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• W2017201360 abstract "To the Editors: We read with great interest the article by Llorente et al.1.Llorente A.M. Jensen C.L. Voigt R.G. Fraley J.K. Berretta M.C. Heird W.C. Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing.Am J Obstet Gyncol. 2003; 188: 1348-1353Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar Some methodologic issues may be important to note when interpreting their negative finding on the therapeutic effect of omega-3 polyunsaturated fatty acids (PUFAs) in postpartum depression. According to the previous studies with positive findings, the daily doses of total omega-3 PUFAs range from 1 g2 to 9.6 g.3-5 The dose of 200 mg per day of docosahexaenoic acid (DHA) in the study of Llorente et al is too low and very possibly to be confounded if the dietary fish intake was not controlled. Furthermore, combination of DHA and eicosapentaenoic acid (EPA), but not DHA alone used in the study of Llorente et al, improves symptoms of major depressive disorder.2.Peet M. Horrobin D.F. A dose-ranging study of the effects of ethyl-eicosapentaenoate despite apparently adequate treatment with standard drugs.Arch Gen Psychiatry. 2002; 59: 913-919Crossref PubMed Scopus (514) Google Scholar, 3.Su K.P. Huang S.Y. Chiu C.C. Shen W.W. Omega-3 fatty acids in major depressive disorder: a preliminary double-blind, placebo-controlled trial.Eur Neuropsychopharm. 2003; 13: 267-271Abstract Full Text Full Text PDF PubMed Scopus (451) Google Scholar From the study of Llorente et al, we estimate that there might be about 10 to 15 women who met the Diagnostic and Statistical Manual, 4th edition, diagnosis of postpartum type of major depressive disorder. We are concerned that the sample size would be too small to draw any positive finding if the therapeutic effect is moderate. A lower level of omega-3 fatty acids in women during pregnancy and breast-feeding is associated with a high demand from the developing fetus for the rapid formation of its brain. Recently, we reported pregnant women with depression4.Chiu C.C. Huang S.Y. Shen W.W. Su K.P. Omega-3 fatty acids for depression in pregnancy.Am J Psychiatry. 2003; 160: 385Crossref PubMed Scopus (54) Google Scholar or schizophrenia5.Su K.P. Shen W.W. Huang S.Y. Omega-3 fatty acids as a psychotherapeutic agent for a pregnant schizophrenic patient.Eur Neuropsychopharm. 2001; 11: 295-299Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar who were successfully treated by omega-3 PUFAs. Because of its safety and psychotherapeutic effects, omega-3 PUFA is still a promising approach for depressive patients during pregnancy or breast-feeding. Further studies with higher dosages, combinations with EPA, and focus on women with definite diagnosis of major depressive disorders are necessary." @default.
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• W2017201360 title "Omega-3 polyunsaturated fatty acids for postpartum depression" @default.
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• W2017201360 doi "https://doi.org/10.1016/j.ajog.2003.10.705" @default.
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