International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major Depressive Disorder

Ta-Wei Guu, David Mischoulon, Jerome Sarris, Joseph Hibbeln, Robert K McNamara, Kei Hamazaki, Marlene P Freeman, Michael Maes, Yutaka J Matsuoka, R H Belmaker, Felice Jacka, Carmine Pariante, Michael Berk, Wolfgang Marx, Kuan-Pin Su

Research output: Contribution to journalReview articleResearchpeer-review

12 Citations (Scopus)

Abstract

Major depressive disorder (MDD) is a complex mental illness with unmet therapeutic needs. The antidepressant effects of ω-3 polyunsaturated fatty acids (n-3 PUFAs) have been widely reported. The subcommittee of the International Society for Nutritional Psychiatry Research organized an expert panel and conducted a literature review and a Delphi process to develop a consensus-based practice guideline for clinical use of n-3 PUFAs in MDD. 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: (1) 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; (2) 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; (3) the quality of n-3 PUFAs may affect therapeutic activity; and (4) 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.

Original languageEnglish
Pages (from-to)263-273
Number of pages11
JournalPsychotherapy and Psychosomatics
Volume88
Issue number5
DOIs
Publication statusPublished - 1 Sep 2019
Externally publishedYes

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    Guu, T-W., Mischoulon, D., Sarris, J., Hibbeln, J., McNamara, R. K., Hamazaki, K., Freeman, M. P., Maes, M., Matsuoka, Y. J., Belmaker, R. H., Jacka, F., Pariante, C., Berk, M., Marx, W., & Su, K-P. (2019). International Society for Nutritional Psychiatry Research Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major Depressive Disorder. Psychotherapy and Psychosomatics, 88(5), 263-273. https://doi.org/10.1159/000502652