title: Efficacy of omega-3 fatty acids in mood disorders - a systematic review and metaanalysis.
abstract: OBJECTIVE
  Existing efficacy trials of Omega-3 (omega-3) fatty acids in mood disorders have yielded inconsistent results. The current paper is an effort to provide a systematic review and meta-analysis to evaluate efficacy of omega-3 fatty acids in treatment of mood disorders.
  
  
  METHODS
  We searched Medline, Embase, PsychInfo, and the Cochrane Controlled Trials registry up to June 2008 for randomized trials investigating efficacy of omega-3 fatty acids in mood disorders.We conducted random effects meta-analyses.We used the I2 statistic to quantify between-study inconsistency, and conducted pre-specified subgroup analyses to explore potential explanations for inconsistency.
  
  
  METHODS
  We included 21 trials in our systematic review and found 13 trials to be eligible for meta-analysis. The pooled standardized mean difference in depressed mood states (n = 554 in 12 trials) was -0.47 (95% CI:-0.92,-0.02; I2 = 82.7; p = 0.07) and in manic mood states (n = 126 in 4 trials) was 0.22 (95% CI: -0.21, 0.65; I2 = 40.5; p = 0.31).We did not identify any treatment- subgroup interaction across forms of omega-3 fatty acids preparations (P = 0.99) or patient diagnosis (bipolar vs. unipolar depressive disorder; P = 0.96); there was a significant correlation between omega-3 fatty acids dose and treatment effect on depressive symptoms (r = 0.5, p = 0.04), but not on manic symptoms (P = 0.3).
  
  
  CONCLUSIONS
  The available evidence suggests that omega-3 fatty acids are a potential treatment of depressive disorders, but not mania. The unexplained between-study inconsistency and imprecision of the pooled estimates mitigate this suggestion. Large randomized placebo-controlled trials are needed to better estimate the value of this intervention for patients with depression.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, MN, USA.
authors.forename: Nina V
authors.initials: NV
authors.lastname: Kraguljac
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: Mani
authors.initials: M
authors.lastname: Pavuluri
authors.forename: High S
authors.initials: HS
authors.lastname: Chai
authors.forename: Brian S
authors.initials: BS
authors.lastname: Wilson
authors.forename: Sencan S
authors.initials: SS
authors.lastname: Unal
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy*; D003866:Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3