Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
J Psychopharmacol. 2021 Mar;35(3):221-235. doi: 10.1177/0269881120981392. Epub 2021 Feb 15.
Several monotherapy and augmentation strategies have been introduced to improve the treatment of schizophrenia. The benefits of omega-3 polyunsaturated fatty acids in patients with mental disorders is becoming increasingly acknowledged. However, its role in the treatment of schizophrenia raises complex considerations about which there has been little consensus. The aim of this study was to synthesize the findings of randomized controlled trials that were conducted to determine the efficacy and safety of omega-3 polyunsaturated fatty acids in patients with schizophrenia.
The MEDLINE, Embase, Cochrane, Scopus, and Web of Science databases were searched for relevant literature. The primary outcome was changes in psychopathology and the secondary outcomes were changes in metabolic parameters and safety profiles.
Twenty double-blind randomized controlled trials in 1494 patients were included. Omega-3 polyunsaturated fatty acids augmentation was associated with significantly improved psychopathology in patients with schizophrenia, particularly general psychopathology and positive symptoms but not negative symptoms. Patients who were severely ill and received omega-3 polyunsaturated fatty acids containing eicosapentaenoic acid >1 g/d showed significant improvement. A favorable effect of omega-3 polyunsaturated fatty acids supplements on serum triglycerides was also demonstrated. Omega-3 polyunsaturated fatty acids are well-tolerated and safe in patients with schizophrenia.
These findings tentatively support the use of omega-3 polyunsaturated fatty acids as a potential augmentation strategy in schizophrenia. Further research in larger samples is warranted to clarify the optimal dosage and the correct proportions of omega-3 polyunsaturated fatty acids to administer, together with elucidation of the underlying mechanisms.
为改善精神分裂症的治疗，已引入了几种单药治疗和增效策略。人们越来越认识到ω-3 多不饱和脂肪酸对精神障碍患者的益处。然而，其在精神分裂症治疗中的作用引发了一些复杂的考虑因素，对此尚未达成共识。本研究旨在综合评估旨在确定ω-3 多不饱和脂肪酸在精神分裂症患者中的疗效和安全性的随机对照试验的结果。
检索 MEDLINE、Embase、Cochrane、Scopus 和 Web of Science 数据库中的相关文献。主要结局为精神病理学的变化，次要结局为代谢参数和安全性特征的变化。
纳入了 20 项涉及 1494 例患者的双盲随机对照试验。ω-3 多不饱和脂肪酸增效治疗与精神分裂症患者的精神病理学显著改善相关，特别是一般精神病理学和阳性症状，但对阴性症状无显著改善。病情严重且接受含 EPA>1 g/d 的 ω-3 多不饱和脂肪酸治疗的患者显示出显著改善。还证明了 ω-3 多不饱和脂肪酸补充剂对血清甘油三酯的有益作用。ω-3 多不饱和脂肪酸在精神分裂症患者中耐受良好且安全。
这些发现初步支持将 ω-3 多不饱和脂肪酸作为精神分裂症的一种潜在增效策略。需要在更大的样本中进行进一步研究，以阐明最佳剂量和应给予的 ω-3 多不饱和脂肪酸的正确比例，并阐明其潜在机制。
