Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in patients, interventions and results) and imprecise results (most of the trials were small with wide confidence intervals).
A Cochrane review [Abstract] 1 included 34 studies with a total of 1924 subjects..N-3PUFA supplementation resulted in a small to modest benefit for depressive symptomology compared to placebo (SMD -0.4, 95% CI -0.64 to -0.16; 33 studies, n=1848), but this effect is unlikely to be clinically meaningful (an SMD of -0.4represents a difference between groups in scores on the HDRS (17-item) of approximately 2.5 points (95% CI 1 to 4), where the minimal clinically important change score on this scale is 3.0 points). The amount of individuals experiencing adverse events were similar in intervention and placebo groups (OR 1.27, 95% CI 0.99 to 1.64; 24 studies, n=1503). Rates of remission and response, quality of life, and rates of failure to complete studies were also similar between groups.The evidence on which these results are based is very limited.
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