Abstract
The usefulness of polyunsaturated fatty acids on inflammatory, cardiovascular, and the nervous system was studied in the last decades, but the mechanisms underlying their benefic properties are still partially unknown. These agents seem to express their action on the membrane phospholipid composition and permeability and modulation of second messenger cascades. In psychiatry, the efficacy and tolerability of omega-3 fatty acids were investigated in several psychiatric disorders, including major depression, bipolar disorder, personality disorders, high-risk conditions to develop psychosis, attention-deficit hyperactivity disorder, and autism spectrum disorders. Initial findings in this field are promising, and some relevant questions need to be addressed. In particular, the effects of these agents on the main symptom dimensions have to be investigated in a trans-diagnostic perspective. The present systematic review is aimed to examine the available data on the efficacy of omega-3 fatty acids on domains of psychotic symptoms, affective symptoms, impulsivity, and aggressiveness, and harmful behaviors, and suicide risk.
Highlights
Several studies [113,114,115,116,117,118,119,120] investigating the efficacy of n-3 polyunsaturated fatty acids (PUFAs) supplementation (2.5 g/day with eicosapentaenoic acid (EPA):docosahexaenoic acid (DHA) = 2:1) in patients who suffer from bipolar disorder treated with mood stabilizers confirmed the effect of these agents on depressive symptoms [120] but not on manic ones [8,9]
The results showed that EPA at doses ranging between 1 and 4 g/day is efficacious in reducing the depressive symptoms [50,54] and anxious symptoms [54] of schizophrenia
↓ depressive symptoms assessed with HDRS, but no statistical significance
Summary
The scientific literature has highlighted an urgent need to identify new compounds to treat psychiatric disorders in order to improve and boost available medications that entail not insignificant side effects. [1] As the harmful effects of the western diet, the absence of polyunsaturated fatty acids (PUFAs), on immune memory and inflammation processes are recognized [2], several studies evaluated the relationships between the low plasma level of long-chain polyunsaturated fatty acids and several medical conditions. [3] The effects of omega-3 fatty acids (n-3 PUFAs), including α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), and of omega-6 fatty acids (n-6 PUFAs), including linoleic and arachidonic acid on overall human health have been extensively studied [4,5,6]. DHA is an essential omega-3 long-chain polyunsaturated fatty acid involved in many cellular processes in mammalian cells [15], represents approximately 60% of PUFAs in neuronal membranes [16], and is a precursor for bioactive compounds that modulate cell signaling and gene expression [17]. It takes part in neuronal growth, development, and function, acting as a neurotrophic factor and modulating synaptic activity [18], and it has been found to reduce the deleterious effects of chronic activation of inflammatory signaling cascades in the brain and to ameliorate neurotoxic injuries implicated in neurodegenerative disorders [19]. The present systematic review is aimed to examine available data on the efficacy of omega-3 fatty acids on domains of psychotic symptoms, affective symptoms, impulsivity, and harmful behaviors
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