Association of Omega-3 Polyunsaturated Fatty Acids With Anxiety Symptom Severity

September 14, 2018
Kuan-Pin Su, MD, PhD; Ping-Tao Tseng, MD; Pao-Yen Lin, MD, PhD; Ryo Okubo, MD, PhD; Tien-Yu Chen, MD; Yen-Wen Chen, MD; Yutaka J. Matsuoka, MD, PhD

Abstract

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.