Media reports failed to dig deep enough to question dubious guidance to UK doctors
by Craig Weatherby
As soon as we saw today's news stories relaying a British report that cast doubt on the anti-depression powers of omega-3s, we called America’s leading researcher in the field: Commander Joe Hibbeln, MD.
The media reports repeated, unquestioned, the opinion of a British panel which told UK doctors that there isn't enough evidence to warrant prescribing fish oil to depressed patients (Drug and Therapeutics Bulletin 2007).
Dr. Hibbeln is Senior Clinical Investigator at the National Institute on Alcohol Abuse and Alcoholism. Just two months ago, he and 10 other prominent researchers in the field appointed by the American Psychiatric Association published a comprehensive review of the relevant evidence on depression and omega-3s (Freeman MP et al 2006; see “Top Psych Panel Says Omega-3s Deter Depression, Bipolar Disorder”).
As we reported then, “The members concluded that the preponderance of evidence supports the hypothesis that people who consume higher amounts of omega-3 EFAs—particularly the long-chain “marine” omega-3s from fish (EPA and DHA)—enjoy reduced risks of depression, bipolar disorder (manic-depression), and related mood disorders.”
So why would the British panel discourage doctors from prescribing omega-3s, citing a lack of sufficient evidence?
We asked Dr. Hibbeln whether he thought it might be because another, more negative assessment of the evidence was published last year (Appleton KM et al 2006).
Dr. Hibbeln couldn’t say for sure, since the British paper is not readily available for review (Unlike the research he and others did for the American Psychiatric Association, the Biritsh paper does not appear, based on media reports, to be a peer-reviewed meta-analysis).
But he noted, comparing the American Psychiatric Association team’s firmly positive findings to the more negative 2006 review, “We had access to more data, and we used data from studies that included measures of depression… we cast a broader net. In addition, the statistical methods were different.”
In short, although he is too polite to put it so bluntly, the competing review was not as rigorous or comprehensive. And as Dr. Hibbeln said, his team’s meta-analysis of prior studies was reviewed by, and accepted as the official position of, the American Psychiatric Association.
Given the mountains of epidemiological evidence in their favor, and the substantial body of positive clinical evidence, there is little doubt that omega-3s can prevent and help treat depression, bipolar disorder, and other mood disorders.
We can only speculate that the British body—whose purpose is to offer unofficial prescribing guidelines for doctors—was unaware of all the evidence, or has a bias toward drugs over nutritional intervention, no matter how well supported by evidence.
- Drug and Therapeutics Bulletin (unknown authors). Do omega-3 fatty acids help in depression?. February 2007. http://www.dtb.org.uk/dtb/do/articles/2007/Feb/1.html
- Freeman MP, Hibbeln JR, Wisner KL, Davis JM, Mischoulon D, Peet M, Keck PE Jr, Marangell LB, Richardson AJ, Lake J, Stoll AL. Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry. 2006 Dec;67(12):1954-67. Review.
- Appleton KM, Hayward RC, Gunnell D, Peters TJ, Rogers PJ, Kessler D, Ness AR. Effects of n-3 long-chain polyunsaturated fatty acids on depressed mood: systematic review of published trials. Am J Clin Nutr. 2006 Dec;84(6):1308-16. Review. Peet M, Stokes C. Omega-3 fatty acids in the treatment of psychiatric disorders. Drugs. 2005;65(8):1051-9. Review.
- Parker G, Gibson NA, Brotchie H, Heruc G, Rees AM, Hadzi-Pavlovic D. Omega-3 fatty acids and mood disorders. Am J Psychiatry. 2006 Jun;163(6):969-78. Review. Erratum in: Am J Psychiatry. 2006 Oct;163(10):1842.
- Freeman MP. Omega-3 fatty acids in psychiatry: a review. Ann Clin Psychiatry. 2000 Sep;12(3):159-65. Review.
- Young G, Conquer J. Omega-3 fatty acids and neuropsychiatric disorders. Reprod Nutr Dev. 2005 Jan-Feb;45(1):1-28. Review.