action:

Mechanism of Action

Mood Disorders:

Mood Disorders Depression: Several meta-analyses examining the use of omega-3 FAs for treating depressive disorders have had ambiguous findings. Variability in results might be partially explained by differences in the severity of baseline depression, diagnostic variation, differing omega-3 supplementation protocols, or other issues.

Mood Disorders:

Mood Disorders Depression: Most studies suggested that omega-3 FAs may be effective in patients with severe depression rather than mild-moderate. A meta-analysis of clinical trials of omega-3 FAs for depressive illness suggested EPA should be ≥60% of total EPA + DHA

Mood Disorders:

Mood Disorders Depression:

Mood Disorders:

Mood Disorders Bipolar Disease: Adding omega-3 supplements to mood stabilizers in patients with BD was associated with a statistically significant reduction of depressive symptoms , but was NOT effective for treating mania. Patients with BD especially those with comorbid cardiovascular or metabolic conditions are recommended to increase their dietary consumption of foods containing omega-3.

Mood Disorders:

Mood Disorders Perinatal and Postpartum Depression: considered a safe treatment for depressive disorders during pregnancy because they provide neurodevelopmental benefits for neonates. RCTs of omega-3 FA monotherapy for perinatal depression were small ( ≤51 patients) and produced mixed findings.


Schizophrenia In a Cochrane review of 8 studies of patients with schizophrenia, adjunctive treatment with omega-3 FAs led to >25% reduction in the Positive and Negative Syndrome Scale, but this improvement was NOT statistically significant. use of omega-3 FAs in patients with schizophrenia remains experimental .


Dementia In vascular dementia, DHA supplementation led to improved Hamilton Depression Rating Scale and Mini-Mental State Examination (MMSE ) scores compared with controls . Administering EPA to 64 patients with Alzheimer’s disease significantly improved MMSE scores, with maximum improvement at 3 months, but this benefit dissipated after 6 months of treatment.

Other Psychiatric Disorders:

Other Psychiatric Disorders Omega-3 FAs appear to lack efficacy in ADHD, OCD and borderline personality disorder

Limitations of The Data:

Limitations of The Data Studies may evaluate the use of EPA alone, EPA combined with DHA, or DHA alone. The doses of EPA and DHA and ratio of EPA to DHA of the supplements used in clinical trials varies greatly. Patients’ dietary consumption of omega-3 FAs is difficult to control. DSM diagnostic criteria, as well as severity of illness, differ within studies.


Conclusions Evidence suggests omega-3 fatty acids (FAs) might help reduce symptoms of bipolar and postpartum depression and dementia, but not schizophrenia. In depressive illness , omega-3 FAs seem to be more effective in patients with more severe symptoms . Patients with cardiovascular disease are recommended to increase their dietary intake of omega-3 FAs or take a supplement with 1 to 1.5 g/d of eicosapentaenoic acid (EPA) + docosahexaenoic acid, with ≥60% EPA.


Conclusions Omega-3 FA supplementation has not shown efficacy for patients with schizophrenia, although it may prevent transition to psychosis in adolescents and young adults at ultra-high risk for a psychotic disorder. Data examining omega-3 FA supplementation in postpartum depression and dementia are limited but show promise.

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References http:// http:// Mary Morreale , MD Assistant Professor Department of Psychiatry Wayne State University Detroit , MI

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