Rossier Alison T, Hallahan Brian
Department of Pharmacology and Therapeutics, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.
Department of Psychiatry, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland.
Eur Psychiatry. 2024 Dec 19;67(1):e88. doi: 10.1192/j.eurpsy.2024.1804.
While omega-3 polyunsaturated fatty acids (PUFAs) have shown promise as an adjunctive treatment for schizophrenia and other psychotic disorders, the overall consensus about their efficacy across studies is still lacking and findings to date are inconclusive. No clinical trials or systematic reviews have yet examined if omega-3 PUFAs are associated with differential levels of efficacy at various stages of psychosis.
A systematic bibliographic search of randomized double-blind placebo-controlled trials (RCTs) examining the effect of omega-3 PUFAs as a monotherapy or adjunctive therapy versus a control group in adults and children at ultra-high risk (UHR) for psychosis, experiencing a first-episode psychosis (FEP), or diagnosed with an established psychotic disorder was conducted. Participants' clinical symptoms were evaluated using total and subscale scores on validated psychometric scales.
No beneficial effect of omega-3 PUFAs treatment was found in comparison with that of placebo ( = -0.26, 95% CI -0.55 to 0.03, = 0.08). Treatment of omega-3 PUFAs did not prove any significant improvement in psychopathology in UHR ( = -0.09, 95% CI -0.45 to 0.27, = 0.63), FEP ( = -1.20, 95% CI -5.63 to 3.22, = 0.59), or schizophrenia patients ( = -0.17, 95% CI -0.38 to -0.03, = 0.10).
These findings confirm previous evidence that disputes the original reported findings of the beneficial effect of omega-3 PUFAs in schizophrenia. Furthermore, accumulative evidence of the use of omega-3 as a preventive treatment option in UHR is not supported, suggesting that the need for future studies in this line of research should not be promoted.
虽然ω-3多不饱和脂肪酸(PUFAs)已显示出作为精神分裂症和其他精神障碍辅助治疗方法的潜力,但目前仍缺乏关于其在各项研究中疗效的总体共识,且迄今为止的研究结果尚无定论。尚无临床试验或系统评价研究ω-3多不饱和脂肪酸是否与精神病不同阶段的疗效差异水平相关。
对随机双盲安慰剂对照试验(RCT)进行系统的文献检索,这些试验研究了ω-3多不饱和脂肪酸作为单一疗法或辅助疗法与处于精神病超高风险(UHR)、首次发作精神病(FEP)或被诊断为已确诊精神病性障碍的成人及儿童对照组相比的效果。使用经过验证的心理测量量表上的总分和子量表分数对参与者的临床症状进行评估。
与安慰剂相比,未发现ω-3多不饱和脂肪酸治疗有有益效果( = -0.26,95%CI -0.55至0.03, = 0.08)。ω-3多不饱和脂肪酸治疗未证明在UHR( = -0.09,95%CI -0.45至0.27, = 0.63)、FEP( = -1.20,95%CI -5.63至3.22, = 0.59)或精神分裂症患者( = -0.17,95%CI -0.38至-0.03, = 0.10)的精神病理学方面有任何显著改善。
这些发现证实了先前的证据,即对ω-3多不饱和脂肪酸在精神分裂症中有益效果的最初报道结果提出质疑。此外,不支持将ω-3作为UHR预防性治疗选择的累积证据,这表明不应推动在这一研究领域进行未来研究。