The subcommittee of the International Society for Nutritional Psychiatry Research recently released a literature review and a Delphi process of Omega-3 fatty acids clinical guidelines for major depressive disorder (MDD). The guidelines were published in Psychotherapy and Psychosomatics Journal.
The ISNPR developed the guidelines because though pharmacological treatments with the currently available antidepressants are effective in treating moderate to severe symptoms in MDD, they have multiple adverse effects. “Therefore, to optimize the patients’ outcomes, clinicians need more efficacious and tolerable treatments supported by valid scientific evidence and reliable practice guidelines,” they write.
The guideline focuses on 5 thematic areas: general concepts, acute treatment strategy, depression recurrence monitoring and prevention, use in special populations, and potential safety issues. The key practice guidelines contend that:
Omega-3 Fatty Acids Clinical Guidelines
- Clinicians and other practitioners are advised to conduct a clinical interview to validate clinical diagnoses, physical conditions, and measurement-based psychopathological assessments in the therapeutic settings when recommending n–3 PUFAs in depression treatment;
- With respect to formulation and dosage, both pure eicosapentaenoic acid (EPA) or an EPA/docosahexaenoic acid (DHA) combination of a ratio higher than 2 (EPA/DHA >2) are considered effective, and the recommended dosages should be 1–2 g of net EPA daily, from either pure EPA or an EPA/DHA (>2:1) formula;
- The quality of n–3 PUFAs may affect therapeutic activity; and
- Potential adverse effects, such as gastrointestinal and dermatological conditions, should be monitored, as well as obtaining comprehensive metabolic panels. The expert consensus panel has agreed on using n–3 PUFAs in MDD treatment for pregnant women, children, and the elderly, and prevention in high-risk populations. Personalizing the clinical application of n-3 PUFAs in subgroups of MDD with a low Omega-3 Index or high levels of inflammatory markers might be regarded as areas that deserve future research.
In this study you will learn the following:
- Diagnosis and Measurement-Based Care
- Disease Stages
- Treatment Strategy (Monotherapy, Augmentation, or Acceleration)
- Dosing, Ratio, and Duration
- Safety and Adverse Effects
Source: Guu T.W. et al. International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major Depressive Disorder. Psychother Psychosom 2019;88:263–273 https://doi.org/10.1159/000502652