Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies

Chang, Jane Pei-Chen; Su, Kuan‐Pin; Mondelli, Valeria; Pariante, Carmine M.

doi:10.1038/npp.2017.160

Cited by 176 publications

(164 citation statements)

References 53 publications

Supporting

Mentioning

147

Contrasting

Unclassified

Order By: Relevance

“…No meta‐analyses directly compared nutrient supplementation to psychotropic medications. All studies were placebo‐controlled.…”

Section: Resultsmentioning

confidence: 99%

“…Specific psychiatric conditions (and reported outcomes) considered in this meta‐review included: schizophrenia (examining total symptoms along with positive, negative, general and depressive symptoms, and tardive dyskinesia); states at risk for psychosis (examining attenuated psychosis symptoms, negative symptoms, transition to psychosis, and functioning); depressive disorders (including any clinical depression, diagnosed major depressive disorder (MDD), depression in pregnancy, in old age, or as a comorbidity to chronic health conditions); anxiety and stress‐related conditions (including generalized anxiety disorder, obsessive‐compulsive disorder (OCD) and trichotillomania); bipolar disorder type I and II (examining overall symptoms, bipolar mania, bipolar depression, functional impairments, and quality of life); and ADHD (including composite symptoms, hyperactivity‐impulsivity, inattention, behavioural comorbidities such as aggression, and cognitive functioning).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

et al. 2019

View full text Add to dashboard Cite

The role of nutrition in mental health is becoming increasingly acknowledged. Along with dietary intake, nutrition can also be obtained from “nutrient supplements”, such as polyunsaturated fatty acids (PUFAs), vitamins, minerals, antioxidants, amino acids and pre/probiotic supplements. Recently, a large number of meta‐analyses have emerged examining nutrient supplements in the treatment of mental disorders. To produce a meta‐review of this top‐tier evidence, we identified, synthesized and appraised all meta‐analyses of randomized controlled trials (RCTs) reporting on the efficacy and safety of nutrient supplements in common and severe mental disorders. Our systematic search identified 33 meta‐analyses of placebo‐controlled RCTs, with primary analyses including outcome data from 10,951 individuals. The strongest evidence was found for PUFAs (particularly as eicosapentaenoic acid) as an adjunctive treatment for depression. More nascent evidence suggested that PUFAs may also be beneficial for attention‐deficit/hyperactivity disorder, whereas there was no evidence for schizophrenia. Folate‐based supplements were widely researched as adjunctive treatments for depression and schizophrenia, with positive effects from RCTs of high‐dose methylfolate in major depressive disorder. There was emergent evidence for N‐acetylcysteine as a useful adjunctive treatment in mood disorders and schizophrenia. All nutrient supplements had good safety profiles, with no evidence of serious adverse effects or contraindications with psychiatric medications. In conclusion, clinicians should be informed of the nutrient supplements with established efficacy for certain conditions (such as eicosapentaenoic acid in depression), but also made aware of those currently lacking evidentiary support. Future research should aim to determine which individuals may benefit most from evidence‐based supplements, to further elucidate the underlying mechanisms.

show abstract

“…No meta‐analyses directly compared nutrient supplementation to psychotropic medications. All studies were placebo‐controlled.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

et al. 2019

View full text Add to dashboard Cite

show abstract

“…These findings have implications beyond mood disorders and are compatible with the RDoC emphasis advocated by NIMH. EF impairment is a prominent characteristic of ADHD, and ADHD symptoms have been responsive to omega‐3 supplementation with small effect (Bloch & Qawasmi, ; Chang et al., ). Most study participants had comorbid ADHD; however, ADHD comorbidity did not significantly influence treatment outcome despite conferring nominally greater benefit.…”

Section: Discussionmentioning

confidence: 99%

“…Ω3 supplementation trials have suggested benefit for childhood MDD and bipolar disorders (Clayton et al., ; Fristad et al., , ; Nemets, Nemets, Apter, Bracha, & Belmaker, ), working memory improvement in young adults (Narendran, Frankle, Mason, Muldoon, & Moghaddam, ), and modest but significant improvement of ADHD symptoms (Chang, Su, Mondelli, & Pariante, ). The primary trials from which the current analyses stem demonstrated significant improvement in bipolar depression with Ω3 supplementation and small–moderate improvement in unipolar depression; there was no treatment impact on mania (Fristad et al., , ).…”

Section: Introductionmentioning

confidence: 99%

Omega‐3 supplementation associated with improved parent‐rated executive function in youth with mood disorders: secondary analyses of the omega 3 and therapy (OATS) trials

Vesco

Young

Arnold

et al. 2017

Child Psychology Psychiatry

View full text Add to dashboard Cite

show abstract

“…The authors concluded that a number of treatment effects may have failed to reach statistical significance due to small sample sizes and within and between study heterogeneity in terms of design and study participants (218) . In seven RCTs involving 534 adolescents with ADHD, very long chain n-3 fatty acids improved ADHD clinical symptom scores, while in three RCTs involving 214 adolescents, very long chain n-3 fatty acids improved cognitive measures associated with attention (219) . A very recent systematic review was supportive of use of n-3 fatty acid supplements in children with ADHD (220) .…”

Section: Neurocognitive Healthmentioning

confidence: 99%

Very long-chainn-3 fatty acids and human health: fact, fiction and the future

2017

View full text Add to dashboard Cite

Eicosapentaenoic acid (EPA) and docosahexaenoioc acid (DHA) appear to be the most important omega-3 (n-3) fatty acids, but roles for n-3 docosapentaenoic acid (DPA) are now also emerging. Intakes of EPA and DHA are usually low, typically below those recommended.Increased intakes result in higher concentrations of EPA and DHA in blood lipids, cells and tissues. Increased content of EPA and DHA modifies the structure of cell membranes and the function of membrane proteins. EPA and DHA modulate the production of lipid mediators and through effects on cell signaling can alter the patterns of gene expression. Through these mechanisms, EPA and DHA alter cell and tissue responsiveness in a way that often results in more optimal conditions for growth, development and maintenance of health. DHA has vital roles in brain and eye development and function. EPA and DHA have a wide range of physiological roles which are linked to certain health or clinical benefits, particularly related to cardiovascular disease, cancer, inflammation, and neurocognitive function. The benefits of EPA and DHA are evident throughout the life course. Future research will include better identification of the determinants of variation of responses to increased intake of EPA and DHA; more in-depth dose response studies of the effects of EPA and DHA; clearer identification of the specific roles of EPA, DPA and DHA; testing strategies to enhance delivery of n-3 fatty acids to the bloodstream; and exploration of sustainable alternatives to fish-derived very long chain n-3 fatty acids. Omega-3 (n-3) fatty acids -structure, metabolic interrelationships, dietary sources and intakes Omega-3 (n-3) fatty acids are a family of polyunsaturated fatty acids (PUFAs) (1) . They are defined by the position of the double bond closest to the methyl terminus of the hydrocarbon (acyl) chain. This is on carbon number three when counting the methyl carbon as number one.Eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) appear to be the most important n-3 fatty acids (2,3) , although roles for docosapentaenoic acid (DPA; 22:5n-3) are now also emerging (4,5) . Because of their long hydrocarbon chain, EPA, DPA and DHA are sometimes termed very long chain n-3 fatty acids, in order to differentiate them from the 18-carbon plant-derived n-3 fatty acids like -linolenic acid (ALA; 18:3n-3) and stearidonic acid (SDA; 18:4n-3). In this article, the term "very long chain n-3 fatty acids" will be used to individually and collectively describe EPA, DPA and DHA.EPA, DPA and DHA are metabolically related to one another, and there is a pathway by which EPA can be synthesized from the simpler plant-derived n-3 fatty acids (Figure 1).The conversion of ALA to EPA involves three steps catalyzed, in turn, by delta-6 desaturase, elongase 5 and delta-5 desaturase (Figure 1). Further conversion of EPA to DHA, via DPA, occurs by a complex pathway (Figure 1) involving chain elongation catalyzed by elongase 5, a second chain elongation catalyzed by elongase 2 or 5...

show abstract

Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies

Cited by 176 publications

References 53 publications

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials

Omega‐3 supplementation associated with improved parent‐rated executive function in youth with mood disorders: secondary analyses of the omega 3 and therapy (OATS) trials

Very long-chainn-3 fatty acids and human health: fact, fiction and the future

Contact Info

Product

Resources

About