ω-3高不饱和脂肪酸治疗抑郁症的疗效
Efficacy of omega-3 highly unsaturated fatty acids in the treatment of depression.
作者信息
Hallahan Brian, Ryan Timothy, Hibbeln Joseph R, Murray Ivan T, Glynn Shauna, Ramsden Christopher E, SanGiovanni John Paul, Davis John M
机构信息
Brian Hallahan, MRCPsych, MD, Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland; Timothy Ryan, BA, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA; Joseph R. Hibbeln, MD, Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry & Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, USA; Ivan T. Murray, MRCPsych, Department of Psychiatry, University Hospital Galway, Galway, Ireland; Shauna Glynn, MRCPsych, Child and Adolescent Mental Health Services, Castlebar, Mayo, Ireland; Christopher E. Ramsden, MD, John Paul SanGiovanni, ScD, Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry & Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, USA; John M. Davis, MD, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA
Brian Hallahan, MRCPsych, MD, Department of Psychiatry, Clinical Science Institute, National University of Ireland Galway, Galway, Ireland; Timothy Ryan, BA, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA; Joseph R. Hibbeln, MD, Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry & Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, USA; Ivan T. Murray, MRCPsych, Department of Psychiatry, University Hospital Galway, Galway, Ireland; Shauna Glynn, MRCPsych, Child and Adolescent Mental Health Services, Castlebar, Mayo, Ireland; Christopher E. Ramsden, MD, John Paul SanGiovanni, ScD, Section on Nutritional Neurosciences, Laboratory of Membrane Biochemistry & Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland, USA; John M. Davis, MD, Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois, USA.
出版信息
Br J Psychiatry. 2016 Sep;209(3):192-201. doi: 10.1192/bjp.bp.114.160242. Epub 2016 Apr 21.
BACKGROUND
Trials evaluating efficacy of omega-3 highly unsaturated fatty acids (HUFAs) in major depressive disorder report discrepant findings.
AIMS
To establish the reasons underlying inconsistent findings among randomised controlled trials (RCTs) of omega-3 HUFAs for depression and to assess implications for further trials.
METHOD
A systematic bibliographic search of double-blind RCTs was conducted between January 1980 and July 2014 and an exploratory hypothesis-testing meta-analysis performed in 35 RCTs including 6665 participants receiving omega-3 HUFAs and 4373 participants receiving placebo.
RESULTS
Among participants with diagnosed depression, eicosapentaenoic acid (EPA)-predominant formulations (>50% EPA) demonstrated clinical benefits compared with placebo (Hedge's G = 0.61, P<0.001) whereas docosahexaenoic acid (DHA)-predominant formulations (>50% DHA) did not. EPA failed to prevent depressive symptoms among populations not diagnosed for depression.
CONCLUSIONS
Further RCTs should be conducted on study populations with diagnosed or clinically significant depression of adequate duration using EPA-predominant omega-3 HUFA formulations.
背景
评估ω-3高不饱和脂肪酸（HUFA）治疗重度抑郁症疗效的试验报告结果不一。
目的
探究ω-3 HUFA治疗抑郁症的随机对照试验（RCT）结果不一致的原因，并评估对进一步试验的启示。
方法
对1980年1月至2014年7月间的双盲RCT进行系统的文献检索，并对35项RCT进行探索性假设检验的荟萃分析，其中包括6665名接受ω-3 HUFA的参与者和4373名接受安慰剂的参与者。
结果
在已确诊抑郁症的参与者中，以二十碳五烯酸（EPA）为主的制剂（>50% EPA）与安慰剂相比显示出临床益处（Hedge's G = 0.61，P<0.001），而以二十二碳六烯酸（DHA）为主的制剂（>50% DHA）则没有。EPA未能预防未诊断出抑郁症人群的抑郁症状。
结论
应使用以EPA为主的ω-3 HUFA制剂，对已确诊或有临床显著抑郁且病程足够长的研究人群进行进一步的RCT。
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