Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA.
J Am Acad Child Adolesc Psychiatry. 2011 Oct;50(10):991-1000. doi: 10.1016/j.jaac.2011.06.008. Epub 2011 Aug 12.
Several studies have demonstrated differences in omega-3 fatty acid composition in plasma and in erythrocyte membranes in patients with attention-deficit/hyperactivity disorder (ADHD) compared with unaffected controls. Omega-3 fatty acids have anti-inflammatory properties and can alter central nervous system cell membrane fluidity and phospholipid composition. Cell membrane fluidity can alter serotonin and dopamine neurotransmission. The goal of this meta-analysis was to examine the efficacy of omega-3 fatty acid supplementation in children with ADHD.
PubMed was searched for randomized placebo-controlled trials examining omega-3 fatty acid supplementation in children with ADHD symptomatology. The primary outcome measurement was standardized mean difference in rating scales of ADHD severity. Secondary analyses were conducted to determine the effects of dosing of different omega-3 fatty acids in supplements.
Ten trials involving 699 children were included in this meta-analysis. Omega-3 fatty acid supplementation demonstrated a small but significant effect in improving ADHD symptoms. Eicosapentaenoic acid dose within supplements was significantly correlated with supplement efficacy. No evidence of publication bias or heterogeneity between trials was found.
Omega-3 fatty acid supplementation, particularly with higher doses of eicosapentaenoic acid, was modestly effective in the treatment of ADHD. The relative efficacy of omega-3 fatty acid supplementation was modest compared with currently available pharmacotherapies for ADHD such as psychostimulants, atomoxetine, or α(2) agonists. However, given its relatively benign side-effect profile and evidence of modest efficacy, it may be reasonable to use omega-3 fatty supplementation to augment traditional pharmacologic interventions or for families who decline other psychopharmacologic options.
多项研究表明，与未受影响的对照组相比，注意力缺陷/多动障碍（ADHD）患者的血浆和红细胞膜中的ω-3 脂肪酸组成存在差异。ω-3 脂肪酸具有抗炎特性，可以改变中枢神经系统细胞膜的流动性和磷脂组成。细胞膜的流动性可以改变 5-羟色胺和多巴胺的神经传递。本荟萃分析的目的是研究 ω-3 脂肪酸补充剂对 ADHD 儿童的疗效。
在 PubMed 上搜索了关于 ω-3 脂肪酸补充剂对有 ADHD 症状的儿童的随机安慰剂对照试验。主要的结果测量是 ADHD 严重程度评定量表的标准化均数差值。进行了二次分析，以确定补充剂中不同 ω-3 脂肪酸剂量的效果。
共有 10 项涉及 699 名儿童的试验纳入了本荟萃分析。ω-3 脂肪酸补充剂在改善 ADHD 症状方面显示出较小但显著的效果。补充剂中二十碳五烯酸的剂量与补充剂的疗效显著相关。未发现试验之间存在发表偏倚或异质性。
ω-3 脂肪酸补充剂，特别是高剂量的二十碳五烯酸，对治疗 ADHD 有一定的疗效。与目前用于 ADHD 的药物治疗方法（如兴奋剂、托莫西汀或 α2 激动剂）相比，ω-3 脂肪酸补充剂的相对疗效适中。然而，鉴于其相对良性的副作用谱和适度的疗效证据，使用 ω-3 脂肪酸补充剂来增强传统的药物干预或对那些拒绝其他精神药理学选择的家庭来说，可能是合理的。
