Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation

Hsu, Mei‐Chi; Tung, Chia-Yi; Chen, Hsing-E

doi:10.1016/j.jad.2018.05.018

Cited by 70 publications

(49 citation statements)

References 113 publications

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“…Levels of EPA and DHA in plasma predicted premature birth, an effect probably partly mediated by EPA-derived eicosanoids [11]. Supplementation with EPA-rich oils during pregnancy or postpartum improved maternal depression, which DHA did not [16,80]. Thus, EPA and DHA are biologically not easily separated, and EPA appears to have some positive effects on its own in pregnancy, suggesting that a metric providing the levels of both EPA and DHA in pregnancy (i.e., the Omega-3 Index) has advantages over measuring only DHA [15].…”

Section: Safety and Tolerabilitymentioning

confidence: 98%

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

Schacky

2020

Nutrients

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Scientific societies recommend increasing intake of docosahexaenoic acid (DHA) by 200 mg/day during pregnancy. However, individually, clinical events correlate quite strongly with levels of eicosapentaenoic acid (EPA) and DHA in blood, but these levels poorly correlate with amounts ingested. EPA and DHA in erythrocytes (Omega-3 Index) have a low biologic variability. If analyzed with a standardized analytical procedure (HS-Omega-3 Index®), analytical variability is low. Thus, the largest database of any fatty acid analytical method was provided. Pregnant women in Germany had a mean Omega-3 Index below the target range suggested for cardiovascular disease of 8–11%, with large interindividual variation, and quite independent of supplementation with EPA and DHA. In Germany, premature birth is a major health issue. Premature birth and other health issues of pregnant women and their offspring correlate with levels of EPA and DHA in blood and can be reduced by increasing intake of EPA and DHA, according to individual trials and pertinent meta-analyses. Very high intake or levels of EPA and DHA may also produce health issues, like bleeding, prolonged gestation, or even premature birth. While direct evidence remains to be generated, evidence from various scientific approaches supports that the target range for the Omega-3 Index of 8–11% might also pertain to pregnancy and lactation.

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Section: Safety and Tolerabilitymentioning

confidence: 98%

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

Schacky

2020

Nutrients

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“…Of these, 105 studies were excluded for either not meeting inclusion criteria or overlapping samples with included studies, and 8 eligible studies [18][19][20][28][29][30] were identified. Of the 8 eligible trials, there were two Persian trials 26,27 which were identified through a relevant systematic review 31 and an included study 28 . The content of these two studies was translated by Google translation.…”

Section: Selection Of Studiesmentioning

confidence: 99%

The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials

Zhang

Yan²,

et al. 2020

Transl Psychiatry

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Omega-3 fatty acids (FA), as a nutrient, has been proven effective in major depressive disorder (MDD), however, the results of monotherapy in perinatal depression (PND) remain unclear. To examine the efficacy and safety of omega-3 fatty acids (FA) monotherapy for perinatal depression (PND) compared with placebo. PubMed, Embase, PsycINFO, MEDLINE, Cochrane Library, and CINAHL were searched from inception up to November 2019. The reference lists of relevant review articles and included studies were also reviewed. Randomized placebo-controlled trials examining the efficacy and safety of omega-3 FA monotherapy in perinatal women with depressive symptoms were included. Pooled standard mean differences (SMD) were calculated and random-effects models were adopted for all analyses. Subgroups analyses and meta-regression were performed to quantify characteristics of the subjects and trials influencing the omega-3 response. In addition, meta-regression was conducted to identify the source of heterogeneity. The study protocol was registered at PROSPERO, CRD42020159542. Eight eligible randomized placebocontrolled trials were included involving 638 participants. There was a significant effect of omega-3 FA on perinatal depression. Omega-3 with higher ratio of EPA/DHA (≥1.5) had significant efficacy both in mild-to-moderate pregnant and postpartum depression with low incidence of side effects. Among the included trials reporting adverse effects, there was no significant difference in incidence of gastrointestinal and neurologic events between the omega-3 and placebo groups. There was no evidence of publication bias. Our findings suggested that omega-3 FA significantly improved depressive symptoms in perinatal women regardless of pregnant or postpartum and well-tolerated. Furthermore, the omega-3 response was linked to higher EPA proportion in omega-3 formula and mild-to-moderate depression.

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“…Previous studies have shown that, fish oil (FO), a rich source of omega-3 fatty acid, has a therapeutic potential on many diseases, especially those related to mood disorders, as supplementation of FO to both humans [ 8 , 9 ] and animals [ 10 , 11 ] has improved their mental health status. Supplementation of omega-3 fatty acid to humans reduced their risk for PPD [ 12 ], while 15 days of FO supplementation to the rat model of PPD exerted antidepressant-like effects [ 13 ]. Moreover, in a bulbectomy rat model of depression, ingestion of FO increased the hippocampal level of brain-derived neurotrophic factor (BDNF) and 5HT, which are the two major regulators of neuronal survival and long-term plasticity in the brain [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Antidepressant-Like Properties of Fish Oil on Postpartum Depression-Like Rats Model: Involvement of Serotonergic System

et al. 2020

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Pathophysiology of postpartum depression (PPD) has been associated with many factors, such as neuroendocrine, neuroinflammation and neurotransmitter changes. Fish oil (FO) improves PPD both in humans and animals. However, little is known with regards to its pharmacology on a PPD-like rat model. Hence, the current study aimed at investigating the effects of FO on a PPD-like rat model. Female rats were induced with PPD-like symptoms and then randomly divided into six groups (n = 6) for two experimental protocols. Protocol 1 consisted of PPD-like rats (2 mL distilled water), PPD-like + FO (9 g/kg/d) and PPD-like + Fluoxetine (FLX) (15 mg/kg/d) groups of rats, whereas Protocol 2 consisted of PPD-like rats (2 mL distilled water) + PCPA (p-chlorophenylalanine) 150 mg/kg, PPD-like + FO (9 g/kg/d) + PCPA 150 mg/kg and PPD-like + FLX (15 mg/d) + PCPA 150 mg/kg groups of rats, respectively. All treatments were administered orally for 10 days postpartum, except PCPA, which was given intraperitoneally. Prior to euthanasia, the antidepressant-like effect of the FO was evaluated using the forced swimming test (FST) and open field test (OFT) on day 10 postpartum. Biochemical analysis of serotonin, serotonin metabolite and serotonin turnover from their prefrontal cortex and hippocampus were also measured. The results showed that FO decreased immobility time and increased swimming time significantly, but not climbing time in FST. Further, it also decreased serotonin metabolite and turnover significantly in the hippocampus of the PPD-like rats. In contrast, administration with PCPA reversed all the outcomes. The antidepressant-like effects of FO were found to be similar with that of FLX. Thus, it can be concluded that FO exerts its antidepressant-like effects in PPD-like rats through modulation of serotonergic system.

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Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation

Cited by 70 publications

References 113 publications

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index

The efficacy and safety of omega-3 fatty acids on depressive symptoms in perinatal women: a meta-analysis of randomized placebo-controlled trials

Antidepressant-Like Properties of Fish Oil on Postpartum Depression-Like Rats Model: Involvement of Serotonergic System

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