Fish Oil Supplementation Shows No Added Benefit in Youth Depression: JAMA
Switzerland: A randomized trial has found that adding a daily fish oil supplement to psychotherapy did not provide any additional benefit compared with placebo in children and adolescents with moderate-to-severe major depressive disorder, including those with suicidal ideation.
Youth who began antidepressant therapy early showed only modest improvement, underscoring the ongoing need for more effective treatment strategies for depression in young populations.
Published in JAMA Network Open, the study by Gregor Berger of the Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zürich, and colleagues evaluated whether ω-3 fatty acid supplementation could improve outcomes in pediatric major depressive disorder (MDD). Although ω-3 fatty acids have been widely promoted for depression, evidence in children and adolescents remains limited and inconsistent, raising concerns that reliance on unproven supplements may delay evidence-based treatment.
The multicenter, double-blind, placebo-controlled randomized clinical trial was conducted across five child and adolescent psychiatry centers in Switzerland. A total of 257 youths with moderate-to-severe MDD were enrolled between 2017 and 2022 and followed for 36 weeks. Participants were randomly assigned to receive either ω-3 fatty acids or a placebo alongside standardized psychotherapy. Antidepressant medications were permitted when clinically indicated, in accordance with national guidelines.
Those in the intervention group received 1.5 g per day of ω-3 fatty acids, comprising 1 g of eicosapentaenoic acid and 0.5 g of docosahexaenoic acid in a 2:1 ratio, while the control group received a medium-chain triglyceride placebo. The primary outcome was change in depression severity measured using the Children’s Depression Rating Scale–Revised (CDRS-R). Secondary outcomes included treatment response, remission, quality of life, suicidality, antidepressant use, and safety.
The study led to the following notable findings:
- Participants had a mean age of 15.7 years, with females accounting for 73% of the study population.
- Depression severity decreased over time in both the ω-3 and placebo groups, with no significant differences observed between the two arms.
- Mean Children’s Depression Rating Scale–Revised scores were comparable between groups at 12 weeks and remained similar at 36 weeks.
- The adjusted difference in depression scores between the ω-3 and placebo groups was small and not statistically significant.
- Clinical response at 12 weeks was observed in about one-third of participants receiving ω-3 supplements and in just under 40% of those receiving placebo.
- Remission rates at 36 weeks were modest and did not differ meaningfully between the two groups.
- Self-rated depression, quality of life, and suicidality improved over time in both groups without any advantage of ω-3 supplementation.
- Treatment adherence was high, as reflected by significant increases in blood ω-3 levels among participants in the supplementation arm.
- Serious adverse events, including suicide attempts, occurred in both groups, with none considered related to the study medication.
"Overall, the findings do not support the use of 1.5 g of ω-3 fatty acids as an adjunct to psychotherapy for pediatric MDD. The authors noted that future studies should explore EPA-enriched formulations and biomarker-guided strategies to identify more effective treatments for depression in young patients," the authors concluded.
Reference:
Berger G, Häberling I, Emery S, et al. ω-3 Fatty Acids in Pediatric Major Depressive Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(1):e2548703. doi:10.1001/jamanetworkopen.2025.48703
Next Story