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Effect of n-3 polyunsaturated fatty acids on the treatment of schizophrenia: an updated systematic review and meta-analysis

Lin CY, Lee JA, Peng TR, Tsai PY, Huang PH, Lee MC, Chen SM

BMC psychiatry, 2025

1,435 participants

Abstract

Background: Schizophrenia is a chronic disorder, and treatment options for its negative and cognitive symptoms are limited. Omega-3 fatty acids have potential neuroprotective effects, but evidence of their efficacy in schizophrenia and ultra-high risk group is inconsistent. This study aimed to provide an updated meta-analysis of randomized controlled trials evaluating the effectiveness of omega-3 fatty acid supplementation in patients with schizophrenia and ultra-high risk group.

Methods: A PRISMA-guided meta-analysis of randomized controlled trials comparing omega-3 fatty acids with placebo in schizophrenia was conducted. The literature search was concluded on November 12, 2024, and was conducted without any restrictions on language or timeframe. Data were extracted and analyzed using fixed or random-effects model depending on heterogeneity. Subgroup, sensitivity, and bias assessments were performed.

Results: The meta-analysis, which included 16 trials with 1,435 participants, revealed no significant difference between omega-3 fatty acids and placebo in schizophrenia at the endpoint of intervention (standard mean difference = - 0.123; 95% confidence interval = - 0.267 to 0.021; p = 0.095), and ultra-high risk of schizophrenia at the endpoint of follow-up after intervention (standard mean difference = - 0.070; 95% confidence interval = - 0.425 to 0.285; p = 0.699). A small number of subgroup analyses suggested potential benefits for patients with first-episode schizophrenia…

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: 1,435 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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