Omega-3 fatty acids for depression in adults

Cochrane Database of Systematic Reviews

Volumn 2015, Issue 11, 2015, Pages

  Appleton, Katherine M ^a   Sallis, Hannah M ^b   Perry, Rachel ^c   Ness, Andrew R ^c   Churchill, Rachel ^b  

^a BOURNEMOUTH UNIVERSITY   (United Kingdom)

^b UNIVERSITY OF BRISTOL   (United Kingdom)

^c UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CITALOPRAM; DOCOSAHEXAENOIC ACID; FLUOXETINE; ICOSAPENTAENOIC ACID; OMEGA 3 ACID ETHYL ESTER; OMEGA 3 FATTY ACID; PLACEBO; SERTRALINE; ANTIDEPRESSANT AGENT;

ADULT; ALLERGIC REACTION; BECK DEPRESSION INVENTORY; CLINICAL GLOBAL IMPRESSION SCALE; COMORBIDITY; DIARRHEA; DRUG DOSE COMPARISON; DRUG WITHDRAWAL; ERUCTATION; FECES; GASTROINTESTINAL DISEASE; GASTROINTESTINAL SYMPTOM; GERIATRIC DEPRESSION SCALE; GLOBAL ASSESSMENT OF FUNCTIONING; HAMILTON DEPRESSION RATING SCALE; HEADACHE; HUMAN; MAJOR DEPRESSION; MENTAL DISEASE; MONTGOMERY ASBERG DEPRESSION RATING SCALE; MORNING DOSAGE; NAUSEA; PATIENT COMPLIANCE; PHYSICAL DISEASE; PRIORITY JOURNAL; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL (TOPIC); REMISSION; REVIEW; SEDATION; SEXUAL DYSFUNCTION; SHORT FORM 36; SIDE EFFECT; STOMACH PAIN; SYSTEMATIC REVIEW; DEPRESSIVE DISORDER, MAJOR; META ANALYSIS;

ADULT; ANTIDEPRESSIVE AGENTS; DEPRESSIVE DISORDER, MAJOR; FATTY ACIDS, OMEGA-3; HUMANS; RANDOMIZED CONTROLLED TRIALS AS TOPIC;

EID: 84957546834     PISSN: 14651858     EISSN: None     Source Type: Journal    
DOI: 10.1002/14651858.CD004692.pub4     Document Type: Review

References (190)

1. Bot M, Pouwer F, Assies J, Jansen E, Beekman ATF, De Jonge P. Supplementation with eicosapentaenoic omega-3 fatty acid does not influence serum brain-derived neurotrophic factor in diabetes mellitus patients with major depression: A randomized controlled pilot study. Neuropsychobiology 2011;63(4):219-23.
2. Bot M, Pouwer F, Assies J, Jansen E, Diamant M, Snoek FJ, et al. Eicosapentaenoic acid as an add-on to antidepressant medication for co-morbid major depression in patients with diabetes mellitus: A randomized, double-blind placebo-controlled study [ISRCTN30877831; NTR624]. Journal of Affective Disorders 2010;126(1-2):282-6.
3. Mocking RJ, Assies J, Bot M, Jansen E, Schene AH, Pouwer F. Biological effects of add-on eicosapentaenoic acid supplementation in diabetes mellitus and co-morbid depression: a randomized controlled trial. PloS One 2012;7(11):e49431.
4. Pouwer F. Addition of eicosapentaenoic acid to maintenance anti-depressant therapy in diabetes patients with major depressive disorder: a double-blind, placebo-controlled pilot study. www.controlled-trials.com/ISRCTN30877831 (Accessed 21 August 2014).
5. Anonymous News breaks. Nutrition Today 2009;44(6):234-5.
6. Anonymous Use of omega-3 with treatment for depression in heart disease patients may not provide benefit. Nurse Prescribing 2009;7(11):523-4.
7. Bot M, Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer BC, et al. Inflammation and treatment response to sertraline in patients with coronary heart disease and comorbid major depression. Journal of Psychosomatic Research 2011;71(1):13-7.
8. Carney RM. Omega-3 fatty acids to improve depression and reduce cardiovascular risk factors. ClinicalTrials.gov/show/NCT00116857 (Accessed 21 August 2014).
9. Carney RM, Freedland KE, Rubin EH, Rich MW, Steinmeyer MS, Harris WS. Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: A randomized controlled trial [NCT00116857]. JAMA 2009;302(15):1651-7.
10. Carney RM, Freedland KE, Steinmeyer BC. 'Omega-3 fatty acids for CHD with depression': Reply to comment. JAMA 2010;303(9):836.
11. D'Anci KE. Nutrition updates. Nutrition Reviews 2010;68(1):71-3.
12. Roest AM, Carney RM, Stein PK, Freedland KE, Meyer H, Steinmeyer BC, et al. Obstructive sleep apnea/hypopnea syndrome and poor response to sertraline in patients with coronary heart disease. Journal of Clinical Psychiatry 2012;73(1):31-6.
13. Coryell WH. Essential fatty acids for major depression. ClinicalTrials.gov/show/NCT00256412 (Accessed 22/07/2014).
14. Fiedorowicz JG, Hale N, Spector AA, Coryell WH. Neuroticism but not omega-3 fatty acid levels correlate with early responsiveness to escitalopram. Annals of Clinical Psychiatry 2010;22(3):157-63.
15. Coryell WH. Essential fatty acids for major depression. ClinicalTrials.gov/show/NCT00256412 (Accessed 22/07/2014).
16. Fiedorowicz JG, Hale N, Spector AA, Coryell WH. Neuroticism but not omega-3 fatty acid levels correlate with early responsiveness to escitalopram. Annals of Clinical Psychiatry 2010;22(3):157-63.
17. Da Silva TM, Munhoz RP, Alvarez C, Naliwaiko K, Kiss A, Andreatini R, et al. Depression in Parkinson's disease: a double-blind, randomized, placebo-controlled pilot study of omega-3 fatty-acid supplementation. Journal of Affective Disorders 2008;111(2-3):351-9.
18. Da Silva TM, Munhoz RP, Alvarez C, Naliwaiko K, Kiss A, Andreatini R, et al. Depression in Parkinson's disease: a double-blind, randomized, placebo-controlled pilot study of omega-3 fatty-acid supplementation. Journal of Affective Disorders 2008;111(2-3):351-9.
19. Gertsik L. PUFA augmentation in treatment of major depression. ClinicalTrials.gov/show/NCT00067301 (Accessed 21 August 2014).
20. Gertsik L, Poland RE, Bresee C, Rapaport MH. Omega-3 fatty acid augmentation of citalopram treatment for patients with major depressive disorder. Journal of Clinical Psychopharmacology 2012;32(1):61-4.
21. Dashti-Khavidaki S, Gharekhani A, Khatami M-R, Miri E-S, Khalili H, Razeghi E, et al. Effects of omega-3 fatty acids on depression and quality of life in maintenance hemodialysis patients. American Journal of Therapeutics 2014;21(4):275-87.
22. Gharekhani A, Khatami M-R, Dashti-Khavidaki S, Razeghi E, Noorbala A-A, Hashemi-Nazari S-S, et al. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: A randomized, placebo-controlled clinical trial. European Journal of Clinical Pharmacology 2014;70(6):655-65.
23. Gharekhani A, Khatami MR, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari SS, et al. Potential effects of omega-3 fatty acids on anemia and inflammatory markers in maintenance hemodialysis patients. DARU 2014;22(1):11.
24. Khatami MR. Evaluating therapeutic effects of omega-3 fatty acids on anemia and nutritional status in hemodialysis patients with depression. www.irct.ir/searchresult.php?id=3043&number=5 (Accessed 25th June 2015).
25. Gonzalez A, Mata S, Sanchez P, Gonzalez D, Urbina M, Fazzino F, et al. Omega-3 fatty acids as adjunctive of antidepressant therapy and its effects on brain-derived neurotrophic factor in serum, monocytes and lymphocytes. Archivos Venezolanos de Farmacologia y Terapeutica 2011;30(4):72-8.
26. Grenyer BF, Crowe T, Meyer B, Owen AJ, Grigonis-Deane EM, Caputi P, et al. Fish oil supplementation in the treatment of major depression: a randomised double-blind placebo-controlled trial. Progress in Neuro-psychopharmacology & Biological Psychiatry 2007;31(7):1393-6.
27. Meyer BJ, Grenyer BFS, Crowe T, Owen AJ, Grigonis-Deane EM, Howe PR. Improvement of major depression is associated with increased erythrocyte DHA. Lipids 2013;48(9):863-868.
28. Rotblatt M, Grenyer BFS. Fish oil not effective for chronic refractory depression. Focus on Alternative & Complementary Therapies 2008;13(1):30-1.
29. Jazayeri S, Keshavarz SA, Tehrani-Doost M, Djalali M, Hosseini M, Amini H, et al. Effects of eicosapentaenoic acid and fluoxetine on plasma cortisol, serum interleukin-1beta and interleukin-6 concentrations in patients with major depressive disorder. Psychiatry Research 2010;178(1):112-5.
30. Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, et al. Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder. Australian and New Zealand Journal of Psychiatry 2008;42(3):192-8.
31. Jazayeri S, Keshavarz SA, Tehrani-Doost M, Djalali M, Hosseini M, Amini H, et al. Effects of eicosapentaenoic acid and fluoxetine on plasma cortisol, serum interleukin-1beta and interleukin-6 concentrations in patients with major depressive disorder. Psychiatry Research 2010;178(1):112-5.
32. Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, et al. Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder. Australian and New Zealand Journal of Psychiatry 2008;42(3):192-8.
33. Lespérance F. Double-blind, placebo-controlled, randomised trial of eicosapentaenoic acid (EPA) for major depression. www.controlled-trials.com/ISRCTN47431149/ (Accessed 21 August 2014).
34. Lespérance F, Frasure-Smith N, St-André E, Turecki G, Lesperance P, Wisniewski SR. The efficacy of omega-3 supplementation for major depression: A randomized controlled trial [ISRCTN47431149]. Journal of Clinical Psychiatry 2011;72(8):1054-62.
35. Lucas M. Double-blind, placebo-controlled, randomised, clinical trial of eicosapentaenoic acid in the treatment of mood disorders among middle-aged women. www.controlled-trials.com/ISRCTN69617477 (Accessed 21 August 2014).
36. Lucas M, Asselin G, Mérette C, Poulin MJ, Dodin S. Ethyl-eicosapentaenoic acid for the treatment of psychological distress and depressive symptoms in middle-aged women: a double-blind, placebo-controlled, randomized clinical trial. American Journal of Clinical Nutrition 2009;89(2):641-51.
37. Marangell LB, Martinez JM, Zboyan HA, Kertz B, Kim HF, Puryear LJ. A double-blind, placebo-controlled study of the omega-3 fatty acid docosahexaenoic acid in the treatment of major depression. American Journal of Psychiatry 2003;160(5):996-8.
38. Marangell LB, Zboyan HA, Cress KK, Benisek D, Arterburn L. A double-blind, placebo-controlled study of docosahexaenoic acid (DHA) in the treatment of depression. 4th Congress of the International Society for the Study of Lipids and Fatty Acids, Tsukuba, Japan. 2000:105.
39. Mischoulon D. Omega-3 fatty acids for treatment of major depression: differential effects of EPA and DHA, and associated biochemical and immune parameters. ClinicalTrials.gov/ct2/show/NCT00361374 (Accessed 25th June 2015).
40. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead B, Fehling K, Martinson M, et al. Clinical predictors of response to omega-3 fatty acids in major depressive disorder [abstract]. Biological Psychiatry [abstracts of the 70th Annual Scientific Convention and Meeting of the Society of Biological Psychiatry, SOBP; 2015 May 14 - 16;Toronto, ON Canada]. 2015:147S.
41. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead BL, Fehling K, Martinson MA, et al. A double-blind, randomized controlled clinical trial comparing eicosapentaenoic acid versus docosahexaenoic acid for depression. Journal of Clinical Psychiatry 2015;76(1):54-61.
42. Rapaport MH. Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder [abstract]. Biological Psychiatry [abstracts of the 70th Annual Scientific Convention and Meeting of the Society of Biological Psychiatry, SOBP; 2015 May 14 - 16; Toronto, ON Canada]. 2015:146S-7S.
43. Rapaport MH, Mischoulon D. Omega-3 fatty acids for treatment of major depression: differential effects of EPA and DHA, and associated biochemical and immune parameters. ClinicalTrials.gov/ct2/show/NCT00517036 (Accessed 25th June 2015).
44. Rapaport MH, Nierenberg AA, Schettler PJ, Kinkead B, Cardoos A, Walker R, et al. Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study. Molecular Psychiatry 2015 Mar 24 [Epub ahead of print].
45. Rapaport MH, Schettler P, Pace TW, Kinkead B, Nierenberg AA, Mischoulon D. Inflammation, depression and N-3 fatty acids: A case of personalized medicine abstract. Neuropsychopharmacology [abstracts of the 52nd Annual Meeting of the American College of Neuropsychopharmacology, ACNP; 2013 Dec 8 - 12; Hollywood, FL United States]. 2013:S353-S4.
46. Mischoulon D. Omega-3 fatty acids for treatment of major depression: differential effects of EPA and DHA, and associated biochemical and immune parameters. ClinicalTrials.gov/ct2/show/NCT00361374 (Accessed 25th June 2015).
47. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead B, Fehling K, Martinson M, et al. Clinical predictors of response to omega-3 fatty acids in major depressive disorder [abstract]. Biological Psychiatry [abstracts of the 70th Annual Scientific Convention and Meeting of the Society of Biological Psychiatry, SOBP; 2015 May 14 - 16;Toronto, ON Canada]. 2015:147S.
48. Mischoulon D, Nierenberg AA, Schettler PJ, Kinkead BL, Fehling K, Martinson MA, et al. A double-blind, randomized controlled clinical trial comparing eicosapentaenoic acid versus docosahexaenoic acid for depression. Journal of Clinical Psychiatry 2015;76(1):54-61.
49. Rapaport MH. Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder [abstract]. Biological Psychiatry [abstracts of the 70th Annual Scientific Convention and Meeting of the Society of Biological Psychiatry, SOBP; 2015 May 14 - 16; Toronto, ON Canada]. 2015:146S-7S.
50. Rapaport MH, Mischoulon D. Omega-3 fatty acids for treatment of major depression: differential effects of EPA and DHA, and associated biochemical and immune parameters. ClinicalTrials.gov/ct2/show/NCT00517036 (Accessed 25th June 2015).
51. Rapaport MH, Nierenberg AA, Schettler PJ, Kinkead B, Cardoos A, Walker R, et al. Inflammation as a predictive biomarker for response to omega-3 fatty acids in major depressive disorder: a proof-of-concept study. Molecular Psychiatry 2015 Mar 24 [Epub ahead of print].
52. Rapaport MH, Schettler P, Pace TW, Kinkead B, Nierenberg AA, Mischoulon D. Inflammation, depression and N-3 fatty acids: a case of personalized medicine abstract. Neuropsychopharmacology [abstracts of the 52nd Annual Meeting of the American College of Neuropsychopharmacology, ACNP; 2013 Dec 8 - 12; Hollywood, FL United States]. 2013:S353-S4.
53. Anonymous Omega-3 fatty acid effective as monotherapy for MDD. Brown University Psychopharmacology Update 2009;20(12):3-4.
54. Mischoulon D. Ethyl eicosapentanoic acid (Ethyl-EPA) for treating major depression. ClinicalTrials.gov/show/NCT00096798 (Accessed 22nd July 2014).
55. Mischoulon D, Papakostas GI, Dording CM, Farabaugh AH, Sonawalla SB, Agoston AM, et al. A double-blind, randomized controlled trial of ethyl-eicosapentaenoate for major depressive disorder [NCT00096798]. Journal of Clinical Psychiatry 2009;70(12):1636-44.
56. Nemets B, Stahl Z, Belmaker RH. Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder. American Journal of Psychiatry 2002;159(3):477-9.
57. Nemets B, Stahl Z, Belmaker RH. Omega-3 fatty acid treatment of depressive breakthrough during unipolar maintenance. International Journal of Neuropsychopharmacology 2002;5(Suppl 1):149.
58. Stahl Z, Nemets B, Belmaker RH. Omega-3 fatty acid treatment of depressive breakthrough during unipolar maintenance. European Neuropsychopharmacology 2002;12(Suppl 3):S178.
59. Park Y. Omega-3 index as a risk factor for depression in Korean and effect of Omega-3 fatty acids on Korean patients with depression [KCT0001206]. cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=4315 (Accessed 25th June 2015).
60. Park Y, Park Y-S, Kim SH, Oh DH, Park Y-C. Supplementation of n-3 polyunsaturated fatty acids for major depressive disorder: A randomized, double-blind, 12-week, placebo-controlled trial in Korea. Annals of Nutrition & Metabolism 2015;66(2-3):141-148.
61. Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Archives of General Psychiatry 2002;59(10):913-9.
62. Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Archives of General Psychiatry 2002;59(10):913-9.
63. Peet M, Horrobin DF. A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs. Archives of General Psychiatry 2002;59(10):913-9.
64. Rizzo AM, Corsetto PA, Montorfano G, Opizzi A, Faliva M, Giacosa A, et al. Comparison between the AA/EPA ratio in depressed and non depressed elderly females: Omega-3 fatty acid supplementation correlates with improved symptoms but does not change immunological parameters. Nutrition Journal 2012;11:82.
65. Rondanelli M, Giacosa A, Opizzi A, Pelucchi C, La Vecchia C, Montorfano G, et al. Effect of omega-3 fatty acids supplementation on depressive symptoms and on health-related quality of life in the treatment of elderly women with depression: A double-blind, placebo-controlled, randomized clinical trial. Journal of the American College of Nutrition 2010;29(1):55-64.
66. Rondanelli M, Giacosa A, Opizzi A, Pelucchi C, La Vecchia C, Montorfano G, et al. Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression: effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life. Journal of Nutrition, Health & Aging 2011;15(1):37-44.
67. Anonymous Adjunctive fish oil for depression. Nurses' Drug Alert 2005;29(3):22-3.
68. Silvers KM, Woolley CC, Hamilton FC, Watts PM, Watson RA. Randomised double-blind placebo-controlled trial of fish oil in the treatment of depression. Prostaglandins, Leukotrienes, and Essential Fatty Acids 2005;72(3):211-8.
69. Su KP, Huang SY, Chiu CC, Shen WW. Corrigendum to "Omega-3 fatty acids in major depressive disorder A preliminary double-blind, placebo-controlled trial" [Eur Neuropsychopharmacol. 13 (2003) 267-271]. European Neuropsychopharmacology 2004;14(2):173.
70. Su KP, Huang SY, Chiu CC, Shen WW. Omega-3 fatty acids in major depressive disorder. A preliminary double-blind, placebo-controlled trial. European Neuropsychopharmacology 2003;13(4):267-71.
71. Clayton A. Study of supplementation of antidepressants with fish oil to improve time to clinical response (SADFAT). ClinicalTrials.gov/show/NCT00963196 (Accessed 11 September 2014).
72. EUCTR2006-004949-41-IT Randomized double-blind study to evaluate the adjuvant effect of polyunsaturated fatty acids omega-3 in therapy with SSRI paroxetine mesylate in unipolar mood depression and recurrent depression. www.ClinicalTrialsregister.eu/ctr-search/trial/2006-004949-41/IT (Accessed 22nd July 2014).
73. Kwak KP, Lee KH. A comparative study of addition therapy of choline alfoscerate and omega 3 fatty acid in older depressed patients with or without executive dysfunction. International Psychogeriatrics 2014;25:S75-192.
74. Lima L. A randomised study on the antidepressive effect of fluoxetine and folic acid, as possible augmenter, and the SYNThesis of serotonin (5-HT) in lymphocytes prior and after treatment. isrctn.org/ISRCTN06123818 (Accessed 26th June 2015).
75. Murck H. A multicentre, double-blind, randomised, parallel group, placebo-controlled trial of Lax-101 (ethyl eicosapentaenoate) as adjunct therapy in patients who remain depressed following treatment with standard antidepressant therapy. National Research Register 2004.
76. Naqvi S. Treating adolescent depression with fish oils. ClinicalTrials.gov/show/NCT00658476 (Accessed 26th June 2015).
77. NCT00816322 The effect of fish oil in major depressive disorder. ClinicalTrials.gov/show/NCT00816322 (Accessed 22nd July 2014).
78. Rees AM, Parker GB, Owen C. A study of omega-3 as a treatment for major depression. ClinicalTrials.gov/show/NCT00238758 (Accessed 26th June 2015).
79. Rees AM, Parker GB, Owen CA. Omega-3 polyunsaturated fatty acids as a treatment for major depression. Australian and New Zealand Journal of Psychiatry 2005;39 Suppl 2:A52.
80. Shinto L. Fish oil for the treatment of depression in patients with multiple sclerosis. ClinicalTrials.gov/show/NCT00122954 (Accessed 25th June 2015).
81. Su KP. The effect of fish oil in major depressive disorder. ClinicalTrials.gov/show/NCT01371383 (Accessed 26th June 2015).
82. Amminger GP, Rice S. Youth Depression Alleviation: a randomised controlled trial of omega-3 fatty acids (fish oil) for major depressive disorder in young people (YoDA-F). www.anzctr.org.au/ACTRN12613001352796.aspx (Accessed 26th June 2015).
83. Rice SM, Hickie IB, Yung AR, Mackinnon A, Berk M, Davey C, et al. Youth depression alleviation: the Fish Oil Youth Depression Study (YoDA-F): A randomized, double-blind, placebo-controlled treatment trial. Early Intervention in Psychiatry 13 Aug 2014 [Epub ahead of print].
84. Carney RM. Omega-3 for depression and other cardiac risk factors - 2. ClinicalTrials.gov/show/NCT02021669 (Accessed 26th June 2015).
85. Gabbay V. Omega-3 fatty acids in adolescent depression. ClinicalTrials.gov/show/NCT00312897 (Accessed 26th June 2015).
86. Gabbay V. The role of omega-3 fatty acids In adolescent depression. ClinicalTrials.gov/show/NCT00962598 (Accessed 26th June 2015).
87. Howe P. Fish oil treatment for depression in cardiovascular disease. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82950 ([Accessed 26th June 2015).
88. Jiang W. Omega 3 for treatment of depression in patients with heart failure (OCEAN). ClinicalTrials.gov/show/NCT02057406 (Accessed 26th June 2015).
89. Kamath J. Omega 3 FA supplements as augmentation in the treatment of depression. ClinicalTrials.gov/show/NCT01803711 (Accessed 26th June 2015).
90. Khalili H. Comparing efficacy of omega-3 and placebo in reducing Beck depression score in HIV/AIDS patients. www.irct.ir/searchresult.php?id=3449&number=17 (Accessed 25th June 2015). [: IRCT201410073449N17]
91. Lanctôt K, Hermann N. Treating depression in coronary artery disease with omega-3 fatty acids. ClinicalTrials.gov/show/NCT00981383 (Accessed 26th June 2015).
92. Mostafavi S-A, Akhondzadeh S. Evaluating effects of omega-3 supplementation on weight and depression among overweight or obese women with depression compared to placebo. www.irct.ir/searchresult.php?id=16465&number=3 (Accessed 25th June 2015). [: IRCT2014053016465N3]
93. Nakano W. Augmentation of omega-3 fatty acid with antidepressants for major depressive disorder: a double-blind, randomized controlled trial. apps.who.int/trialsearch/Trial.aspx?TrialID=JPRN-UMIN000013525 (Accessed 26th June 2015).
94. Parker GB. A study of omega-3 as an augmentor of antidepressant treatment for major depression. ClinicalTrials.gov/show/NCT00289484 (Accessed 26th June 2015).
95. Parletta N. Effects of a Mediterranean-style diet and fish oil supplements on mood and health. www.anzctr.org.au/ACTRN12614000438651.aspx (Accessed 26th June 2015).
96. Piperoglou M. Adjunctive natural low dose docosahexaenoic acid (DHA) omega-3 in a 16 week random double-blind placebo controlled (RDBPC) cross-over withdrawal study in a group of chronic, psychiatric out-patients with anxiety and mood disorders. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365804 (Accessed 26th June 2015).
97. Smith D. An 8 week randomised, double-blind, placebo controlled trial investigating the role of adjunctive bioactive lipids specifically; docosahexaenoic acid (DHA) versus eicosapentaenoic acid (EPA) in major depressive disorder - with a 6 week open label extension of DHA in patients aged 18 - 65 years. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12610000710022 (Accessed 26th June 2015).
98. Tayama J. Omega-3 polyunsaturated fatty acids and psychological interventions for workers with mild to moderate depression: a randomized controlled trial. www.umin.ac.jp/ctr/index.htm (Accessed 26th June 2015).
99. Yao JK. Coronary artery disease (CAD) risk in schizophrenia: effect of omega-3 fatty acid supplementation. ClinicalTrials.gov/show/NCT00167310 (Accessed 26th June 2015).
100. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Washington, DC: American Psychiatric Association, 2013.
101. Appleton KM, Hayward RC, Gunnell D, Peters TJ, Rogers PJ, Kessler, D, et al. Effects of n3 long chain polyunsaturated fatty acids on depressed mood: systematic review of published trials. American Journal of Clinical Nutrition 2006;84(6):1308-16.
102. Appleton KM, Peters TJ, Hayward RC, Heatherley SV, McNaughton SA, Rogers PJ, et al. Depressed mood and n-3 polyunsaturated fatty acid intake from fish: non-linear or confounded association?. Social Psychiatry and Psychiatric Epidemiology 2007;42(2):100-4.
103. Appleton KM, Gunnell D, Peters TJ, Ness AR, Kessler D, Rogers PJ. No clear evidence of an associations between plasma concentrations of n-3 long chain polyunsaturated fatty acids and depressed mood in a non-clinical population. Prostaglandins, Leukotrienes and Essential Fatty Acids 2008;78:337-42.
104. Appleton KM, Rogers PJ, Ness AR. Is there a role for n-3 long-chain polyunsaturated fatty acids in the regulation of mood and behaviour? A review of the evidence to date from epidemiological studies, clinical studies and intervention trials. Nutrition Research Reviews 2008;21(1):13-41.
105. Appleton KM, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n-3 long-chain polyunsaturated fatty acids on depressed mood. American Journal of Clinical Nutrition 2010;91(3):757-70.
106. Beck AT, Steer RA. Beck Depression Inventory Manual. San Antonio, Texas: Psychological Corporation, 1987.
107. Bloch MH, Hannestad J. Omega-3 fatty acids for the treatment of depression: Systematic review and meta-analysis. Molecular Psychiatry 2012;17(12):1272-82.
108. British Nutrition Foundation. BNF Briefing paper: n-3 fatty acids and health. London: British Nutrition Foundation, 1999.
109. Browne JC, Scott KM, Silvers KM. Fish consumption in pregnancy and omega-3 status after birth are not associated with postnatal depression. Journal of Affective Disorders 2006;90(2-3):131-9.
110. Calder PC. n-3 polyunsaturated fatty acids and inflammation: from molecular biology to the clinic. Lipids 2003;38(4):342-52.
111. Caughey GE, Mantzioris E, Gibson RA, Cleland LG, James MJ. The effect on human tumor necrosis factor alpha and interleukin 1B production of diets enriched in n-3 fatty acids from vegetable oil or fish oil. American Journal of Clinical Nutrition 1996;63:116-22.
112. Chalon S. Omega-3 fatty acids and monoamine neurotransmission. Prostaglandins, Leukotrienes, and Essential Fatty Acids 2006;75(4-5):259-69.
113. Cho MJ, Kim MH. Use of the Center for Epidemiological Studies Depression (CES-D) scale in Korea. J Nerv Ment Dis 1998;186:304-10.
114. De la Presa Owens S, Innis SM. Docosahexaenoic and arachidonic acid prevent a decrease in dopaminergic and serotoninergic neurotransmitters in frontal cortex caused by a linoleic and alpha-linolenic acid deficient diet in formula fed piglets. Journal of Nutrition 1999;129(11):2088-93.
115. Deeks JJ, Altman DG, Bradbrun MJ. Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta-analysis in Context. London: BMJ Publishing Group, 2001:285-312.
116. Delion S, Chalon S, Hérault J, Guilloteau D, Besnard JC, Durand G. Chronic dietary alpha-linolenic acid deficiency alters dopaminergic and serotonergic neurotransmission in rats. Journal of Nutrition 1994;124(12):2466-76.
117. Delion S, Chalon S, Guilloteau D, Besnard JC, Durand G. Alpha-linolenic acid dietary deficiency alters age related changes in dopaminergic and serotonergic neurotransmission in the rat frontal cortex. Journal of Neurochemistry 1996;66(4):1582-91.
118. Dennis CL, Dowswell T. Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression. Cochrane Database of Systematic Reviews 2013, Issue 7. [DOI: 10.1002/14651858.CD006795.pub3]
119. Diguer L, Barber J, Luborsky L. Three concommitants: personality disorders, psychiatric severity, and outcome of dynamic psychotherapy of major depression. American Journal of Psychiatry 1993;150(8):1246-8.
120. Dupuy H. The psychological general well-being (PGWB) index. In: Wenger NK, Mattson ME, Furber CD, et al. editor(s). Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies. New York, US: Le Jaq Publishing Inc., 1984:170-83.
121. Edwards R, Peet M, Shay J, Horrobin D. Depletion of docosahexaenoic acid in red blood cell membranes of depressive patients. Biochemical Society Transactions 1998;26:s142.
122. Egger M, Davey Smith G. Principles of and procedures for systematic reviews. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic Reviews in Health Care: Meta-analysis in Context. London: BMJ Publishing Group, 2001:23-42.
123. Ehringer W, Belcher D, Wassall SR, Stillwell W. A comparison of the effects of linolenic acid (18:3 omega 3) and docosahexaenoic (22:6 omega 3) acids on phospholipid bilayers. Chemistry and Physics of Lipids 1990;54(2):79-88.
124. Endicott J, Nee J, Harrison W, Blumenthal R. Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacology Bulletin 1993;29(2):321-6.
125. Folstein MF, Folstein SE, McHugh PR. "Min-mental state": a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 1975;12(3):189-98.
126. Fountoulakis KN, Veroniki AA, Siamouli M, et al. No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis. Annals of General Psychiatry 2013;12(1):26.
127. Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 2010;303(1):47-53.
128. Frangou S, Lewis M, McCrone P. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. British Journal of Psychiatry 2006;188:46-50.
129. Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta-analyses can provide accurate results. Journal of Clinical Epidemiology 2006;59(1):7-10.
130. Garland MR, Hallahan B, McNamara M, Carney PA, Grimes H, Hibbeln JR, et al. Lipids and essential fatty acids in patients presenting with self-harm. British Journal of Psychiatry 2007;190:112-7.
131. Gregory J, Foster K, Tyler H, Wiseman M. National Diet and Nutritional Survey of British Adults. London: Her Majesty's Stationary Office, 2000.
132. Grosso G, Pajak A, Marventano S, Castellano S, Galvano F, Bucolo C, et al. Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials. PloS One 2014;9(5):e96905.
133. Guy W. Clinical Global Impressions. ECDEU Assessment Manual for Psychopharmacology, revised. Rockville, MD: National Institute of Mental Health, 1976.
134. Haag M. Essential fatty acids and the brain. Canadian Journal of Psychiatry 2003;48(3):195-203.
135. Hakkarainen R, Partonen T, Haukka J, Virtamo J, Albanes D, Lönnqvist J. Is dietary intake of omega-3 fatty acids associated with depression?. American Journal of Psychiatry 2004;161(3):567-9.
136. Hamazaki K, Itomura M, Huan M, Nishizawa H. Effects of w-3 fatty acid-containing phospholipids on blood catecholamine concentrations in healthy volunteers: a randomized, placebo controlled, double blind trial. Nutrition 2005;21:705-10.
137. Hamilton M. A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 1960;23:56-62.
138. Hibbeln JR. Fish consumption and major depression. Lancet 1998;351(9110):1213.
139. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 2002;21(11):1539-58.
140. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327(7414):557-60.
141. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org. 5.1. Chichester, UK: The Cochrane Collaboration & John Wiley & Sons, Ltd.
142. Hirashima F, Parow AM, Stoll AL, Demopulos CM, Damico KE, Rohan ML, et al. Omega-3 fatty acid treatment and T2 whole brain relaxation times in bipolar disorder. American Journal of Psychiatry 2004;161(10):1922-4.
143. Hoehn M, Yahr M. Parkinsonism: onset, progression and mortality. Neurology 1967;17(5):427-42.
144. James MJ, Gibson RA, Cleland LG. Dietary polyunsaturated fatty acids and inflammatory mediator production. American Journal of Clinical Nutrition 2000;71(1 Suppl):343s-8s.
145. Keck PE Jr, Mintz J, McElroy SL, Freeman MP, Suppes T, Frye MA, et al. Double-blind, randomized, placebo-controlled trials of ethyl-eicosapentanoate in the treatment of bipolar depression and rapid cycling bipolar disorder. Biological Psychiatry 2006;60(9):1020-2.
146. Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine 2008;5(2):e45.
147. Lin PY, Su KP. A meta-analytic review of double-blind, placebo-controlled trials of anti-depressant efficacy of omega-3 fatty acids. Journal of Clinical Psychiatry 2007;68(7):1056-61.
148. Lin P-Y, Mischoulon D, Freeman MP, et al. Are omega-3 fatty acids anti-depressants or just mood-improving agents?. Mol Psychiatry 2012;17:1161-1163.
149. Linde K, Berner MM, Kriston L. St John's wort for major depression. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD000448.pub3]
150. Ma J, Folsom AR, Eckfeldt JH, Lewis L, Chambless LE. Short- and long-term repeatability of fatty acid composition of human plasma phospholipids and cholesterol esters: The Atherosclerosis Risk in Communities (ARIC) Study Investigators. American Journal of Clinical Nutrition 1995;62(3):572-8.
151. Mamalakis G, Tornaritis M, Kafatos A. Depression and adipose essential polyunsaturated fatty acids. Prostaglandins, Leukotrienes and Essential Fatty Acids 2002;67(5):311-8.
152. Mamalakis G, Kiriakakis M, Tsibinos G, Kafatos A. Depression and adipose polyunsaturated fatty acids in an adolescent group. Prostaglandins, Leukotriens and Essential Fatty Acids 2004;71(5):289-94.
153. Mamalakis G, Kiriakakis M, Tsibinos G, Hatzis C, Flouri S, Mantzoros C, et al. Depression and serum adiponectin and adipose omega-3 and omega-6 fatty acids in adolescents. Pharmacology, Biochemistry and Behavior 2006;85(2):474-9.
154. Martins JG. EPA but not DHA appears to be responsible for the efficacy of omega-3 LC-PUFA supplementation in depression: Evidence from an updated meta-analysis of randomized controlled trials. OCL - Oleagineux Corps Gras Lipides 2011;18:188-98.
155. McNamara RK, Richtand NM, Levant B. Omega-3 fatty acid deficiency decreases dopamine D2 receptor binding and increases serotonin 5-HT2A receptor binding in the adult rat prefrontal cortex. Biological Psychiatry 2006;59:146S.
156. Miller BJ, Murray L, Beckmann MM, Kent T, Macfarlane B. Dietary supplements for preventing postnatal depression. Cochrane Database of Systematic Reviews 2013, Issue 10. [DOI: 10.1002/14651858.CD009104.pub2]
157. Miyake Y, Sasaki A, Yokoyama T, Tanaka K, Ohya Y, Fukushima W. Risk of postpartum depression in relation to dietary fish and fat intake in Japan: the Osaka Maternal and Child Health Study. Psychological Medicine 2006;36(12):1727-37.
158. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. British Journal of Psychiatry 1979;134:382-9.
159. National Institute for Clinical Excellence. Depression: Management of Depression in Primary and Secondary Care. London, England: National Institute for Clinical Excellence, 2004.
160. Noaghiul S, Hibbeln JR. Cross-national comparisons of seafood consumption and rates of bipolar disorders. American Journal of Psychiatry 2003;160(12):2222-7.
161. Parker G, Gibson NA, Brotchie H, Heruc G, Rees AM, Hadzi-Pavlovic D. Omega-3 fatty acids and mood disorders. American Journal of Psychiatry 2006;163(6):969-78.
162. Peet M, Murphy B, Shay J, Horrobin D. Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients. Biological Psychiatry 1998;43(5):315-9.
163. Peet M. International variations in the outcome of schizophrenia and the prevalence of depression in relation to national dietary practices: an ecological analysis. British Journal of Psychiatry 2004;184:404-8.
164. Rallidis LS, Paschos G, Liakos GK, Velissaridou AH, Anastasiadis G, Zampelas A. Dietary alpha-linolenic acid decreases C-reactive protein, serum amyloid A and interleukin-6 in dyslipidaemic patients. Atherosclerosis 2003;167(2):237-42.
165. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.
166. Reynolds WM, Kobak KA. Hamilton Depression Inventory. Psychological Assessment Resources. Odessa, FL: Psychological Assessment Resources, 1995.
167. Rogers PJ, Appleton KM, Kessler D, Peters TJ, Gunnell D, Hayward RC, et al. No effect of n-3 long chain polyunsaturated fatty acid (EPA and DHA) supplementation on depressed mood and cognitive function: a randomized controlled trial. British Journal of Nutrition 2008;99(2):421-31.
168. Ross BM, Seguin J, Sieswerda LE. Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid?. Lipids in Health and Disease 2007;6:21.
169. Ruxton CHS, Calder PC, Reed SC, Simpson MJA. The impact of long chain n-3 polyunsaturated fatty acids on human health. Nutrition Research Reviews 2005;18(1):113-29.
170. Ryff CD, Keyes CL. The structure of psychological well-being revisited. J Pers Soc Psychol 1995;69:719-27.
171. Sawazaki S, Hamazaki T, Yazawa K, Kobayashi M. The effect of docosahexaenoic acid on plasma catecholamine concentrations and glucose tolerance during long-lasting psychological stress: a double blind placebo controlled study. Journal of Nutritional Science and Vitaminology 1999;45(5):655-65.
172. Silvers KM, Scott KM. Fish consumption and self-reported physical and mental health status. Public Health Nutrition 2002;5(3):427-31.
173. Simopoulos AP. Evoluntionary aspects of omega-3 fatty acids in the food supply. Prostaglandins, Leukotrienes and Essential Fatty Acids 1999;60(5-6):421-9.
174. Smith MA, Beilin LJ, Mori TA, Oddy WH. Essential fatty acids and mood: a systematic review of observational studies. American Journal of Food and Nutrition 2011;1:14-27.
175. Stahl LA, Begg DP, Weisinger RS, Sinclair AJ. The role of omega-3 fatty acids in mood disorders. Current Opinion in Investigational Drugs 2008;9(1):57-64.
176. Sterne JAC, Egger M, Davey Smith G. Investigating and dealing with publication and other biases. In: Egger M, Davey Smith G, Altman DG, eds editor(s). Systematic Reviews in Health Care: Meta-analysis in Context. London: BMJ Publishing Group, 2001:189-208.
177. Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, et al. Omega-3 fatty acids in bipolar disorder - a preliminary double-blind, placebo-controlled trial. Archives of General Psychiatry 1999;56(5):407-12.
178. Sublette ME, Ellis SP, Geant AL, Mann JJ. Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression. Journal of Clinical Psychiatry Diseases of the Nervous System 2011;72(12):1577-84.
179. Takeuchi T, Fukumoto Y, Harada E. Influence of a dietary n-3 fatty acid deficiency on the cerebral catecholamine contents, EEG and learning ability in rat. Behavioral Brain Research 2002;131(1-2):193-203.
180. Tanskanen A, Hibblen JR, Hintikka J, Haatainen K, Honkalampi K, Viinamäki K. Fish consumption, depression, and suicidality in a general population. Archives of General Psychiatry 2001;58(5):512-3.
181. Tappia PS, Ladha S, Clark DC, Grimble RF. The influence of membrane fluidity, TNF receptor binding, cAMP production and GTPase activity on macrophage cytokine production in rats fed a variety of fat diets. Molecular and Cellular Biochemistry 1997;166(1-2):135-43.
182. Taylor T, Jefferis GS, Koop M, Hill BC, Hastie T, Heit G, et al. Quantitative measurements of alternating finger tapping in Parkinson's disease correlate with UPDRS motor disability and reveal the improvement in fine motor control from medication and deep brain stimulation. Movement Disorders 2005;20:01286-98.
183. Trivedi MH, Rush AJ, Ibrahim HM, Carmody TJ, Biggs MM, Suppes T, et al. The Inventory of Depressive Symptomology, clinician rating (IDS-C) and self report (IDS-SR), and the Quick Inventory of Depressive Symptomology, clinician rating (QIDS-C) and self-report (QIDS-SR) in public sector patients with mood disorders; a psychometric evaluation. Psychological Medical 2004;34(1):73-82.
184. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine 2008;358(3):252-60.
185. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey: Manual and Interpretation Guide. Boston MA: The Health Institute, 1993.
186. World Health Organization. Global Burden of Disease. www.who.int/healthinfo/global_burden_disease/gbd/en/index.html (Accessed 1st February 2014).
187. Williams JW Jr, Stellato CP, Cornell J, Barrett JE. The 13- and 20-item Hopkins Symptom Checklist Depression Scale: psychometric properties in primary care patients with minor depression or dysthymia. International Journal of Psychiatry in Medicine 2004;34(1):37-50.
188. Yao JK, Magan S, Sonel AF, Gurklis JA, Sanders R, Reddy RD. Effects of omega-3 fatty acid on platelet serotonin responsivity in patients with schizophrenia. Prostaglandins, Leukotrienes and Essential Fatty Acids 2004;71(3):171-6.
189. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VP. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research 1983;17(1):37-49.
190. Silvers KM, Hackett ML, Scott KM. Omega 3 fatty acids for depression. Cochrane Database of Systematic Reviews 2009, Issue 1. [DOI: 10.1002/14651858.CD004692.pub2]