Role of Long-Chain Omega-3 Fatty Acids in Psychiatric Practice.
Role of Long-Chain Omega-3 Fatty Acids in Psychiatric Practice.
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DOI：
10.1016/j.phanu.2012.10.004
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发表时间：
2013-04
期刊：
影响因子：
3.2
通讯作者：
Strawn JR
中科院分区：
文献类型：
--
作者：
McNamara RK;Strawn JR
营养在精神科实践中起着次要作用，目前主要是药物治疗算法。越来越多的证据表明，在几种主要精神疾病的病理生理学中，饮食中必需的长链欧米茄-3（LCn-3）脂肪酸、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）的不足。LCn-3脂肪酸在一般人群中具有既定的长期安全性记录，现有证据表明，增加LCn-3脂肪酸状态可能会降低心血管疾病发病率和死亡率的风险。LCn-3脂肪酸补充剂已被证明可增强抗抑郁药、情绪稳定剂和第二代抗精神病药物的疗效，并可额外减轻不良心脏代谢副作用。初步证据还表明，LCn-3脂肪酸补充剂作为单一疗法可能对一级和早期二级预防以及围产期症状有效。总体成本效益比支持将LCn-3脂肪酸纳入精神病治疗算法。最近专门用于确定血液LCn-3脂肪酸状态的实验室设施的可用性以及关于安全有效的LCn-3脂肪酸剂量范围的新兴循证共识指南提供了实施所需的基础设施。本文概述了将LCn-3脂肪酸治疗纳入精神病学实践的基本原理。
Nutrition plays a minor role in psychiatric practice which is currently dominated by a pharmacological treatment algorithm. An accumulating body of evidence has implicated deficits in the dietary essential long-chain omega-3 (LCn-3) fatty acids, eicosapenaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology of several major psychiatric disorders. LCn-3 fatty acids have an established long-term safety record in the general population, and existing evidence suggests that increasing LCn-3 fatty acid status may reduce the risk for cardiovascular disease morbidity and mortality. LCn-3 fatty acid supplementation has been shown to augment the therapeutic efficacy of antidepressant, mood-stabilizer, and second generation antipsychotic medications, and may additionally mitigate adverse cardiometabolic side-effects. Preliminary evidence also suggests that LCn-3 fatty acid supplementation may be efficacious as monotherapy for primary and early secondary prevention and for perinatal symptoms. The overall cost-benefit ratio endorses the incorporation of LCn-3 fatty acids into psychiatric treatment algorithms. The recent availability of laboratory facilities that specialize in determining blood LCn-3 fatty acid status and emerging evidence-based consensus guidelines regarding safe and efficacious LCn-3 fatty acid dose ranges provide the infrastructure necessary for implementation. This article outlines the rationale for incorporating LCn-3 fatty acid treatment into psychiatric practice.