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the amount of fish consumed per capita worldwide.^7 There are at least four studies
showing reduced levels of omega-3 essential fatty acids in the blood of depressed
people^8. Uncontrolled clinical trials of omega-3 essential fatty acid supplements have
shown promise in the treatment of major depression, and several controlled trials are
underway.
Brown et al. recommend omega-3 essential fatty acids for depression based on the
preliminary studies summarized by Parker et al in a 2006 review.^9 According to Brown et
al., “the mixed results [of the studies cited by Parker et al.] reflect differences in the
dose and proportions of EPA and DHA, patient selection, and other [unspecified]
factors.”^10 The 2006 review included Mischoulon as a coauthor. Brown et al. II included
Mischoulon as the lead author on omega 3s. See below.
Mischoulon and Rosenbaum’s perspective on omega-3 fatty acids is provided by Andrew
L. Stoll, M.D., Director, Psychopharmacology Research Laboratory, McLean Hospital
Faculty, Harvard Medical School. Writing one year before his book was published, Stoll
updates his single 1999 bipolar study with three more double-blind, placebo controlled
studies of bipolar disorder and seven of unipolar depression. As of 2007, the score stood
at two positive studies and two no benefit studies of the use of omega-3s in bipolar
disorder and four positive studies and three no benefit studies of the use of omega-3s in
unipolar depression.^11 Stoll concludes that the problem with the studies is that the
optimal omega-3 fatty acid formulation for mood disorders needs to be determined.^12
Stoll critiques the studies, including his own 2007 study which showed no benefit in
depression. In that case, the formula of omega-3s that was used was DHA 2.2 g. per day
and EPA 0.6 g. per day, the reverse of the ratios recommended by Stoll and Brown et al.,
and less than 1/3 of the dose used by Stoll himself in his 1999 bipolar study. But many
other methodological issues are debatable, including, in particular, the lack of an active
placebo, since most of the consumers were taking antidepressants (both tricyclics and
SSRIs) throughout the studies. Interestingly, one of the no benefit studies involved
consumers who had gone off their anti-depressants at least two weeks before the study
began. In addition, the same study used a dose of 2 g. per day of DHA, with no EPA at