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Appleton KM, Sallis HM, Perry R, Ness AR, Churchill R. Omega-3 fatty acids for depression in adults. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No.: CD004692. DOI: 10.1002/14651858.CD004692.pub4.
This review assessed the effects of n-3 polyunsaturated fatty acids (also known as omega-3 fatty acids) versus a comparator (e.g. placebo, antidepressant treatment, standard care, no treatment, wait-list control) for major depressive disorder (MDD) in adults. All doses and sources of omega-3 fatty acid interventions were included in the review, including both food and supplement sources.
Results: Studies included were randomized controlled trials which provided n-3PUFAs as an intervention; used a comparator; measured depressive symptomology as an outcome; and were conducted in adults with MDD. Primary outcomes were depressive symptomology and adverse events. The authors found 26 relevant studies: 25 studies involving 1438 people compared the impact of n-3PUFAs with that of placebo, and one study involving 40 people compared the impact of n-3PUFAs with that of antidepressants. For the placebo comparison, the authors found a small-to-modest positive effect of n-3PUFAs compared to placebo (standardized mean difference (SMD) -0.32 (95% confidence interval (CI) -0.12 to -0.52; 25 studies, 1373 participants) but felt the size of this effect is unlikely to be meaningful to people with depression. The authors considered the quality of the evidence to be low to very low.
Conclusions: At present, we do not have enough high quality evidence to determine the effects of n-3PUFAs as a treatment for MDD. Based on the low quality evidence currently available, there is a small to modest treatment benefit which may not be clinically significant