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This protocol was developed for practitioners using Fullscript in Canada and the templates cannot be applied to accounts operating outside of Canada

Low mood is one of the leading causes of disability worldwide.1 It is an independent risk factor for cardiovascular disease and mortality and has impacts on the immune system as well as metabolism.1 Low mood causes social disruption often leading to more days of missed work compared to patients who exhibit physical symptoms of illness.1 However, only about 1 in 2 Canadians report receiving adequate care during a major depressive episode.2 

Patients with depressive or low mood symptoms often have lower levels of omega-3 fatty acids in cell tissue and through dietary intake.3 The anti-inflammatory impacts of omega-3 fatty acids (largely EPA) have been well studied for immune and metabolic health.2 Omega-3 fatty acids may influence symptoms of low mood through their suppression of inflammatory cytokines.4 Additionally, these fatty acids increase the release of both serotonin and dopamine neurotransmitters.4 Both, disrupted cell signaling and inflammation have been implicated in a depressed mood.5 An increased risk of suicide, commonly associated with depression, has also been linked with omega-3 fatty acid deficiency.6

Evidence for omega-3 fatty acids in low mood

  • When used as an adjunct treatment for major depressive disorder, omega-3 fatty acids improved the Hamilton Rating Scale for Depression significantly, when compared to placebo group.3
  • Omega-3 fatty acids had a significant benefit on depression symptoms with a dose containing >60% EPA.7 
  • Fish oil used in the treatment of elderly depressed patients with mild to moderate depression had substantial impacts when compared to a placebo.8

A study which looked at major depressive disorder in children and teens, found that levels of EPA and the omega‐6/omega‐3 ratio were negatively correlated with severity symptoms. After 6 and 12 weeks of intervention, Children’s Depression Inventory ratings were decreased with omega-3 supplementation.9

AquaOmega High EPA Omega-3

Low Mood: Take 1.5 tsp of High EPA Omega-3 (3380 mg EPA and 670 mg DHA) once per day for at least 6 weeks

Ingredients: Anchovy oil, natural flavours, green tea extract, monk fruit extract, rosemary leaf extract, mixed tocopherol concentrate.

AquaOmega High EPA Omega-3 – Capsules

Low Mood: Take 4 capsules of High EPA Omega-3 daily (2650mg EPA and 530mg DHA) once per day for at least 6 weeks

Ingredients: Anchovy oil, natural flavours, green tea extract, rosemary leaf extract, monk fruit extract, mixed tocopherol concentrate.

Key Features: EPA is an essential fatty acid responsible for reducing inflammation in the body. AquaOmega’s high dose of pharmaceutical-grade Omega-3 EPA formula is up to 5 times more concentrated than the other leading brands of high EPA products on the market. It contains no artificial colouring or sugars. 

Caution: Omega-3 fatty acids do not replace prescribed depression medications and should be used in conjunction with current anti-depressive protocols. Check with a health care practitioner before starting.

References 

  1. Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS. Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosomatic Medicine. 2009 Apr 1;71(3):273-9.
  2. Patten et al. (2016). Major depression in Canada: what has changed over the past 10 years? Canadian Journal of Psychiatry, 61: 80-85. “Potentially adequate treatment” defined as “taking an antidepressant or 6 or more visits to a health professional for mental health reasons.”
  3. Su KP, Huang SY, Chiu CC, Shen WW. Omega-3 fatty acids in major depressive disorder: a preliminary double-blind, placebo-controlled trial. European Neuropsychopharmacology. 2003 Aug 1;13(4):267-71.
  4. Bae JH, Kim G. Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression. Nutrition Research. 2018 Feb 1;50:1-9.
  5. Duffy A. Depression and Bipolar Disorder: Stahl’s Essential Psychopharmacology. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2010 Feb;19(1):55.
  6. Grosso G, Galvano F, Marventano S, Malaguarnera M, Bucolo C, Drago F, Caraci F. Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxidative Medicine and Cellular Longevity. 2014 Oct;2014.
  7. Liao Y, Xie B, Zhang H, He Q, Guo L, Subramaniapillai M, Fan B, Lu C, Mclntyer RS. Efficacy of omega-3 PUFAs in depression: a meta-analysis. Translational Psychiatry. 2019 Aug 5;9(1):1-9.
  8. Bae JH, Kim G. Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression. Nutrition Research. 2018 Feb 1;50:1-9.
  9. Jana T, Zuzana H, Anna S, Barbora K, Irina G, Iveta W, Katarína S, Iveta G, Ján Š, Zdeňka Ď. Omega-3 fatty-acids modulate symptoms of depressive disorder, serum levels of omega-3 fatty acids and omega-6/omega-3 ratio in children. A randomized, double-blind and controlled trial. Psychiatry Research. 2020 Mar 7:112911.

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

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