Omega-3 fatty acids as treatments for mental illness: which disorder and which fatty acid?

Table 3 Double-blind placebo controlled trials of omega-3 fatty acids in schizophrenia.

Ref	Jadad score	Meds	Age	Gender	Omega-3 fatty acid	Prep. type	Duration	N	Average baseline score	Δ	Statistical significance vs. placebo
3	5	100%	43	38%	2 g/day EPA	Crude mixture	12 weeks	29	75	-4.1	Yes
			43	29%	2 g/day DHA	Crude mixture	12 weeks	40	73	+2.2	No
3	5	0%¹	35	40%	2 g/day EPA	Crude mixture	12 weeks	26	75	-3.6	Yes
52	5	100% (typical)	39	54%	1 g/day EPA	Ethyl ester	12 weeks	21	74	+7.0	No
			37	47%	2 g/day EPA	Ethyl ester	12 weeks	17	75	+4.2	No
			38	57%	4 g/day EPA	Ethyl ester	12 weeks	22	77	+2.5	No
		100% (atypical)	39	54%	1 g/day EPA	Ethyl ester	12 weeks	23	76	+5.2	No
			37	47%	2 g/day EPA	Ethyl ester	12 weeks	26	82	-0.9	No
			38	57%	4 g/day EPA	Ethyl ester	12 weeks	23	81	+10.6	No
		100% (clozapine)	39	54%	1 g/day EPA	Ethyl ester	12 weeks	16	79	-10.1	No
			37	47%	2 g/day EPA	Ethyl ester	12 weeks	16	81	-17.8	Yes
			38	57%	4 g/day EPA	Ethyl ester	12 weeks	13	74	-6.9	No
		100% (all meds)	39	54%	1 g/day EPA	Ethyl ester	12 weeks	60	77	-1.0²	No²
			37	47%	2 g/day EPA	Ethyl ester	12 weeks	59	78	+5.4²	No²
			38	57%	4 g/day EPA	Ethyl ester	12 weeks	58	77	-3.7²	No²
53	4	100%	40	39%	3 g/day EPA	Ethyl ester	12 weeks	87	75	+2.0	No
							16 weeks	87		+1.0	No
56	3	100%	45	NS	3 g/day EPA	Ethyl ester	9 weeks	40	75	-9.5	Yes
							12 weeks	40		-7.3³	Yes

Δ is refers to the change from baseline symptom scores for the omega-3 fatty acid group minus change from baseline scores for the placebo group. Jadad design quality scores can range from 0 to 5 with 5 being best. The symptom scale used in all the trials is the Positive and Negative Symptom Scale (PANSS). Zero is best for this scale hence a negative Δ value indicates an improvement over placebo. The average baseline score is the average of the omega-3 and placebo group scores at the start of the trial. Gen (gender) refers to the % of female participants in the trial. Meds refers to the percentage of trial participant who were in receipt of conventional medications for schizophrenia. Prep. type describes whether a crude oil mixture or a purified fatty acid was used. Notes: ¹Although trial participants were not in receipt of medication at commencement, they were giving anit-psychotic medications as required during the trial. ²The primary outcome measure was stated by the authors to be 12 weeks, but this was not reported in the text; therefore this estimate is an approximation based on Figure 1 in Emsley and colleagues [56]. ³ Calculated from Tables 6 – 8 in Peet and Horrobin [52].

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