omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study. Omega-3 fatty acids in major depressive disorder: A preliminary double-blind, placebo-controlled trial Blood profiles, body fat and mood state in healthy subjects on different diets supplemented with Omega-3 polyunsaturated fatty acids. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Omega-3 treatment of childhood depression: a controlled, double-blind pilot study. A placebo-controlled cross-over trial of adjunctive EPA in OCD. A placebo-controlled trial of omega-3 fatty acid (ethyl eicosapentaenoic acid) supplementation for residual symptoms and cognitive impairment in schizophrenia. The role of essential fatty acids in chronic fatigue syndrome: A case‐controlled study of red‐cell membrane essential fatty acids (EFA) and a placebo‐controlled treatment study with high dose of EFA Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. Depletion of Omega-3 Fatty Acid Levels in Red Blood Cell Membranes of Depressive Patients A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. Fish consumption and depression: the Northern Finland 1966 birth cohort study. Lowered ω3 polyunsaturated fatty acids in serum phospholipids and cholesteryl esters of depressed patients Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Omega-3 fatty acid treatment and T(2) whole brain relaxation times in bipolar disorder. Effect of high doses of essential fatty acids on the postviral fatigue syndrome Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Advice to Eat Fish and Mood: A Randomised Controlled Trial in Men with Angina
OBJECTIVE The purpose of this study was to compare the efficacy of ethyl-eicosapentaenoic acid ( E-EPA ) and placebo in the treatment of female subjects with borderline personality disorder . METHOD The authors conducted an 8-week , placebo-controlled , double-blind study of E-EPA in 30 female subjects meeting Revised Diagnostic Interview for Borderlines and DSM-IV criteria for borderline personality disorder . RESULTS Twenty subjects were r and omly assigned to 1 g of E-EPA ; 10 subjects were given placebo . Ninety percent of those in both groups completed all 8 weeks of the trial . Analyses that used r and om-effects regression modeling and controlled for baseline severity showed E-EPA to be superior to placebo in diminishing aggression as well as the severity of depressive symptoms . CONCLUSIONS The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder Patients with depression have been extensively reported to be associated with the abnormality of omega-3 polyunsaturated fatty acids ( PUFAs ) , including significantly low eicosapentaenoic acid and docosahexaenoic acid in cell tissue contents ( red blood cell membrane , plasma , etc . ) and dietary intake . However , more evidence is needed to support its relation . In this study , we conducted an 8-week , double-blind , placebo-controlled trial , comparing omega-3 PUFAs ( 6.6 g/day ) [ corrected ] with placebo , on the top of the usual treatment , in 28 patients with major depressive disorder . Patients in the omega-3 PUFA group had a significantly decreased score on the 21-item Hamilton Rating Scale for Depression than those in the placebo group ( P < 0.001 ) . From the preliminary findings in this study , omega-3 PUFAs could improve the short-term course of illness and were well tolerated in patients with major depressive disorder BACKGROUND Diets and Omega-3 polyunsaturated fatty acids have been considered as important factors to reduce the risk of cardiovascular and inflammatory diseases , but there are few details on the effects on healthy subjects . The aim of the present study was to examine the variation of several physiological parameters in healthy subjects on different diets supplemented with Omega-3 fatty acids .  MATERIAL S AND METHODS The experiment was carried out on 33 subjects divided into four groups according to a double-blind cross-over design with a 1 : 1 ratio for Omega-3 ( vs. placebo ) and open-label parallel-groups with a 1 : 1 ratio for the Zone diet ( vs. the diet suggested by the Italian National Research Institute for Nutrition and Foods ) . Blood sample s were collected at the beginning of the experiment and after 35 ( cross-over ) and 70 days . The Profile of Mood States test ( POMS ) was also performed . RESULTS The arachidonic acid/eicosapentaenoic acid ratio ( AA/EPA ) was strongly reduced by Omega-3 with a supplementary effect of the diet and in particular the Zone diet . The AA/EPA reduction was correlated with a concomitant decrease of insulin and homocysteine levels . The Zone diet reduced skinfold thickness and body fat percentage and also showed antioxidant effects . The mood state changed after Omega-3 supplementation , with an increased POMS index . This was related to a concomitant reduction of AA/EPA and was particularly evident in the Zone diet . CONCLUSION AA/EPA and mood state are differently influenced by diet and Omega-3 , body fat is particularly reduced by Zone diet , while blood parameters such as triglycerides/HDL ratio , insulin and homocysteine are related to AA/EPA variations . These findings are discussed in terms of differences in the composition of the diets and the influences of Omega-3 on physiological functions BACKGROUND Omega3 fatty acids may inhibit neuronal signal transduction pathways in a manner similar to that of lithium carbonate and valproate , 2 effective treatments for bipolar disorder . The present study was performed to examine whether omega3 fatty acids also exhibit mood-stabilizing properties in bipolar disorder . METHODS A 4-month , double-blind , placebo-controlled study , comparing omega3 fatty acids ( 9.6 g/d ) vs placebo ( olive oil ) , in addition to usual treatment , in 30 patients with bipolar disorder . RESULTS A Kaplan-Meier survival analysis of the cohort found that the  omega3 fatty acid  patient group had a significantly longer period of remission than the placebo group ( P = .002 ; Mantel-Cox ) . In addition , for nearly every other outcome measure , the omega3 fatty acid group performed better than the placebo group . CONCLUSION Omega3 fatty acids were well tolerated and improved the short-term course of illness in this preliminary study of patients with bipolar disorder OBJECTIVE Major depressive disorder in children may be more common than previously thought , and its therapeutics are unclear . Because of success in a previous study on omega-3 fatty acids in adult major depressive disorder , the authors planned a pilot study of omega-3 fatty acids in childhood major depression . METHOD Children who entered the study were between the ages of 6 and 12 . Ratings were performed at baseline and at 2 , 4 , 8 , 12 , and 16 weeks using Children 's Depression Rating Scale ( CDRS ) , Children 's Depression Inventory ( CDI ) , and Clinical Global Impression ( CGI ) .  Children were r and omized to  omega-3 fatty acids or placebo as pharmacologic monotherapy . Twenty-eight patients were r and omized , and 20 completed at least 1 month 's ratings . RESULTS Analysis of variance showed highly significant effects of omega-3 on symptoms using the CDRS , CDI , and CGI . CONCLUSIONS Omega-3 fatty acids may have therapeutic benefits in childhood depression Several clinical studies showed beneficial effects of omega-3 fatty acids in major affective disorders , including resistant depression . Some antidepressants are also effective , albeit less so , in obsessive-compulsive disorder ( OCD ) . We therefore undertook a preliminary placebo-controlled cross-over trial of adjunctive eicosapentaenoic acid ( EPA ) in OCD . Eleven patients with current obsessive-compulsive disorder , who were on a stable maximally tolerated dose of SSRI with no further improvement over at least the last two months , were recruited . Subjects were r and omly allocated to begin 6 weeks of placebo ( 2 g liquid paraffin per day ) followed by 6 weeks of 2 g of EPA or EPA followed by placebo . Patients continued their prior SSRIs at the same dose . Assessment s were performed with the Yale-Brown Obsessive-Compulsive Scale ( YBOCS ) , and the Hamilton Rating Scales for depression ( HAM-D ) and anxiety ( HAM-A ) . There were no effects of order of treatment . Time had a main effect of YBOCS scores ; mean scores declined from 26.0 ( + /-5 ) to 17.6 ( + /-6 ) by week 6 on placebo and to 18.5 ( + /-4 ) on EPA . There were no effects on HAM-D and HAM-A. No clinical ly relevant side effects were reported . The results of this study suggest that adjunctive EPA is ineffective against OCD OBJECTIVE This study determined if augmentation of neuroleptics with 3 g/day of ethyl eicosapentaenoic acid ( EPA ) improves symptoms and cognition in patients with schizophrenia or schizoaffective disorder . METHOD Eighty-seven patients meeting criteria for schizophrenia or schizoaffective disorder who had residual symptoms despite neuroleptic treatment were r and omly assigned to receive either 3 g/day of ethyl EPA ( N=43 ) or placebo ( N=44 ) in a 16-week , double-blind supplementation trial . Assessment s were performed at baseline and at weeks 1 , 2 , 4 , 8 , 12 , and 16 ; a cognitive battery was administered at baseline and at week 16 . RESULTS No differences were found between groups in positive or negative symptoms , mood , cognition , or global impression ratings . Results were similar for the intention-to-treat ( N=87 ) and completer ( N=75 ) groups . CONCLUSIONS For schizophrenia patients treated with 3 g/day of ethyl EPA , improvement in residual symptoms and cognitive impairment was no greater than for schizophrenia patients treated with placebo Objective To replicate the treatment study by Behan et al. ( 1990 ) using current research criteria for Chronic Fatigue Syndrome ( CFS ) OBJECTIVE The purpose of this study was to determine the effect of docosahexaenoic acid supplementation on plasma phospholipid docosahexaenoic acid content and indices of depression and information processing for women who breast-feed . STUDY DESIGN Mothers who planned to breast-feed their infants were assigned r and omly in a double-masked fashion to receive either docosahexaenoic acid ( approximately 200 mg/d ) or placebo for the first 4 months after the delivery . Major outcome variables included plasma phospholipid fatty acid patterns and scores on a self-rating question naire of current depression symptoms . A structured clinical interview of depression , scores on another self-rating question naire of depression symptoms , and a laboratory measure of information processing were obtained in subgroups of the total population . RESULTS Plasma phospholipid contents of docosahexaenoic acid at baseline were 3.15 + /- 0.78 and 3.31 + /- 0.70 ( mg/dL of total fatty acids ) in the docosahexaenoic acid and placebo groups , respectively . After 4 months , the plasma phospholipid docosahexaenoic acid content of the docosahexaenoic acid group was 8 % higher ( 3.40 + /- 0.97 mg/dL ) , whereas that of the placebo group was 31 % lower ( 2.27 + /- 0.87 mg/dL ) . Despite the higher plasma phospholipid docosahexaenoic acid content of the supplemented group after 4 months , there was no difference between groups in either self-rating or diagnostic measures of depression ; information processing scores of the two groups also did not differ . CONCLUSION Docosahexaenoic acid supplementation ( approximately 200 mg/d ) for 4 months after the delivery prevented the usual decline in plasma phospholipid docosahexaenoic acid content of women who breastfeed but did not influence self-ratings of depression , diagnostic measures of depression , or information processing OBJECTIVE Studies have reported that countries with high rates of fish oil consumption have low rates of depressive disorder . The authors studied a specific omega-3 fatty acid , the ethyl ester of eicosapentaenoic acid ( E-EPA ) , as an adjunct to treatment for depressive episodes occurring in patients with recurrent unipolar depressive disorder who were receiving maintenance antidepressant therapy . METHOD Twenty patients with a current diagnosis of major depressive disorder participated in a 4-week , parallel-group , double-blind addition of either placebo or E-EPA to ongoing antidepressant therapy .  Seventeen of the patients were women , and three were men . RESULTS Highly significant benefits of the addition of the omega-3 fatty acid compared with placebo were found by week 3 of treatment . CONCLUSIONS It is not possible to distinguish whether E-EPA augments antidepressant action in the manner of lithium or has independent antidepressant properties of its own BACKGROUND It has been hypothesized that depletion of cell membrane n3 polyunsaturated fatty acids ( PUFA ) , particularly docosahexanoic acid ( DHA ) , may be of etiological importance in depression . METHODS We measured the fatty acid composition of phospholipid in cell membranes from red blood cells ( RBC ) of 15 depressive patients and 15 healthy control subjects . RESULTS Depressive patients showed significant depletions of total n3 PUFA and particularly DHA . Incubation of RBC from control subjects with hydrogen peroxide abolished all significant differences between patients and controls . CONCLUSIONS These findings suggest that RBC membranes in depressive patients show evidence of oxidative damage . Possible interpretations , and implication s for the etiology and treatment of depression , are discussed OBJECTIVE This study was an evaluation of the omega-3 fatty acid docosahexaenoic acid ( DHA ) for the treatment of major depression . METHOD Thirty-six depressed patients were r and omly assigned to receive DHA , 2 g/day , or placebo for 6 weeks . Response was defined a priori as a > or = 50 % reduction in the score on the Montgomery-Asberg Depression Rating Scale .  Thirty-five participants were evaluable ; 18 received DHA , and 17 received placebo . RESULTS Response rates were 27.8 % in the DHA group and 23.5 % in the placebo group . The difference in response rates between groups did not reach statistical significance . CONCLUSIONS This trial failed to show a significant effect of DHA monotherapy in subjects with major depression BACKGROUND Since low fish consumption and omega-3 fatty acids have recently been linked with depression , we investigated by means of a large , general population data base , whether a low fish consumption is associated with increased risk of developing depression . METHODS The Northern Finl and 1966 Birth Cohort was followed up prospect ively from pregnancy up to the age of 31 years . The data on  HSCL-25 depression subscale , doctor-diagnosed life-time depression and fish consumption  ( during the previous 6 months ) of cohort members were obtained by postal question naires at the age of 31 . The final number of cohort members , whose completed variable information was available in multivariate logistic analyses , was 2721 males and 2968 females . RESULTS After adjusting for body mass index , serum total cholesterol level and socioeconomic situation , logistic regression analyses showed that among females the risk of developing depression increased up to 2.6-fold ( 95%CI 1.4 - 5.1 ) among rare fish eaters when compared with regular eaters . In males , there were no significant differences between rare and regular fish eaters for any of the estimates of depression . LIMITATIONS The data on life-time fish consumption of cohort members were not available . CONCLUSIONS A low frequency of fish consumption was statistically significantly associated with  depression in women , but not in men . Possible background -theories behind the gender difference are discussed Depression is associated with a lowered degree of esterification of serum cholesterol , an increased C20:4omega6/C20:5omega3 ratio and decreases in omega3 fractions in fatty acids ( FAs ) or in the red blood cell membrane . The aims of the present study were to examine : ( i ) serum phospholipid and cholesteryl ester compositions of individual saturated fatty acids ( SFAs ) , monounsaturated FAs ( MUFAs ) and polyunsaturated FAs ( PUFAs ) in major depressed patients vs. healthy volunteers ; ( ii ) the relationships between the above FAs and lowered serum zinc ( Zn ) , a marker of the inflammatory response in depression ; and ( iii ) the effects of subchronic treatment with antidepressants on FAs in depression . The composition of the FAs was determined by means of thin layer chromatography in conjunction with gas chromatography . Lipid concentrations were assayed by enzymatic colorimetric methods . The oxidative potential index ( OPI ) of FAs was computed in 34 major depressed in patients and 14 normal volunteers . Major depression was associated with : increased MUFA and C22:5omega3 proportions and increased C20:4omega6/C20:5omega3 and C22:5omega6/C22:6omega3 ratios ; lower C22:4omega6 , C20:5omega3 and C22:5omega3 fractions in phospholipids ; lower C18:3omega3 , C20:5omega3 and total (sigma)omega3 FAs , and higher C20:4omega6/C20:5omega3 and sigmaomega6/sigmaomega3 ratios in cholesteryl esters ; lower serum concentrations of phospholipids and cholesteryl esters ; and a decreased OPI . In depression , there were significant and positive correlations between serum Zn and C20:5omega3 and C22:6omega3 fractions in phospholipids ; and significant inverse correlations between serum Zn and the sigmaomega6/sigmaomega3 , C20:4omega6/C20:5omega3 , and C22:5omega6/C22:6omega3 ratios in phospholipids . There was no significant effect of antidepressive treatment on any of the FAs . The results show that , in major depression , there is a deficiency of omega3 PUFAs and a compensatory increase in MUFAs and C22:5omega6 in phospholipids . The results suggest that : ( i ) there is an abnormal metabolism of omega3 PUFAs in depression ; ( ii ) the FA alterations in depression are related to the inflammatory response in that illness ; and ( iii ) the disorders may persist despite successful antidepressant treatment BACKGROUND Epidemiological and clinical studies suggest that increased intake of eicosapentaenoic acid ( EPA ) alleviates unipolar depression . AIMS To examine the efficacy of EPA in treating depression in bipolar disorder . METHOD In a12-week , double-blind study individuals with bipolar depression were r and omly assigned to adjunctive treatment with placebo ( n=26 ) or with 1 g/day ( n=24 ) or 2 g/day ( n=25 ) of ethyl-EPA . Primary efficacy was assessed by the Hamilton Rating Scale for Depression ( HRSD ) , with changes in the Young Mania Rating Scale and Clinical Global Impression Scale ( CGI ) as secondary outcome measures . RESULTS There was no apparent benefit of 2 g over 1 g ethyl-EPA daily . Significant improvement was noted with ethyl-EPA treatment compared with placebo in the HRSD ( P=0.04 ) and the CGI ( P=0.004 ) scores . Both doses were well tolerated . CONCLUSIONS Adjunctive ethyl-EPA is an effective and well-tolerated intervention in bipolar depression OBJECTIVE The authors hypothesized that changes in brain membrane composition result ing from omega-3 fatty acid administration in patients with bipolar disorder would result in greater membrane fluidity , as detected by reductions in T(2 ) values . METHOD Women with bipolar disorder ( N=12 ) received omega-3 fatty acids for 4 weeks . A cohort of bipolar subjects ( N=9 ) and a group without bipolar disorder ( N=12 ) did not receive omega-3 fatty acids .  T(2 ) values were acquired at baseline and after 4 weeks . RESULTS Bipolar subjects who received omega-3 fatty acids had significant decreases in T(2 ) . There was a dose-dependent effect when the bipolar omega-3 fatty acid group was subdivided into high- and low-dose cohorts . CONCLUSIONS Omega-3 fatty acids lowered T(2 ) values , consistent with the hypothesis that the fluidity of cell membranes was altered . Further studies are needed to clarify the significance of alterations in brain physiology induced by omega-3 fatty acids , as reflected in T(2 ) values Sixty‐three adults with the diagnosis of the postviral fatigue syndrome were enrolled in a double‐blind , placebo‐controlled study of essential fatty acid therapy . The patients had been ill for from one to three years after an apparently viral infection , suffering from severe fatigue , myalgia and a variety of psychiatric symptoms . The preparation given contained linoleic , gamma‐linolenic , eicosapentaenoic and docosahexaenoic acids and either it , or the placebo , was given as 8 times 500 mg capsules per day over a 3‐month period . The trial was parallel in design and patients were evaluated at entry , one month and three months . In consultation with the patient the doctors assessed overall condition , fatigue , myalgia , dizziness , poor concentration and depression on a 3‐point scale . The essential fatty acid composition of their red cell membrane phospholipids was analysed at the first and last visits . At 1 month , 74 % of patients on active treatment and 23 % of those on placebo assessed themselves as improved over the baseline , with the improvement being much greater in the former . At 3 months the corresponding figures were 85 % and 17 % ( p < 0.0001 ) since the placebo group had reverted towards the baseline state while those in the active group showed continued improvement . The essential fatty acid levels were abnormal at the baseline and corrected by active treatment . There were no adverse events . We conclude that essential fatty acids provide a rational , safe and effective treatment for patients with the post‐viral fatigue syndrome Converging evidence suggests that omega-3 polyunsaturated fatty acids have aetiological importance in depression . To determine the effect of adding fish oil to existing therapy in participants who were being treated for depression in a community setting , 77 participants were r and omly assigned to receive 8 g of either fish or olive oil per day in addition to their existing therapy . Fifty-nine ( 77 % ) participants completed 12 weeks of treatment . Dietary , biochemical and lifestyle factors were measured throughout the study . Mood was assessed using the Short Form Hamilton Depression Rating Scale ( HDRS-SF ) and the Beck Depression Inventory II . Sample size calculations were based on the HDRS-SF . Intention-to-treat and per protocol analyses were carried out using residual maximum likelihood . There was no evidence that fish oil improved mood when compared to the placebo oil , despite an increase in circulating omega-3 polyunsaturated fatty acids . However , mood improved significantly in both groups within the first 2 weeks of the study ( P<0.001 ) and this improvement was sustained throughout . In conclusion , fish oil was no more effective than the control as an add-on therapy for depression in this setting BACKGROUND In depressed patients , low blood levels of eicosapentaenoic acid are seen . We tested the antidepressive effect of ethyl-eicosapentaenoate in these patients . METHODS We included 70 patients with persistant depression despite ongoing treatment with an adequate dose of a st and ard antidepressant .  Patients were r and omized on a double-blind basis to placebo or ethyl-eicosapentaenoate at dosages of 1 , 2 , or 4 g/d for 12 weeks in addition to unchanged background medication . Patients underwent assessment using the 17-item Hamilton Depression Rating Scale , the Montgomery-Asberg Depression Rating Scale , and the Beck Depression Inventory . RESULTS Forty-six ( 88 % ) of 52 patients receiving ethyl-eicosapentaenoate and 14 ( 78 % ) of 18 patients receiving placebo completed the 12-week study with no serious adverse events . The 1-g/d group showed a significantly better outcome than the placebo group on all 3 rating scales . In the intention-to-treat group , 5 ( 29 % ) of 17 patients receiving placebo and 9 ( 53 % ) of 17 patients receiving 1 g/d of ethyl-eicosapentaenoate achieved a 50 % reduction on the Hamilton Depression Rating Scale score . In the per- protocol group , the corresponding figures were 3 ( 25 % ) of 12 patients for placebo and 9 ( 69 % ) of 13 patients for the 1-g/d group . The 2-g/d group showed little evidence of efficacy , whereas the 4-g/d group showed nonsignificant trends toward improvement . All of the individual items on all 3 rating scales improved with the 1-g/d dosage of ethyl-eicosapentaenoate vs placebo , with strong beneficial effects on items rating depression , anxiety , sleep , lassitude , libido , and suicidality . CONCLUSION Treatment with ethyl-eicosapentaenoate at a dosage of 1 g/d was effective in treating  depression in patients who remained depressed despite adequate st and ard therapy Abstract People with high intake of fish have lower reported rates of depression and a small trial in psychiatric patients suggested that fish oil supplements reduced episodes of depression and mania . As part of a factorial trial of interventions to reduce mortality in angina 452 men were r and omised to advice to eat more fatty fish or no fish advice . Maxepa fish oil capsules were supplied to men who found the fish unpalatable . Fish intake and mood were assessed at baseline and six months . Most men ( 83 % ) had mood assessed using the Derogatis Stress Profile at baseline and follow-up . Self reported intake of fish was higher in the fish advice group at six months . There was , however , no difference in depression or anxiety in those allocated to receive fish advice . After controlling for baseline mood , the difference in depression score between those r and omised to fish advice and those not was 1.29 ( 95 % CI −0.29 to 2.88 ) and the difference in anxiety was 0.82 ( 95 % CI −0.57 to 2.22 ) with positive differences indicating more depression or anxiety in those allocated to the fish arm . This trial provides no evidence that increased fatty fish intake in people without depressive symptoms has any substantial effect on mood
BACKGROUND Greater dietary intakes of n-3 long-chain polyunsaturated fatty acids ( n-3 PUFAs ) may be beneficial for depressed mood .
OBJECTIVE This study aim ed to systematic ally review all published r and omized controlled trials investigating the effects of n-3 PUFAs on depressed mood .