| Participants . | Treatment . | Length of Trial . | Measurements . | Outcomes . | References . |
|---|---|---|---|---|---|
| 18–70 years depressed (>15 on HDRS), medicated (n = 70). | Ethyl-EPA – 1, 2, or 4g/d or placebo. | 12 weeks parallel design, adjunctive therapy. | HDRS, MADRS, BDI. | Treatment > placebo on all 3 rating scales with 1g/d EPA – strong effects for core depressive symptoms. Treatment = placebo on 2g and 4g/d (nonsignificant trends). | (Peet and Horrobin, 2002) |
| 28–73 years diagnosed MDD (85% women) HDRS score > 18 (n = 20). | 2g ethyl-EPA (96% from fish oil) or placebo, Vit E. | 4 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo at weeks 2, 3, and 4 on HDRS score and on core depressive symptom subscales. | (Nemets et al., 2002) |
| 18–60 years outpatients with MDD; HDRS score > 18, medicated, (n = 22). | 3.3g/d n-3 PUFA (2.2g DHA, 1.1g EPA). | 8 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo on HDRS. | (Su et al., 2003) |
| 18–65 years MDD diagnosis; HDRS score > 16 (80% female) (n = 35). | 2g/d DHA or placebo. | 6 weeks parallel. | MADRS, HDRS, GAFS. | Treatment = placebo on outcome measures. | (Marangell et al., 2003) |
| 18–65 years recruited, (mean age 38), treated for current depressive episode (53% female) (n =77). | 3g/d n-3 PUFA (2.4g DHA; 0.6g EPA) + Vit E or olive oil placebo. | 12 weeks parallel, adjunctive therapy. | HDRS short form, BDI. | Treatment = placebo on outcome measures (improvements in both groups at week 2). | (Silvers et al., 2005) |
| 18–72 years outpatients with major depression diagnosis (n = 83, 45 males). | 3g/d n-3 PUFA (2.2g DHA, 0.6g EPA) + Vit E or olive oil placebo. | 4 month parallel design, adjunctive therapy. | HDRS, BDI, GAFS. | Treatment = placebo on outcome measures (improvements in both groups). | (Grenyer et al., 2007) |
| 18–40 years with MDD during pregnancy (n = 24). | 2.2g EPA + 1.2g DHA or placebo, both with tocopherols and orange flavor. | 8 weeks, parallel design. | HDRS, EPDS, GDI. | Treatment > placebo on outcome measures. | (Su et al., 2008) |
| 18–70 years recruited, (mean age = 38); people from GP surgeries or public with mild-moderate depression (77% female) (n = 190). | 630mg EPA, 850mg DHA, 870mg olive oil, or olive oil placebo (both with tocopherols and orange oil). | 12 weeks parallel design. | DASS, BDI, STAEI, mood using diary and visual probe task, cognitive function. | Treatment = placebo on outcome measures (improvements in both groups). | (Rogers et al., 2008) |
| 40–55 years recruited, (mean age 49) postmenopausal women with psychological distress and depressive symptoms (n = 120). | 1.5g ethyl-EPA, 0.5g ethyl-DHA. | 8 weeks parallel design. | PGWB, HSCL-D-20, HDRS. | Treatment = placebo on all measures (improvements in both groups). Treatment > placebo in women without MDE (major depressive episode diagnosis). | (Lucas et al., 2009) |
| Major depression + coronary heart disease (n = 122). | 930mg ethyl-EPA + 750mg ethyl DHA/d or corn oil placebo. | 10 weeks parallel design, adjunctive therapy. | BDI-II, HDRS. | Treatment = placebo on outcome measures (improvements in both groups). | (Carney et al., 2009) |
| 18–65 years inpatients with bipolar disorder (n = 30). | 9.6g/d n-3 PUFA (6.2g EPA, 3.4g DHA) or olive oil esther placebo. | 4 month parallel design; adjunctive therapy. | HDRS, YMRS, CGI-S, GAS. | Treatment > placebo on GAS, HDRS and CGI; treatment = placebo on YMRS. | (Stoll et al., 1999) |
| 57 Bipolar depressed and 59 rapid cycling (mean age 45) (n = 116, 51% male). | 6g/d ethyl-EPA or liquid paraffin placebo. | 4 month parallel design; adjunctive therapy. | IDS, YMRS, CGI- BP (bipolar disorder). | Treatment = placebo on outcome measures. | (Keck et al., 2006) |
| Outpatients with bipolar depression + scores > 17 on HDRS, (mean age 47) (n = 75, 76% female). | 1g/d ethyl EPA (n = 24); 2g/d ethyl EPA (n = 25) or paraffin placebo. | 12 week parallel design, adjunctive therapy. | HDRS, YMRS, CGI. | Treatment > placebo on HDRS & CGI on 1g and 2g/d. Treatment = placebo on YMRS. | (Frangou et al., 2007) |
| 16–64 years presenting after act of repeated self-harm (n = 49, 65% women). | 1.2g/d EPA + 0.9g DHA or corn oil placebo (with 1% EPA/DHA). | 12 weeks parallel design in addition to standard care. | BDI, HDRS, OAS-M, IMT/ DMT, PSS, DHUS. | Treatment > placebo on BDI, HDRS, PSS, DHUS. Treatment = placebo on OAS-M and IMT/DMT (hostility/aggression, memory). | (Hallahan et al., 2007) |
| Study 1: schizophrenic patients, PANSS score > 40, mean age 44 (n = 45). Study 2: diagnosed schizophrenia, untreated, mean age 35, (n = 30). | 2g/d EPA or corn oil placebo. | 3 months parallel, single therapy unless drugs needed. | PANSS; need for antipsychotic medication. | Treatment > placebo, particularly on positive subscale; 12/12 placebo and 8/14 EPA patients took medication. | (Peet et al., 2001) |
| (18–65 years, M = 40; 61% male) diagnosed schizophrenia or schizoaffective disorder (n = 30). | 3g/d ethyl EPA + Vit E or mineral oil + Vit E placebo. | 16 weeks parallel design, adjunctive therapy. | PANSS, CGI, MADRS, RBANS, AIMS, SARS. | Treatment = placebo on outcome measures (some showed improvements in both groups). | (Fenton et al., 2001) |
| 18–55 years schizophrenic, treatment resistant patients, PANSS score > 10 (n = 40, mean age 45). | 3g/d ethyl-EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, ESRS. | Treatment > placebo on PANSS and dyskinesia subscale of ESRS. Treatment = placebo on other ESRS subscales. | (Emsley et al., 2002) |
| 20–62 years treatment- resistant schizophrenia; PANSS > 50, (n = 115, mean age 37, 66% male). | 1, 2, or 4g/d ethyl- EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, LUNSERS, MADRS, AIMS, BAS, SARS. | Treatment = placebo on all rating scales; 2g treatment > placebo for patients on clozapine (associated with ↑AA). | (Peet et al., 2002) |
| First-episode psychosis patients (n = 69, mean age 21, 76% male). | 2g/d ethyl-EPA or mineral oil placebo not absorbed by intestinal tract (both with Vit E). | 12 weeks parallel design, adjunctive therapy. | BPRS, SANS, CDSS, CGI, GAF, SOFAS. | Treatment = placebo on all outcome measures. Treatment > placebo on CGI co-varying for duration of untreated psychosis; treatment > placebo at weeks 4–6. | (Berger et al., 2007) |
| 13–25 years met defined risk factors for psychosis (n = 81, mean age 16, 40% male). | 1.2g/d n-3 PUFAs 0.7g EPA, 0.48g DHA, and 7.6mg of vitamin E). | 12 weeks. | PANSS, MADRS, GAF. | Treatment > placebo on PANSS and GAF at 12 weeks, 6 and 12 months. | (Amminger et al., 2010) |
| 19–30 years university students (study measured aggression and executive function) (n= 41, 70% female). | 1.5–1.8g/d DHA or 97% soybean oil + 3% fish oil placebo capsules. | 3 months parallel design. | P-F Study; Stroop; Dementia- detecting test. | Treatment > placebo on aggression (increased in placebo group during exam time); treatment = placebo on other measures. | (Hamazaki et al., 1996) |
| 18–40 years females with moderately severe borderline personality disorder (n= 30, mean age 26). | 1g/d ethyl-EPA or mineral oil placebo. | 8 weeks parallel design. | OAS-M; MADRS. | Treatment > placebo aggression and depressive symptoms | (Zanarini and Frankenburg, 2003) |
| MDD patients (n= 154). | (1) EPA 1g/d; (2) DHA 1g/d; (3) Placebo. | 8 weeks. | HDRS-17, QIDS- SR-16, CGI-S. | Treatments and placebo improved HDRS-17, QIDS- SR-16, CGI-S. | (Mischoulon et al., 2015) |
| Participants . | Treatment . | Length of Trial . | Measurements . | Outcomes . | References . |
|---|---|---|---|---|---|
| 18–70 years depressed (>15 on HDRS), medicated (n = 70). | Ethyl-EPA – 1, 2, or 4g/d or placebo. | 12 weeks parallel design, adjunctive therapy. | HDRS, MADRS, BDI. | Treatment > placebo on all 3 rating scales with 1g/d EPA – strong effects for core depressive symptoms. Treatment = placebo on 2g and 4g/d (nonsignificant trends). | (Peet and Horrobin, 2002) |
| 28–73 years diagnosed MDD (85% women) HDRS score > 18 (n = 20). | 2g ethyl-EPA (96% from fish oil) or placebo, Vit E. | 4 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo at weeks 2, 3, and 4 on HDRS score and on core depressive symptom subscales. | (Nemets et al., 2002) |
| 18–60 years outpatients with MDD; HDRS score > 18, medicated, (n = 22). | 3.3g/d n-3 PUFA (2.2g DHA, 1.1g EPA). | 8 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo on HDRS. | (Su et al., 2003) |
| 18–65 years MDD diagnosis; HDRS score > 16 (80% female) (n = 35). | 2g/d DHA or placebo. | 6 weeks parallel. | MADRS, HDRS, GAFS. | Treatment = placebo on outcome measures. | (Marangell et al., 2003) |
| 18–65 years recruited, (mean age 38), treated for current depressive episode (53% female) (n =77). | 3g/d n-3 PUFA (2.4g DHA; 0.6g EPA) + Vit E or olive oil placebo. | 12 weeks parallel, adjunctive therapy. | HDRS short form, BDI. | Treatment = placebo on outcome measures (improvements in both groups at week 2). | (Silvers et al., 2005) |
| 18–72 years outpatients with major depression diagnosis (n = 83, 45 males). | 3g/d n-3 PUFA (2.2g DHA, 0.6g EPA) + Vit E or olive oil placebo. | 4 month parallel design, adjunctive therapy. | HDRS, BDI, GAFS. | Treatment = placebo on outcome measures (improvements in both groups). | (Grenyer et al., 2007) |
| 18–40 years with MDD during pregnancy (n = 24). | 2.2g EPA + 1.2g DHA or placebo, both with tocopherols and orange flavor. | 8 weeks, parallel design. | HDRS, EPDS, GDI. | Treatment > placebo on outcome measures. | (Su et al., 2008) |
| 18–70 years recruited, (mean age = 38); people from GP surgeries or public with mild-moderate depression (77% female) (n = 190). | 630mg EPA, 850mg DHA, 870mg olive oil, or olive oil placebo (both with tocopherols and orange oil). | 12 weeks parallel design. | DASS, BDI, STAEI, mood using diary and visual probe task, cognitive function. | Treatment = placebo on outcome measures (improvements in both groups). | (Rogers et al., 2008) |
| 40–55 years recruited, (mean age 49) postmenopausal women with psychological distress and depressive symptoms (n = 120). | 1.5g ethyl-EPA, 0.5g ethyl-DHA. | 8 weeks parallel design. | PGWB, HSCL-D-20, HDRS. | Treatment = placebo on all measures (improvements in both groups). Treatment > placebo in women without MDE (major depressive episode diagnosis). | (Lucas et al., 2009) |
| Major depression + coronary heart disease (n = 122). | 930mg ethyl-EPA + 750mg ethyl DHA/d or corn oil placebo. | 10 weeks parallel design, adjunctive therapy. | BDI-II, HDRS. | Treatment = placebo on outcome measures (improvements in both groups). | (Carney et al., 2009) |
| 18–65 years inpatients with bipolar disorder (n = 30). | 9.6g/d n-3 PUFA (6.2g EPA, 3.4g DHA) or olive oil esther placebo. | 4 month parallel design; adjunctive therapy. | HDRS, YMRS, CGI-S, GAS. | Treatment > placebo on GAS, HDRS and CGI; treatment = placebo on YMRS. | (Stoll et al., 1999) |
| 57 Bipolar depressed and 59 rapid cycling (mean age 45) (n = 116, 51% male). | 6g/d ethyl-EPA or liquid paraffin placebo. | 4 month parallel design; adjunctive therapy. | IDS, YMRS, CGI- BP (bipolar disorder). | Treatment = placebo on outcome measures. | (Keck et al., 2006) |
| Outpatients with bipolar depression + scores > 17 on HDRS, (mean age 47) (n = 75, 76% female). | 1g/d ethyl EPA (n = 24); 2g/d ethyl EPA (n = 25) or paraffin placebo. | 12 week parallel design, adjunctive therapy. | HDRS, YMRS, CGI. | Treatment > placebo on HDRS & CGI on 1g and 2g/d. Treatment = placebo on YMRS. | (Frangou et al., 2007) |
| 16–64 years presenting after act of repeated self-harm (n = 49, 65% women). | 1.2g/d EPA + 0.9g DHA or corn oil placebo (with 1% EPA/DHA). | 12 weeks parallel design in addition to standard care. | BDI, HDRS, OAS-M, IMT/ DMT, PSS, DHUS. | Treatment > placebo on BDI, HDRS, PSS, DHUS. Treatment = placebo on OAS-M and IMT/DMT (hostility/aggression, memory). | (Hallahan et al., 2007) |
| Study 1: schizophrenic patients, PANSS score > 40, mean age 44 (n = 45). Study 2: diagnosed schizophrenia, untreated, mean age 35, (n = 30). | 2g/d EPA or corn oil placebo. | 3 months parallel, single therapy unless drugs needed. | PANSS; need for antipsychotic medication. | Treatment > placebo, particularly on positive subscale; 12/12 placebo and 8/14 EPA patients took medication. | (Peet et al., 2001) |
| (18–65 years, M = 40; 61% male) diagnosed schizophrenia or schizoaffective disorder (n = 30). | 3g/d ethyl EPA + Vit E or mineral oil + Vit E placebo. | 16 weeks parallel design, adjunctive therapy. | PANSS, CGI, MADRS, RBANS, AIMS, SARS. | Treatment = placebo on outcome measures (some showed improvements in both groups). | (Fenton et al., 2001) |
| 18–55 years schizophrenic, treatment resistant patients, PANSS score > 10 (n = 40, mean age 45). | 3g/d ethyl-EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, ESRS. | Treatment > placebo on PANSS and dyskinesia subscale of ESRS. Treatment = placebo on other ESRS subscales. | (Emsley et al., 2002) |
| 20–62 years treatment- resistant schizophrenia; PANSS > 50, (n = 115, mean age 37, 66% male). | 1, 2, or 4g/d ethyl- EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, LUNSERS, MADRS, AIMS, BAS, SARS. | Treatment = placebo on all rating scales; 2g treatment > placebo for patients on clozapine (associated with ↑AA). | (Peet et al., 2002) |
| First-episode psychosis patients (n = 69, mean age 21, 76% male). | 2g/d ethyl-EPA or mineral oil placebo not absorbed by intestinal tract (both with Vit E). | 12 weeks parallel design, adjunctive therapy. | BPRS, SANS, CDSS, CGI, GAF, SOFAS. | Treatment = placebo on all outcome measures. Treatment > placebo on CGI co-varying for duration of untreated psychosis; treatment > placebo at weeks 4–6. | (Berger et al., 2007) |
| 13–25 years met defined risk factors for psychosis (n = 81, mean age 16, 40% male). | 1.2g/d n-3 PUFAs 0.7g EPA, 0.48g DHA, and 7.6mg of vitamin E). | 12 weeks. | PANSS, MADRS, GAF. | Treatment > placebo on PANSS and GAF at 12 weeks, 6 and 12 months. | (Amminger et al., 2010) |
| 19–30 years university students (study measured aggression and executive function) (n= 41, 70% female). | 1.5–1.8g/d DHA or 97% soybean oil + 3% fish oil placebo capsules. | 3 months parallel design. | P-F Study; Stroop; Dementia- detecting test. | Treatment > placebo on aggression (increased in placebo group during exam time); treatment = placebo on other measures. | (Hamazaki et al., 1996) |
| 18–40 years females with moderately severe borderline personality disorder (n= 30, mean age 26). | 1g/d ethyl-EPA or mineral oil placebo. | 8 weeks parallel design. | OAS-M; MADRS. | Treatment > placebo aggression and depressive symptoms | (Zanarini and Frankenburg, 2003) |
| MDD patients (n= 154). | (1) EPA 1g/d; (2) DHA 1g/d; (3) Placebo. | 8 weeks. | HDRS-17, QIDS- SR-16, CGI-S. | Treatments and placebo improved HDRS-17, QIDS- SR-16, CGI-S. | (Mischoulon et al., 2015) |
Abbreviations: AIMS, Abnormal Involuntary Movement Scale; BDI, Beck Depression Inventory; BPRS, Brief Psychiatric Rating Scale; CBC, Child Behaviour Checklist; CDSS, Calgary Depression Scale for Schizophrenia; CGI-S, Clinical Global Impression-Severity; DASS, Depression & Anxiety Stress Scale; DHUS, Daily Hassles & Uplifts Scale; DMT, Delayed Memory Task; ESRS, Extrapyramidal Symptom Rating Scale; GAFS, Global Assessment of Functioning Scale (revised GAS); GAS, Global Assessment Scale; HDRS, Hamilton Depression Rating Scale; HSCL-D-20, 20-item Hopkins Symptom Checklist Depression Scale; IDS, Inventory for Depressive Symptomology; IMT, Immediate Memory Task; LUNSERS, Liverpool University Neuroleptic Side-Effects Rating Scale; MADRS, Montgomery-Asberg Depression Rating Scale; MDD, major depressive disorder; OAS-M, The Overt Aggression Scale, Modified; PANSS, Positive and Negative Syndrome Scale; PGWB, Psychological General Well-Being Schedule; PSS, Perceived Stress Scale; RBANS, Repeatable Battery for the Assessment of Neuropsychological Status; SANS, Scale for the Assessment of Negative Symptoms; SARS, Simpson-Angus Rating Scale; SOFAS, Social and Occupational Functioning Assessment Scale; STAEI, State-Trait Anger Expression Inventory; YMRS, Young Mania Rating Scale.
| Participants . | Treatment . | Length of Trial . | Measurements . | Outcomes . | References . |
|---|---|---|---|---|---|
| 18–70 years depressed (>15 on HDRS), medicated (n = 70). | Ethyl-EPA – 1, 2, or 4g/d or placebo. | 12 weeks parallel design, adjunctive therapy. | HDRS, MADRS, BDI. | Treatment > placebo on all 3 rating scales with 1g/d EPA – strong effects for core depressive symptoms. Treatment = placebo on 2g and 4g/d (nonsignificant trends). | (Peet and Horrobin, 2002) |
| 28–73 years diagnosed MDD (85% women) HDRS score > 18 (n = 20). | 2g ethyl-EPA (96% from fish oil) or placebo, Vit E. | 4 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo at weeks 2, 3, and 4 on HDRS score and on core depressive symptom subscales. | (Nemets et al., 2002) |
| 18–60 years outpatients with MDD; HDRS score > 18, medicated, (n = 22). | 3.3g/d n-3 PUFA (2.2g DHA, 1.1g EPA). | 8 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo on HDRS. | (Su et al., 2003) |
| 18–65 years MDD diagnosis; HDRS score > 16 (80% female) (n = 35). | 2g/d DHA or placebo. | 6 weeks parallel. | MADRS, HDRS, GAFS. | Treatment = placebo on outcome measures. | (Marangell et al., 2003) |
| 18–65 years recruited, (mean age 38), treated for current depressive episode (53% female) (n =77). | 3g/d n-3 PUFA (2.4g DHA; 0.6g EPA) + Vit E or olive oil placebo. | 12 weeks parallel, adjunctive therapy. | HDRS short form, BDI. | Treatment = placebo on outcome measures (improvements in both groups at week 2). | (Silvers et al., 2005) |
| 18–72 years outpatients with major depression diagnosis (n = 83, 45 males). | 3g/d n-3 PUFA (2.2g DHA, 0.6g EPA) + Vit E or olive oil placebo. | 4 month parallel design, adjunctive therapy. | HDRS, BDI, GAFS. | Treatment = placebo on outcome measures (improvements in both groups). | (Grenyer et al., 2007) |
| 18–40 years with MDD during pregnancy (n = 24). | 2.2g EPA + 1.2g DHA or placebo, both with tocopherols and orange flavor. | 8 weeks, parallel design. | HDRS, EPDS, GDI. | Treatment > placebo on outcome measures. | (Su et al., 2008) |
| 18–70 years recruited, (mean age = 38); people from GP surgeries or public with mild-moderate depression (77% female) (n = 190). | 630mg EPA, 850mg DHA, 870mg olive oil, or olive oil placebo (both with tocopherols and orange oil). | 12 weeks parallel design. | DASS, BDI, STAEI, mood using diary and visual probe task, cognitive function. | Treatment = placebo on outcome measures (improvements in both groups). | (Rogers et al., 2008) |
| 40–55 years recruited, (mean age 49) postmenopausal women with psychological distress and depressive symptoms (n = 120). | 1.5g ethyl-EPA, 0.5g ethyl-DHA. | 8 weeks parallel design. | PGWB, HSCL-D-20, HDRS. | Treatment = placebo on all measures (improvements in both groups). Treatment > placebo in women without MDE (major depressive episode diagnosis). | (Lucas et al., 2009) |
| Major depression + coronary heart disease (n = 122). | 930mg ethyl-EPA + 750mg ethyl DHA/d or corn oil placebo. | 10 weeks parallel design, adjunctive therapy. | BDI-II, HDRS. | Treatment = placebo on outcome measures (improvements in both groups). | (Carney et al., 2009) |
| 18–65 years inpatients with bipolar disorder (n = 30). | 9.6g/d n-3 PUFA (6.2g EPA, 3.4g DHA) or olive oil esther placebo. | 4 month parallel design; adjunctive therapy. | HDRS, YMRS, CGI-S, GAS. | Treatment > placebo on GAS, HDRS and CGI; treatment = placebo on YMRS. | (Stoll et al., 1999) |
| 57 Bipolar depressed and 59 rapid cycling (mean age 45) (n = 116, 51% male). | 6g/d ethyl-EPA or liquid paraffin placebo. | 4 month parallel design; adjunctive therapy. | IDS, YMRS, CGI- BP (bipolar disorder). | Treatment = placebo on outcome measures. | (Keck et al., 2006) |
| Outpatients with bipolar depression + scores > 17 on HDRS, (mean age 47) (n = 75, 76% female). | 1g/d ethyl EPA (n = 24); 2g/d ethyl EPA (n = 25) or paraffin placebo. | 12 week parallel design, adjunctive therapy. | HDRS, YMRS, CGI. | Treatment > placebo on HDRS & CGI on 1g and 2g/d. Treatment = placebo on YMRS. | (Frangou et al., 2007) |
| 16–64 years presenting after act of repeated self-harm (n = 49, 65% women). | 1.2g/d EPA + 0.9g DHA or corn oil placebo (with 1% EPA/DHA). | 12 weeks parallel design in addition to standard care. | BDI, HDRS, OAS-M, IMT/ DMT, PSS, DHUS. | Treatment > placebo on BDI, HDRS, PSS, DHUS. Treatment = placebo on OAS-M and IMT/DMT (hostility/aggression, memory). | (Hallahan et al., 2007) |
| Study 1: schizophrenic patients, PANSS score > 40, mean age 44 (n = 45). Study 2: diagnosed schizophrenia, untreated, mean age 35, (n = 30). | 2g/d EPA or corn oil placebo. | 3 months parallel, single therapy unless drugs needed. | PANSS; need for antipsychotic medication. | Treatment > placebo, particularly on positive subscale; 12/12 placebo and 8/14 EPA patients took medication. | (Peet et al., 2001) |
| (18–65 years, M = 40; 61% male) diagnosed schizophrenia or schizoaffective disorder (n = 30). | 3g/d ethyl EPA + Vit E or mineral oil + Vit E placebo. | 16 weeks parallel design, adjunctive therapy. | PANSS, CGI, MADRS, RBANS, AIMS, SARS. | Treatment = placebo on outcome measures (some showed improvements in both groups). | (Fenton et al., 2001) |
| 18–55 years schizophrenic, treatment resistant patients, PANSS score > 10 (n = 40, mean age 45). | 3g/d ethyl-EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, ESRS. | Treatment > placebo on PANSS and dyskinesia subscale of ESRS. Treatment = placebo on other ESRS subscales. | (Emsley et al., 2002) |
| 20–62 years treatment- resistant schizophrenia; PANSS > 50, (n = 115, mean age 37, 66% male). | 1, 2, or 4g/d ethyl- EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, LUNSERS, MADRS, AIMS, BAS, SARS. | Treatment = placebo on all rating scales; 2g treatment > placebo for patients on clozapine (associated with ↑AA). | (Peet et al., 2002) |
| First-episode psychosis patients (n = 69, mean age 21, 76% male). | 2g/d ethyl-EPA or mineral oil placebo not absorbed by intestinal tract (both with Vit E). | 12 weeks parallel design, adjunctive therapy. | BPRS, SANS, CDSS, CGI, GAF, SOFAS. | Treatment = placebo on all outcome measures. Treatment > placebo on CGI co-varying for duration of untreated psychosis; treatment > placebo at weeks 4–6. | (Berger et al., 2007) |
| 13–25 years met defined risk factors for psychosis (n = 81, mean age 16, 40% male). | 1.2g/d n-3 PUFAs 0.7g EPA, 0.48g DHA, and 7.6mg of vitamin E). | 12 weeks. | PANSS, MADRS, GAF. | Treatment > placebo on PANSS and GAF at 12 weeks, 6 and 12 months. | (Amminger et al., 2010) |
| 19–30 years university students (study measured aggression and executive function) (n= 41, 70% female). | 1.5–1.8g/d DHA or 97% soybean oil + 3% fish oil placebo capsules. | 3 months parallel design. | P-F Study; Stroop; Dementia- detecting test. | Treatment > placebo on aggression (increased in placebo group during exam time); treatment = placebo on other measures. | (Hamazaki et al., 1996) |
| 18–40 years females with moderately severe borderline personality disorder (n= 30, mean age 26). | 1g/d ethyl-EPA or mineral oil placebo. | 8 weeks parallel design. | OAS-M; MADRS. | Treatment > placebo aggression and depressive symptoms | (Zanarini and Frankenburg, 2003) |
| MDD patients (n= 154). | (1) EPA 1g/d; (2) DHA 1g/d; (3) Placebo. | 8 weeks. | HDRS-17, QIDS- SR-16, CGI-S. | Treatments and placebo improved HDRS-17, QIDS- SR-16, CGI-S. | (Mischoulon et al., 2015) |
| Participants . | Treatment . | Length of Trial . | Measurements . | Outcomes . | References . |
|---|---|---|---|---|---|
| 18–70 years depressed (>15 on HDRS), medicated (n = 70). | Ethyl-EPA – 1, 2, or 4g/d or placebo. | 12 weeks parallel design, adjunctive therapy. | HDRS, MADRS, BDI. | Treatment > placebo on all 3 rating scales with 1g/d EPA – strong effects for core depressive symptoms. Treatment = placebo on 2g and 4g/d (nonsignificant trends). | (Peet and Horrobin, 2002) |
| 28–73 years diagnosed MDD (85% women) HDRS score > 18 (n = 20). | 2g ethyl-EPA (96% from fish oil) or placebo, Vit E. | 4 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo at weeks 2, 3, and 4 on HDRS score and on core depressive symptom subscales. | (Nemets et al., 2002) |
| 18–60 years outpatients with MDD; HDRS score > 18, medicated, (n = 22). | 3.3g/d n-3 PUFA (2.2g DHA, 1.1g EPA). | 8 weeks parallel design, adjunctive therapy. | HDRS. | Treatment > placebo on HDRS. | (Su et al., 2003) |
| 18–65 years MDD diagnosis; HDRS score > 16 (80% female) (n = 35). | 2g/d DHA or placebo. | 6 weeks parallel. | MADRS, HDRS, GAFS. | Treatment = placebo on outcome measures. | (Marangell et al., 2003) |
| 18–65 years recruited, (mean age 38), treated for current depressive episode (53% female) (n =77). | 3g/d n-3 PUFA (2.4g DHA; 0.6g EPA) + Vit E or olive oil placebo. | 12 weeks parallel, adjunctive therapy. | HDRS short form, BDI. | Treatment = placebo on outcome measures (improvements in both groups at week 2). | (Silvers et al., 2005) |
| 18–72 years outpatients with major depression diagnosis (n = 83, 45 males). | 3g/d n-3 PUFA (2.2g DHA, 0.6g EPA) + Vit E or olive oil placebo. | 4 month parallel design, adjunctive therapy. | HDRS, BDI, GAFS. | Treatment = placebo on outcome measures (improvements in both groups). | (Grenyer et al., 2007) |
| 18–40 years with MDD during pregnancy (n = 24). | 2.2g EPA + 1.2g DHA or placebo, both with tocopherols and orange flavor. | 8 weeks, parallel design. | HDRS, EPDS, GDI. | Treatment > placebo on outcome measures. | (Su et al., 2008) |
| 18–70 years recruited, (mean age = 38); people from GP surgeries or public with mild-moderate depression (77% female) (n = 190). | 630mg EPA, 850mg DHA, 870mg olive oil, or olive oil placebo (both with tocopherols and orange oil). | 12 weeks parallel design. | DASS, BDI, STAEI, mood using diary and visual probe task, cognitive function. | Treatment = placebo on outcome measures (improvements in both groups). | (Rogers et al., 2008) |
| 40–55 years recruited, (mean age 49) postmenopausal women with psychological distress and depressive symptoms (n = 120). | 1.5g ethyl-EPA, 0.5g ethyl-DHA. | 8 weeks parallel design. | PGWB, HSCL-D-20, HDRS. | Treatment = placebo on all measures (improvements in both groups). Treatment > placebo in women without MDE (major depressive episode diagnosis). | (Lucas et al., 2009) |
| Major depression + coronary heart disease (n = 122). | 930mg ethyl-EPA + 750mg ethyl DHA/d or corn oil placebo. | 10 weeks parallel design, adjunctive therapy. | BDI-II, HDRS. | Treatment = placebo on outcome measures (improvements in both groups). | (Carney et al., 2009) |
| 18–65 years inpatients with bipolar disorder (n = 30). | 9.6g/d n-3 PUFA (6.2g EPA, 3.4g DHA) or olive oil esther placebo. | 4 month parallel design; adjunctive therapy. | HDRS, YMRS, CGI-S, GAS. | Treatment > placebo on GAS, HDRS and CGI; treatment = placebo on YMRS. | (Stoll et al., 1999) |
| 57 Bipolar depressed and 59 rapid cycling (mean age 45) (n = 116, 51% male). | 6g/d ethyl-EPA or liquid paraffin placebo. | 4 month parallel design; adjunctive therapy. | IDS, YMRS, CGI- BP (bipolar disorder). | Treatment = placebo on outcome measures. | (Keck et al., 2006) |
| Outpatients with bipolar depression + scores > 17 on HDRS, (mean age 47) (n = 75, 76% female). | 1g/d ethyl EPA (n = 24); 2g/d ethyl EPA (n = 25) or paraffin placebo. | 12 week parallel design, adjunctive therapy. | HDRS, YMRS, CGI. | Treatment > placebo on HDRS & CGI on 1g and 2g/d. Treatment = placebo on YMRS. | (Frangou et al., 2007) |
| 16–64 years presenting after act of repeated self-harm (n = 49, 65% women). | 1.2g/d EPA + 0.9g DHA or corn oil placebo (with 1% EPA/DHA). | 12 weeks parallel design in addition to standard care. | BDI, HDRS, OAS-M, IMT/ DMT, PSS, DHUS. | Treatment > placebo on BDI, HDRS, PSS, DHUS. Treatment = placebo on OAS-M and IMT/DMT (hostility/aggression, memory). | (Hallahan et al., 2007) |
| Study 1: schizophrenic patients, PANSS score > 40, mean age 44 (n = 45). Study 2: diagnosed schizophrenia, untreated, mean age 35, (n = 30). | 2g/d EPA or corn oil placebo. | 3 months parallel, single therapy unless drugs needed. | PANSS; need for antipsychotic medication. | Treatment > placebo, particularly on positive subscale; 12/12 placebo and 8/14 EPA patients took medication. | (Peet et al., 2001) |
| (18–65 years, M = 40; 61% male) diagnosed schizophrenia or schizoaffective disorder (n = 30). | 3g/d ethyl EPA + Vit E or mineral oil + Vit E placebo. | 16 weeks parallel design, adjunctive therapy. | PANSS, CGI, MADRS, RBANS, AIMS, SARS. | Treatment = placebo on outcome measures (some showed improvements in both groups). | (Fenton et al., 2001) |
| 18–55 years schizophrenic, treatment resistant patients, PANSS score > 10 (n = 40, mean age 45). | 3g/d ethyl-EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, ESRS. | Treatment > placebo on PANSS and dyskinesia subscale of ESRS. Treatment = placebo on other ESRS subscales. | (Emsley et al., 2002) |
| 20–62 years treatment- resistant schizophrenia; PANSS > 50, (n = 115, mean age 37, 66% male). | 1, 2, or 4g/d ethyl- EPA or liquid paraffin placebo. | 12 weeks parallel design, adjunctive therapy. | PANSS, LUNSERS, MADRS, AIMS, BAS, SARS. | Treatment = placebo on all rating scales; 2g treatment > placebo for patients on clozapine (associated with ↑AA). | (Peet et al., 2002) |
| First-episode psychosis patients (n = 69, mean age 21, 76% male). | 2g/d ethyl-EPA or mineral oil placebo not absorbed by intestinal tract (both with Vit E). | 12 weeks parallel design, adjunctive therapy. | BPRS, SANS, CDSS, CGI, GAF, SOFAS. | Treatment = placebo on all outcome measures. Treatment > placebo on CGI co-varying for duration of untreated psychosis; treatment > placebo at weeks 4–6. | (Berger et al., 2007) |
| 13–25 years met defined risk factors for psychosis (n = 81, mean age 16, 40% male). | 1.2g/d n-3 PUFAs 0.7g EPA, 0.48g DHA, and 7.6mg of vitamin E). | 12 weeks. | PANSS, MADRS, GAF. | Treatment > placebo on PANSS and GAF at 12 weeks, 6 and 12 months. | (Amminger et al., 2010) |
| 19–30 years university students (study measured aggression and executive function) (n= 41, 70% female). | 1.5–1.8g/d DHA or 97% soybean oil + 3% fish oil placebo capsules. | 3 months parallel design. | P-F Study; Stroop; Dementia- detecting test. | Treatment > placebo on aggression (increased in placebo group during exam time); treatment = placebo on other measures. | (Hamazaki et al., 1996) |
| 18–40 years females with moderately severe borderline personality disorder (n= 30, mean age 26). | 1g/d ethyl-EPA or mineral oil placebo. | 8 weeks parallel design. | OAS-M; MADRS. | Treatment > placebo aggression and depressive symptoms | (Zanarini and Frankenburg, 2003) |
| MDD patients (n= 154). | (1) EPA 1g/d; (2) DHA 1g/d; (3) Placebo. | 8 weeks. | HDRS-17, QIDS- SR-16, CGI-S. | Treatments and placebo improved HDRS-17, QIDS- SR-16, CGI-S. | (Mischoulon et al., 2015) |
Abbreviations: AIMS, Abnormal Involuntary Movement Scale; BDI, Beck Depression Inventory; BPRS, Brief Psychiatric Rating Scale; CBC, Child Behaviour Checklist; CDSS, Calgary Depression Scale for Schizophrenia; CGI-S, Clinical Global Impression-Severity; DASS, Depression & Anxiety Stress Scale; DHUS, Daily Hassles & Uplifts Scale; DMT, Delayed Memory Task; ESRS, Extrapyramidal Symptom Rating Scale; GAFS, Global Assessment of Functioning Scale (revised GAS); GAS, Global Assessment Scale; HDRS, Hamilton Depression Rating Scale; HSCL-D-20, 20-item Hopkins Symptom Checklist Depression Scale; IDS, Inventory for Depressive Symptomology; IMT, Immediate Memory Task; LUNSERS, Liverpool University Neuroleptic Side-Effects Rating Scale; MADRS, Montgomery-Asberg Depression Rating Scale; MDD, major depressive disorder; OAS-M, The Overt Aggression Scale, Modified; PANSS, Positive and Negative Syndrome Scale; PGWB, Psychological General Well-Being Schedule; PSS, Perceived Stress Scale; RBANS, Repeatable Battery for the Assessment of Neuropsychological Status; SANS, Scale for the Assessment of Negative Symptoms; SARS, Simpson-Angus Rating Scale; SOFAS, Social and Occupational Functioning Assessment Scale; STAEI, State-Trait Anger Expression Inventory; YMRS, Young Mania Rating Scale.
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