Marine omega-3 fatty acid possible add-on treatment option for patients with BPD

Marine omega-3 fatty acids improved borderline personality disorder symptoms, according to results of a meta-analysis published in Journal of Clinical Psychiatry.

Improvements appeared especially pronounced for behavioral dyscontrol and affective dysregulation.

“Several randomized controlled trials (RCTs) have investigated the effect of marine omega 3 [polyunsaturated fatty acid] supplementation in the treatment of various psychiatric disorders,” Dominika M. Karaszewska, BSc, of the department of psychiatry at the University of Amsterdam in the Netherlands, and colleagues wrote. “Effects seem largest in major depressive disorder, in [ADHD] and on aggressive behaviors. Meta-analyses of RCTs in MDD suggest a clinically relevant effect, which led to the inclusion of marine omega-3 [polyunsaturated fatty acids] in MDD treatment guidelines.”

Because of this growing evidence in the area of MDD, several RCTs evaluated marine omega-3 polyunsaturated fatty acids in BPD; however, to the researchers’ knowledge, there has yet to be a meta-analysis on these studies. They aimed to address this research gap via the current meta-analysis by collecting estimates of effectiveness of omega-3 fatty acids in BPD, and they differentiated a priori affective, impulsive and cognitive-perceptual symptom domains. They used terms associated with BPD and omega-3 fatty acids to search four databases with no publication date restriction and included five studies that described four RCTs testing effects of omega-3 fatty acids among 137 patients with BPD or behavior related to BPD. Further, the researchers collected data on intervention dose, duration and BPD scale scores via a pre-piloted data extraction form.

Results of random-effects meta-analysis showed omega-3 fatty acids exhibited an overall significant decreasing effect on overall BPD symptoms severity, with a standardized difference in means (SDM) of 0.54 (95% CI, 0.91-0.17) and no heterogeneity. The researchers observed significant effects on affect dysregulation (SDM = 0.74; 95% CI, 1.21-0.27) and impulsive behavior (SDM = 0.45; 95% CI, 0.84-0.059) according to a priori differentiation of relevant symptom domains. Effects on cognitive-perceptual symptoms did not reach the threshold for significance.

“Marine omega-3 fatty acids could be presented as an (add-on) treatment option for BPD patients in a shared decision-making context,” Karaszewska and colleagues wrote. “As with all supplement interventions, it is important to stress that they do not form an alternative to a healthy diet and lifestyle, and they are not free from side effects, although side effects are generally considered manageable. Clinically relevant effects could be particularly expected on impulsivity and affective symptom domains.”