Review Article

N-3 (Omega-3) Fatty Acids in Postpartum Depression: Implications for Prevention and Treatment

Table 1

Double-blind, randomized, placebo-controlled trials of n-3 PUFAs in nonpuerperal depression.

AuthorYearDisorderPopulationInterventionTreatment groups DoseDurationMajor finding

Nemets et al. [94]2002Major depressive disorderIsrael,  85% femaleAdd-on to current antidepressantEthyl-EPA, placebo (not stated), 2 g/day4 weeksImprovement in HDRS score over placebo ( )
Peet and Horrobin [95]2002Major depressive disorderUK, 84% femaleAdd-on to current antidepressantethyl-EPA 1 g/kg, 2 g/kg,
4 g/kg,
placebo (liquid paraffin),
1, 2, or 4 g/day12 weeksImprovement in HDRS score over placebo at 1 mg/kg ( ). No effect at 2 or 4 mg/kg
Su et al. [96]2003Major depressive disorderTaiwan, 82% femaleAdd-on to current antidepressatFish oil, ,
placebo (olive oil ethyl esters),
9.6 g/day containing EPA: 4.4 g/day DHA: 2.2 g/day8 weeksImprovement in HDRS score over placebo ( )
Marangell et al. [104]2003Major depressive disorderUSA, 80% femaleMonotherapyDHA,
placebo (not stated),
2 g/day6 weeksNo effect of treatment on HDRS, CGI or MADRS scores
Silvers et al. [106]2005DepressionNew Zealand, 53% femaleAdd-on to current antidepressantFish oil,
placebo (olive oil),
8 g/day containing EPA: 0.6 g/day DHA: 2.4 g/day12 weeksImprovements in HDRS and BDI scores were greater than, but not significantly different from placebo
Nemets et al. [97]2006Childhood depressionIsrael, Gender ratio not statedMonotherapyEPA   DPA,
placebo (olive or safflower oil),
1 g/day containing EPA: 400 mg/day DHA: 200 mg/day16 weeksImprovement in CDRS score over placebo ( )
Grenyer et al. [108]2007Major depressive disorderAustralia, 74% femaleAdd-on to current antidepressant (74% of subjects) or MonotherapyFish oil,
placebo (olive oil),
8 g/day containing EPA: 0.6 g/day DHA: 2.2 g/day16 weeksNo effect of treatment on BDI score
Su et al. [98]2008Major depression during pregnancyTaiwan,  100% femaleMonotherapyEPA DHA, placebo (olive oil ethyl esters), EPA: 2.2 g/day DHA: 1.2 g/day8 weeksImprovement in HDRS over placebo ( ) and higher response rate ( )
da Silva et al. [101]2008Depression in Parkinson's diseaseBrazil, Gender ratio not statedMonotherapy or add-on to current antidepressantFish oil only, , Fish oil   antidepressant, , placebo (mineral oil), , , EPA: 720 mg/day DHA: 480 mg/day12 weeksImprovement in MADRS score compared to placebo or placebo   antidepressant ( )
Rogers et al. [105]2008Mild to moderate depressionUK, Gender ratio not statedMonotherapyEPA   DHA, , placebo (olive oil with 7.5 mg mixed tocopherols), EPA: 630 mg/day, DHA: 850 mg/day12 weeksNo effect of treatment on DASS or BDI scores
Lucas et al. [99]2009Middle-aged women with psycholo gical distress and depressive symptomsCanada,   100% femaleMonotherapyEthyl-EPA, placebo (sunflower oil), 1.5 g/day containing  EPA: 1.05 g/day DHA: 0.15 g/day8 weeksImprovement in HDRS score was greater than placebo only for subjects not meeting criteria for major depression ( )
Mischoulon et al. [107]2009Major depressive disorderUSA, 65% femaleMonotherapyEthyl-EPA, placebo (paraffin oil with 0.2%   -tocopherol), 1 g/day8 weeksImprovement in HDRS score was greater than, but not significantly different from placebo
Rondanelli et al. [100]2010Elderly women with depressionItaly, 100% femaleMonotherapyEPA   DHA, , placebo (paraffin oil), EPA: 1.67 g/day, DHA: 0.83 g/day8 weeksImprovement in GDS score over placebo ( ).
Bot et al. [109]2010Major depression in diabetes mellitusThe Netherlands, 52% femaleAdd-on to current antidepressantEthyl-EPA, placebo (rapeseed oil with medium chain triglycerides), 1 g/day12 weeksNo effect of treatment on MADRS score

Sample size at end of study.
HDRS:Hamilton Depression Rating Scale, CGI:Clinical Global Impression, MADRS:Montgomery- sberg Depression Rating Scale, BDI:Beck Depression Inventory, CDRS:Childhood Depression Rating Scale, DASS:Depression, Anxiety, and Stress Scales, GDS:Geriatric Depression Scale.