Major Depression and Bipolar Disorder
Data from ecological studies across different countries suggest an inverse association between seafood consumption and national rates of major depression and bipolar disorder. Several small studies have found omega-3 fatty acid concentrations to be lower in the plasma and adipose tissue (fat) of individuals suffering from depression compared to controls.
Although it is not known how increased omega-3 fatty acid intake affects the incidence of depression, modulation of neuronal signaling pathways and eicosanoid production have been proposed as possible mechanisms. The results of randomized controlled trials of supplementation with long-chain omega-3 fatty acids on depression have been mixed. Adding fish oil supplements (8 g/day) to existing therapy in people who were being treated for depression was not significantly more effective than adding the same amount of olive oil for 12 weeks.
Supplementation with 2 g/day of DHA for 6 weeks was not significantly more effective than a placebo in the treatment of major depression. However, a small randomized controlled trial in Chinese patients diagnosed with major depression found that supplementation with 6.6 g/day of EPA + DHA for 8 weeks improved scores on the Hamilton Rating Scale for Depression compared to placebo.
Another small randomized controlled trial in 30 women diagnosed with borderline personality disorder found that the 20 women randomized to treatment with 1 g/day of ethyl-EPA for 8 weeks experienced less severe depressive symptoms than the 10 women randomized to treatment with a placebo.
Unipolar depression and bipolar disorder are considered distinct psychiatric conditions, although major depression occurs in both. A randomized controlled trial that assessed the effects of high doses of EPA (6.2 g/day) + DHA (3.4 g/day) in patients with bipolar disorder found that those supplemented with EPA + DHA had a significantly longer period of remission than those on an olive oil placebo over a 4-month period.
Patients who took the EPA + DHA supplements also experienced less depression than those who took the placebo. Although the results of a few small controlled trials are somewhat optimistic, larger and long-term randomized controlled trials are required to determine the efficacy of long-chain omega-3 fatty acid supplementation on major depression.
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