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Omega-3 Fatty Acids for Depression

Frequently Asked Questions About Omega-3 Fatty Acids

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Updated August 26, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

What Are Omega-3 Fatty Acids?

Omega-3 fatty acids, or n-3 fatty acids, are a type of essential fatty acid (EFA). What this means is that they are considered essential for health, but cannot be synthesized within the human body, so must be obtained from food.

How Do They Work?

You will often hear omega-3 fatty acids discussed at the same time as omega-6 fatty acids. This is because there is an important relationship between the two. Like omega-3 fatty acids, omega-6 fatty acids are EFAs. They differ from omega-3 fatty acids, however, in that they play a different role in health. While omega-6 fatty acids aid the immune system by creating inflammation, omega-3 fatty acids work to reduce inflammation. Since they have opposing functions, it is important to maintain a proper balance between them.

Unfortunately, the ratio between these two EFAs is often skewed in the direction of omega-3 fatty acid deficiency, especially in the United States, where omega-6-rich oils like soybean oil are a common part of the diet. Without enough omega-3 fatty acids to balance the pro-inflammatory omega-6's, inflammation goes unchecked, and there may be a variety of health problems, such as heart disease.

Supplementation restores the proper balance between these two types of EFAs, reducing inflammation.

Are They an Effective Treatment for Depression?

About 20 controlled trials and a handful of open studies with EPA and DHA (omega-3 fatty acids found in cold water fish) suggest that supplementation with omega-3 fatty acids at doses of about five or more times the standard dietary intake in the U.S. may have an antidepressant effect. At this time, however, experts do not recommend using omega-3 fatty acids as your sole depression treatment. More research is needed to determine effectiveness and which doses and types of omega-3 fatty acids may be most beneficial. It is instead recommended that patients use omega-3 fatty acids along with a prescription antidepressant.

Are They Safe and Well-Tolerated?

Omega-3 fatty acids are considered to be very safe.

The main complaints that people have with omega-3 fatty acids are gastrointestinal upset and fishy aftertaste, although these tend to mainly be a problem with doses higher than 5 g per day.

Those who are taking blood thinning medications such as warfarin should consult their physician before using omega-3 fatty acids as they may potentially increase the effect of these medications.

There have been a few cases of cycling in bipolar patients, so it is recommended that they use omega-3's with caution, preferably with a mood stabilizer.

Can They Be Used During Pregnancy and Breastfeeding?

From a safety perspective, omega-3 fatty acids are a particularly good option for pregnant and breastfeeding women. However, perhaps due to fears that they won't adequately relieve depression, some experts are hesitant to recommend them as the primary treatment for pregnant and breastfeeding women. While the safety profile and effectiveness of prescription antidepressants in pregnancy has been relatively established, omega-3 fatty acids supplements have not yet been as thoroughly investigated during pregnancy. Women who are considering supplementing with omega-3 fatty acids should discuss with their physician whether omega-3 fatty acids are the best option for their own particular needs.

How Can I Get More Omega-3 Fatty Acids in My Diet?

You can get more omega-3 fatty acids in your diet by either eating fatty fish - such as salmon, tuna and mackerel - or by taking a fish oil supplement. Fish oil is rich in the omega-3 fatty acids EPA and DHA, which have been associated with improved depression symptoms in some clinical studies.

Although there is not currently enough evidence to make a specific dosage recommendation for depression treatment, the American Heart Association recommends two servings of fish per week for general health and heart disease prevention, so this may be a good starting point for fish consumption. If you are opting to use fish oil supplements, experts generally recommend a starting dose of around 0.5 to 2 g daily. Although clinical studies have used doses as high as 9.6 g daily, the FDA recommends that you do not exceed 3 g daily due to an increased risk for bleeding.

Source:

Michoulon, David, MD, Phd. "Update and Critique of Natural Remedies as Antidepressant Treatments." Obstetrics & Gynecology Clinics of North America 36 (2009): 789-807.

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