Omega-3s May Help Ease Anxiety, Review Shows

By Anne Harding

NEW YORK (Reuters Health) - Omega-3 polyunsaturated fatty acids (PUFAs) could have anxiolytic effects, according to a new systematic review and meta-analysis.

"It might be too early to recommend omega-3 as the first-line treatment for anxiety. We need more well-conducted clinical trials to reach that kind of consensus," said Dr. Kuan-Pin Su and Dr. Yutaka Matsuoka of China Medical University Hospital in Taichung, Taiwan.

"However, for patients who are not responsive to traditional anxiety treatment such as antidepressants or psychotherapies, omega-3 might be promising alternative and adjunctive treatment with great safety profiles," they told Reuters Health in a joint email.

Several studies have suggested that omega-3 PUFAs may have beneficial effects on depression and anxiety, Dr. Su, Dr. Matsuoka and their colleagues note in JAMA Network Open, online September 14.

"Despite the largely positive findings of these trials, the clinical application of the findings is unfortunately limited by their small sample sizes," they add.

The authors reviewed 19 studies including 1,203 people who received omega-3 PUFA treatment and 1,037 who did not. Clinical anxiety symptoms were reduced in those on omega-3s compared to those on placebo or a different treatment (Hedges g, 0.374; number needed to treat, 7).

Findings were similar in the 16 placebo-controlled and three non-placebo-controlled trials.

In studies including individuals who did not have a specific clinical condition, there was no significant effect of omega-3 PUFAs on anxiety symptoms, but the effect was significant in studies with participants who did have formal diagnosis (Hedges g, 0.512).

There also was no improvement in anxiety symptoms with omega-3 PUFA dosages below 2,000 mg a day, although the effect was significant at higher doses.

Treatment improved anxiety symptoms when patients were on supplements containing less than 60% ecosapentaenoic acid (EPA), but not in patients on supplements with a higher EPA concentration.

"Our current study showed that omega-3 fatty acids have small to moderate effects on reducing anxiety symptoms," Dr. Su and Dr. Matsuoka said. It's not clear why only those with specific diagnoses saw a benefit, they added.

"This is an important question to investigate in future research. Anxiety is a heterogeneous psychopathology presented in wide range of mental and medical illness. Therefore, the improvement of anxiety symptoms by omega-3 PUFAs might be associated with the improvement of specific clinical condition such as depression or PTSD," they said.

"Participants treated with a daily dose of 2g or more of omega-3 showed a significantly greater association of treatment with reduced anxiety symptoms," Dr. Su and Dr. Matsuoka added. "We would recommend a starting dose of 1g/day and then increase to 2g/day in 2-4 weeks if there is only partial improvement."

Dr. Matsuoka is now planning a phase 2 trial of omega-3 PUFAs to treat fear of cancer recurrence among breast cancer patients, and Dr. Su is investigating the effect of omega-3 PUFAs on somatization anxiety in patients with major depression.

SOURCE: https://bit.ly/2prfWyp

JAMA Netw Open 2018.

(c) Copyright Thomson Reuters 2018. Click For Restrictions - https://agency.reuters.com/en/copyright.html

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