Omega-3 Polyunsaturated Fatty Acids as Adjunctive Therapy to Antipsychotic Treatment in Adults with Schizophrenia: A Systematic Review and Meta-Analysis
Abstract
Background/objectives: Schizophrenia causes substantial disability and reduced life expectancy, while symptoms frequently persist despite antipsychotic treatment. Long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) have been proposed as adjunctive therapy because of their anti-inflammatory and neurobiological properties. This systematic review and exploratory meta-analysis evaluated the efficacy and safety of adjunctive n-3 PUFAs in adults with schizophrenia.
Methods: The review followed PRISMA 2020 and was prospectively registered in PROSPERO (CRD420251178174). PubMed, Web of Science, Scopus, Ovid, CENTRAL, ClinicalTrials.gov, and ICTRP were searched without language or date restrictions. Randomized controlled trials of n-3 PUFAs added to antipsychotic therapy were included. Risk of bias was assessed using RoB 2. PANSS scores were pooled as mean differences (MDs) using an inverse-variance random-effects model with REML estimation; dichotomous outcomes were pooled as risk ratios (RRs) using an inverse-variance random-effects model with the DerSimonian-Laird estimator or a fixed-effect model with the Mantel-Haenszel method, with a 0.5 continuity correction for zero cells.
Results: Of 301 records, 10 randomized controlled trials met the eligibility criteria. Where sufficient comparable data were available, exploratory meta-analyses were conducted. Only one trial provided strict intention-to-treat final PANSS total data. A two-trial sensitivity meta-analysis (116…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 116 participants or records.
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