Safety and Efficacy of Omega-3 Fatty Acids for Depressive Disorders in Children and Adolescent Depression: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials with Trial Sequential Analysis: Efficacité et innocuité des acides gras oméga 3 pour le traitement des troubles dépressifs dans la dépression chez les enfants et les adolescents : une mise à jour de la revue systématique et de la méta-analyse des essais contrôlés à répartition aléatoire avec analyse séquentielle des essais
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background Depression in children and adolescents is a leading cause of disability worldwide, with rising prevalence and limited efficacy of conventional pharmacotherapies. Omega-3 polyunsaturated fatty acids (PUFAs) have emerged as a potential adjunctive or alternative treatment due to their anti-inflammatory and neuroprotective properties. However, evidence in paediatric populations remains inconclusive. This updated meta-analysis aims to evaluate the efficacy and safety of omega-3 PUFA supplementation versus placebo or standard care for depressive symptoms in children and adolescents. Methods We conducted a systematic search for randomized controlled trials (RCTs) comparing omega-3 PUFA supplementation in children and adolescents with depressive disorders or clinically significant depressive symptoms. For the meta-analysis, we used R software (version 4.5.0) with the meta and metasens packages. Using a random-effects model, we evaluated continuous outcomes using standardized mean differences (SMDs) and dichotomous outcomes using risk ratios (RRs), each with 95 per cent confidence intervals (95% CIs). Trial sequential analysis (TSA) was performed to assess the robustness of findings and calculate required information sizes (RISs). Results We included nine RCTs with a total of 848 participants. There were no statistically significant differences between omega-3 and control groups in change in depression symptom severity at any follow-up duration: 3–4 weeks, 6–8 weeks, 10–12 weeks, 16 weeks, or 24–26 weeks. Heterogeneity was significant across most subgroups, with I 2 ranging between 67.1 per cent and 91.8 per cent. Similarly, no significant effects were observed for response rate or remission rate at any time point, or all-cause dropouts. TSA indicated that the cumulative evidence did not reach the RIS. Conclusion Omega-3 did not significantly improve depressive symptoms or remission in children and adolescents. However, TSA showed that the evidence remains underpowered, so a potential benefit cannot be excluded. Significant clinical heterogeneity and insufficient information size underscore the need for large-scale RCTs with standardized outcome measures.
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225302096