Omega-3

Primer

Omega-3 fatty acids (ω-3 fatty acids) are polyunsaturated fatty acids that are primarily found in oily fish and certain nuts and seeds. It is also added as a supplement to other foods such as egg products.

Indications

Dosing

  • Different formulations of Omega-3 fatty acids have been studied, the most common being eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).
  • The typical dose range is:
    • 3 to 9 gram per day of Omega-3, or
    • 1 to 2 grams of EPA, plus 1 to 2 grams of DHA per day
  • For major depressive episodes, the typical duration of treatment ranges from 4 to 16 weeks.

Side Effects

  • Omega-3 supplements are generally well tolerated with only mild side effects, such as diarrhea, nausea, and a fishy aftertaste.

Drug-Drug Interactions

  • Patients on anticoagulant and antiplatelet medications may require additional monitoring, since Omega-3 has the ability to inhibit platelet aggregation and promote bleeding.

References

1) Carney, R. M., Freedland, K. E., Rubin, E. H., Rich, M. W., Steinmeyer, B. C., & Harris, W. S. (2009). Omega-3 augmentation of sertraline in treatment of depression in patients with coronary heart disease: a randomized controlled trial. Jama, 302(15), 1651-1657.
2) Ravindran, A. V., Balneaves, L. G., Faulkner, G., Ortiz, A., McIntosh, D., Morehouse, R. L., ... & CANMAT Depression Work Group. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 5. Complementary and alternative medicine treatments. The Canadian Journal of Psychiatry, 61(9), 576-587.