Abstract
A new application for omega-3 fatty acids has recently emerged, concerning the treatment of several mental disorders. This indication is supported by data of neurobiological research, as highly unsaturated fatty acids (HUFAs) are highly concentrated in neural phospholipids and are important components of the neuronal cell membrane. They modulate the mechanisms of brain cell signaling, including the dopaminergic and serotonergic pathways. The aim of this review is to provide a complete and updated account of the empirical evidence of the efficacy and safety that are currently available for omega-3 fatty acids in the treatment of psychiatric disorders. The main evidence for the effectiveness of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has been obtained in mood disorders, in particular in the treatment of depressive symptoms in unipolar and bipolar depression. There is some evidence to support the use of omega-3 fatty acids in the treatment of conditions characterized by a high level of impulsivity and aggression and borderline personality disorders. In patients with attention deficit hyperactivity disorder, small-to-modest effects of omega-3 HUFAs have been found. The most promising results have been reported by studies using high doses of EPA or the association of omega-3 and omega-6 fatty acids. In schizophrenia, current data are not conclusive and do not allow us either to refuse or support the indication of omega-3 fatty acids. For the remaining psychiatric disturbances, including autism spectrum disorders, anxiety disorders, obsessive-compulsive disorder, eating disorders and substance use disorder, the data are too scarce to draw any conclusion. Concerning tolerability, several studies concluded that omega-3 can be considered safe and well tolerated at doses up to 5 g/day.
Highlights
The role of omega-3 highly unsaturated fatty acids (HUFAs) in human mental health has been widely studied in the last two decades.Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are derived from alpha-linolenic acid (ALA) and are dietary essential fatty acids
The omega-6 family of fatty acids is converted to arachidonic acid and into prostaglandins and leukotrienes, which are responsible of the pro-inflammatory effects
The results showed a significant effect of E-EPA on aggressive behaviors measured with the Modified Overt Aggression Scale (MOAS) and on depressive symptoms assessed with the Montgomery-Åsberg Depression Rating Scale (MADRS) compared to placebo
Summary
The role of omega-3 highly unsaturated fatty acids (HUFAs) in human mental health has been widely studied in the last two decades. Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are derived from alpha-linolenic acid (ALA) and are dietary essential fatty acids. They cannot be synthetized de novo by mammals and are provided by supplementation, such as fish oil. EPA and DHA act as competitive inhibitors of omega-6 fatty acids causing a reduction in the synthesis of pro-inflammatory mediators [1]. The omega-6 family of fatty acids is converted to arachidonic acid and into prostaglandins and leukotrienes, which are responsible of the pro-inflammatory effects. A diet rich in fish oil has been shown to decrease the incidence of inflammatory diseases
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