Anxiety severity reduced if more than 2 grams of Omega-3 – meta-analysis Sept 2018

Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms – A Systematic Review and Meta-analysis

JAMA Network Open. 2018;1(5):e182327. doi:10.1001/jamanetworkopen.2018.2327
Kuan-Pin Su, MD, PhD1,2,3; Ping-Tao Tseng, MD4; Pao-Yen Lin, MD, PhD5,6,7; et al Ryo Okubo, MD, PhD8; Tien-Yu Chen, MD9,10,11; Yen-Wen Chen, MD12; Yutaka J. Matsuoka, MD, PhD3,8
Key Points

• Question Is omega-3 polyunsaturated fatty acid treatment associated with an improvement in anxiety symptoms?
• Findings In this systematic review and meta-analysis of 19 clinical trials including 2240 participants from 11 countries, improvement in anxiety symptoms was associated with omega-3 polyunsaturated fatty acid treatment compared with controls in both placebo-controlled and non–placebo-controlled trials. The anxiolytic effects of omega-3 polyunsaturated fatty acids were also stronger in participants with clinical conditions than in subclinical populations.
• Meaning Omega-3 polyunsaturated fatty acid treatment for anxiety might be effective in clinical settings.

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Ten studies with 10 data sets used omega-3 PUFA dosages of at least 2000 mg/d.33,34,36,49,50,52,54,55,57-59 The main results revealed a significantly greater association of treatment with reduced anxiety symptoms in patients receiving omega-3 PUFA treatment than in those not receiving it (k, 11; Hedges g, 0.213; 95% CI, 0.031-0.395; P = .02)

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Importance No systematic review or meta-analysis has assessed the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) for anxiety.

Objective To evaluate the association of anxiety symptoms with omega-3 PUFA treatment compared with controls in varied populations.

Data Sources PubMed, Embase, ProQuest, ScienceDirect, Cochrane Library, ClinicalKey, Web of Science, and ClinicalTrials.gov databases were searched up to March 4, 2018.

Study Selection A search was performed of clinical trials assessing the anxiolytic effect of omega-3 PUFAs in humans, in either placebo-controlled or non–placebo-controlled designs. Of 104 selected articles, 19 entered the final data extraction stage.

Data Extraction and Measures Two authors independently extracted the data according to a predetermined list of interests. A random-effects model meta-analysis was performed and this study was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Main Outcomes and Measures Changes in the severity of anxiety symptoms after omega-3 PUFA treatment.

Results In total, 1203 participants with omega-3 PUFA treatment (mean age, 43.7 years; mean female proportion, 55.0%; mean omega-3 PUFA dosage, 1605.7 mg/d) and 1037 participants without omega-3 PUFA treatment (mean age, 40.6 years; mean female proportion, 55.0%) showed an association between clinical anxiety symptoms among participants with omega-3 PUFA treatment compared with control arms (Hedges g, 0.374; 95% CI, 0.081-0.666; P = .01). Subgroup analysis showed that the association of treatment with reduced anxiety symptoms was significantly greater in subgroups with specific clinical diagnoses than in subgroups without clinical conditions.
The anxiolytic effect of omega-3 PUFAs was significantly better than that of controls only in subgroups with a higher dosage (at least 2000 mg/d) and not in subgroups with a lower dosage (<2000 mg/d).

Conclusions and Relevance This review indicates that omega-3 PUFAs might help to reduce the symptoms of clinical anxiety. Further well-designed studies are needed in populations in whom anxiety is the main symptom.