Influence of adjuvant omega-3-polyunsaturated fatty acids on depression, sleep, and emotion regulation among outpatients with major depressive disorders - Results from a double-blind, randomized and placebo-controlled clinical trial

J Psychiatr Res. 2018 Dec:107:48-56. doi: 10.1016/j.jpsychires.2018.09.016. Epub 2018 Oct 1.


Background: Extant literature shows that adjuvant omega-3-polyunsaturated fatty acids (O3PUFAs) to a standard antidepressant medication impacts favorably on symptoms of depression in participants with major depressive disorders (MDD). The aim of the present study was to investigate, if and to what extent compared to placebo adjuvant O3PUFAs had a favorable impact on symptoms of depression, anxiety, sleep and emotion regulation among outpatients with MDD.

Method: A total of 50 outpatients (mean age: M = 42.46; 68% females) took part in this randomized, double-blind and placebo-controlled study. They were randomly assigned either to the O3PUFA- or to the placebo-condition. Standard medication was sertraline at therapeutic dosages. At baseline, six weeks and 12 weeks later at study completion participants completed questionnaires covering symptoms of depression, anxiety sensitivity, intolerance of uncertainty, sleep disturbances, and emotion regulation. In parallel, experts blind to participants' group assignment rated participants' depression with the Montgomery-Asberg Depression Scale.

Results: Symptoms of depression (self- and experts' ratings) decreased over time, but more so in the O3PUFA condition, compared to the placebo condition. Likewise, anxiety sensitivity, intolerance of uncertainty and sleep disturbances improved, but again more so in the O3PUFA condition. Further, regulation and control of emotions and perception of other's emotions improved over time, but more so in the O3PUFA condition.

Conclusions: Among outpatients with MDD, and compared to placebo, adjuvant O3PUFAs to a standard medication improved not only symptoms of depression, but also dimensions of anxiety and sleep, and above all patients' competencies to regulate their emotions.

Keywords: Anxiety; Emotion regulation; Omega-3-polyunsaturated fatty acids; Sleep.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / pharmacology*
  • Anxiety / drug therapy*
  • Depressive Disorder, Major / drug therapy*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Emotions / drug effects*
  • Fatty Acids, Omega-3 / administration & dosage
  • Fatty Acids, Omega-3 / pharmacology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Self-Control*
  • Sleep Wake Disorders / drug therapy*


  • Antidepressive Agents
  • Fatty Acids, Omega-3