If you suffer from chronic or occasional depression and your medication is not improving your symptoms, fish oil may help. Due to its beneficial fatty acid content, fish oil interactions with antidepressants may be associated with enhancing the effectiveness of drugs that treat mood disorders.
Omega-3 in fish oil may be a viable adjunctive therapy to the treatment of clinically-diagnosed depression, but always talk to your doctor before consuming any supplement if you are taking antidepressants.
Importance of Omega-3 Fish Oil
Fish oil supplements are made from the oils of fatty fish such as salmon, sardines and mackerel. They are a rich source of omega-3 fatty acids, which your body requires but cannot make on its own. The two key fatty acids provided by omega-3 in fish oil are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), according to Harvard Health Publishing.
DHA and EPA may play a role in influencing your health primarily through signaling compounds, known as eicosanoids, says Diet vs. Disease. Eicosanoids are metabolized by the brain to carry out many neural functions, including normal growth and development of the brain, maintaining cognitive ability and reducing oxidative stress.
According to Harvard Health Publishing, omega-3 in fish oil can easily travel through the brain cell membrane and interact with mood-related cerebral molecules. Omega-3's anti-inflammatory properties may also be responsible for helping relieve depression.
Fish oil is often taken to reduce the risk of heart disease and treat high triglycerides and hypertension, says the Mayo Clinic. While omega-3 in fish oil is generally considered safe and well tolerated, past concerns about its risk of increased bleeding have been largely disproved. However, caution is advised if you are taking blood thinners, warns Harvard Medical School.
You can take fish oil pills at any time of the day, but in order to minimize potential side effects, such as bloating and "fish burps," it's best taken with meals. Taking medications, such as fluoxetine, and fish oil together has no known adverse side effects, as is the case with fish oil interaction with antidepressants in general.
Omega 3's Association With Depression
Depression is a complex disorder and a common and serious mental illness. It can cause a feeling of sadness and loss of interest in activities you once enjoyed, which can lead to a variety of emotional and physical problems, according to the American Psychiatric Association.
Diet can impact various aspects of health, including depression. The manuscript published in Nutrients in March 2017 suggests the lack of fatty acids in the Western diet is associated with increased incidence of depression. Since the brain is rich in lipids, essential fatty acids (including omega-3) act within specific brain regions and are required to regulate processes that impact emotional behavior.
The Linus Pauling Institute reports that omega-3 fatty acid concentrations are found to be low in individuals suffering from depression. Although it is not known how omega-3 fatty acid intake specifically affects the incidence of depression and eicosanoid production, the report suggests there may be some benefit of fish oil supplementation on depressive disorders.
Fish Oil Interactions with Antidepressants
Although fish oil may be effective in helping with the symptoms of negative psychological indications on its own, research has shown that omega-3 fatty acids create a favorable combination when paired with antidepressant medications. A meta-analysis of randomized clinical trials, published in May 2014 in the journal PLOS One, assessed a treatment using omega-3 in participants with diagnosed and undiagnosed depressive disorders.
Findings, which included primarily EPA within the preparation, found significant clinical effectiveness when omega-3 was used as an adjuvant to another medication rather than mono-therapy. The overall conclusion of the trial was that the supplementation of omega-3 is effective in patients with major depressive disorders, including bipolar disease.
Another controlled trial published in Schizophrenia Research in February 2019 evaluated the potential role of omega-3 fatty acids for depression and anxiety symptoms in the onset of psychosis. Used in combination with another treatment drug called lorazepam, patients were given 740 milligrams of EPA and 400 milligrams of DHA daily for 16 weeks.
The results revealed a substantial decrease in depression with fewer adverse events with the administration of omega-3 compared to a placebo. Omega-3 had a greater positive influence on conditions, including confusion, anxiety, depression, irritability and fatigue. Researchers suggested that omega-3 is a viable option for use with an adjuvant treatment for depression and anxiety symptoms in people with recent onset psychosis.
Read more: Insufficient Carb Intake and Anxiety
EPA Dosage for Depression
Omega-3 has been found to be a useful addition to antidepressants in patients with diagnosed depression. Fish oil supplements are an inexpensive and safe way to meet your omega-3 requirements. Antidepressants, such as Prozac, and fish oil containing EPA may work together to supercharge positive effects of reducing depressive symptoms, as evidenced in the April 2016 study published in The American Journal of Psychiatry.
Fish oil is available in liquid, tablet and capsule form. For major depression, Harvard Medical School says the dosage for depression can range from less than 1 gram per day to 10 grams per day but recommends 1 to 2 grams daily of an EPA plus DHA combination, with at least 60 percent EPA.
Omega-3 containing fish oil is a promising natural treatment for mood disorders and may be a useful adjunct to prescribed medications. However, most studies acknowledge the need for more research regarding how they work, how effective they really are, and their long-term safety before making conclusive recommendations for people managing mental health conditions or strive to improve mood.
- Harvard Health Publishing: "Fish Oil: Friend or Foe?"
- Diet vs. Disease: "What Is Fish Oil Good For? An Unbiased Look At 8 Popular Claims"
- Harvard Health Publishing: "Omega-3 Fatty Acids For Mood Disorders"
- Mayo Clinic: "Fish Oil"
- American Psychiatric Association: "What Is Depression?"
- Nutrients: "The Relationship Between Fatty Acids and Different Depression-Related Brain Regions, and Their Potential Role as Biomarkers of Response to Antidepressants"
- The Linus Pauling Institute: "Essential Fatty Acids: Major Depression and Bipolar Disorder"
- PLOS One: "Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials"
- Schizophrenia Research: "A Potential Role for Adjunctive Omega-3 Polyunsaturated Fatty Acids for Depression and Anxiety Symptoms in Recent Onset Psychosis: Results From a 16 Week Randomized Placebo-Controlled Trial for Participants Concurrently Treated with Risperidone"
- American Journal of Psychiatry: "Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses"