Eicosapentaenoic acid (EPA): benefits, dosage, contraindications
Other name(s)
Omega-3
Scientific name(s)
EPA, PUFA
Family or group:
Fatty acids
Indications
Scoring methodology
EFSA approval.
Depression ✪✪✪✪✪
Patients already treated with conventional antidepressants may benefit more from EPA than those not taking antidepressants. Preliminary clinical research shows that oral ethyl-EPA at 500 mg to 1 gram twice daily with standard treatment improves symptoms of recurrent major depression. Meta-analyses of clinical research show that pure EPA or omega-3 fatty acids enriched in EPA (at least 60%) moderately reduce depressive symptoms in patients with major depressive disorder (MDD). Other preliminary research shows that oral ethyl-EPA at 500 mg to 1 gram twice daily with standard treatment improves symptoms of recurrent major depression. The World Federation of Societies of Biological Psychiatry (WFSBP) and the Canadian Network for Mood and Anxiety Treatments (CANMAT) indicate that omega-3 fatty acids providing 1 to 2 grams of EPA are recommended for adjunctive use in patients with major depressive disorder. However, omega-3 fatty acids are not recommended as monotherapy, and products containing other doses of EPA are not recommended as adjunctive treatments or as monotherapy in these patients.
Posologie
Oral
1 - 2 g
Efficacy of omega-3 PUFAs in depression: A meta-analysis
Meta-analysis of the Effects of Eicosapentaenoic Acid (EPA) in Clinical Trials in Depression
Meta-analysis of the effects of eicosapentaenoic acid (EPA) in clinical trials in depression
Role of omega-3 fatty acids in the treatment of depressive disorders: a comprehensive meta-analysis of randomized clinical trials
Addition of omega-3 fatty acid to maintenance medication treatment for recurrent unipolar depressive disorder
Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce
Hypertriglyceridemia ✪✪✪✪✪
Taking a specific product containing ethyl-EPA, at a dose of 4 g per day in two divided doses for 12 weeks, resulted in a reduction in triglyceride levels by 33%, total cholesterol by 16%, very-low-density lipoprotein (VLDL) cholesterol by 29%, and apolipoprotein B by 9%, compared with placebo. In diabetic women on statins with persistent hypertriglyceridemia, taking the ethyl-EPA-based product reduced triglyceride levels by about 21.5% and total cholesterol by 12.5%, but did not reduce LDL cholesterol levels compared with placebo. Furthermore, there is no strong evidence that EPA-only supplements reduce triglyceride levels in patients with hypertriglyceridemia.
Posologie
Oral
4 g
12 weeks
ethyl-EPA
Omega-3 polyunsaturated fatty acids improve endothelial function in humans at risk for atherosclerosis: A review.
Lipid Effects of Icosapent Ethyl in Women with Diabetes Mellitus and Persistent High Triglycerides on Statin Treatment: ANCHOR Trial Subanalysis
Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] trial)
Cardiovascular diseases ✪✪✪✪✪
A study showed that taking a specific ethyl-EPA-based product reduced the risk of vascular events by 25% compared with placebo after a median follow-up of 4.9 years, and this was observed in patients treated with statins who had hypertriglyceridemia accompanied by other cardiovascular risk factors. A large study (Japan Eicosapentaenoic Acid Lipid Intervention (JELIS)) conducted in Japanese patients with hypercholesterolemia showed that taking EPA (1800 mg/day) in combination with statin therapy reduced major cardiovascular events by 19% during a mean follow-up of 4.6 years.
Posologie
Oral
1800 mg
ethyl-EPA
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
Reduction in the recurrence of stroke by eicosapentaenoic acid for hypercholesterolemic patients: subanalysis of the JELIS trial
Omega-3 polyunsaturated fatty acids improve endothelial function in humans at risk for atherosclerosis: A review.
Hypercholesterolemia ✪✪✪✪✪
A meta-analysis of clinical studies shows that taking EPA slightly reduces total cholesterol and LDL cholesterol levels compared with placebo. However, not all patients in these studies had hyperlipidemia, and EPA was generally provided in oils that also contained docosahexaenoic acid (DHA). Another study showed that taking EPA in patients with type 2 diabetes increases high-density lipoprotein (HDL) cholesterol levels by approximately 12%.
Posologie
Oral
1 - 2 g
12 - weeks
Effects of dietary eicosapentaenoic acid and docosahexaenoic acid supplementation on metabolic syndrome: A systematic review and meta-analysis of data from 33 randomized controlled trials
Omega-3 polyunsaturated fatty acids improve endothelial function in humans at risk for atherosclerosis: A review.
High blood pressure ✪✪✪✪✪
A meta-analysis of clinical studies conducted in adults with dyslipidemia shows that an EPA supplement reduces systolic blood pressure, but not diastolic, compared with placebo.
Posologie
Orally
1 - 2 g
Attention deficit disorders ✪✪✪✪✪
Some research shows that low plasma levels of EPA and other fatty acids are associated with ADHD in children; however, it is not known whether taking EPA supplements can treat or prevent ADHD.
Posologie
Orally
1 - 2 g
Properties
Neurological
Fatty acids are major components of the brain and are found at high concentrations in the neuronal membrane and the myelin sheath. DHA levels in the brain are 250 to 300 times higher than those of EPA. Like DHA, EPA penetrates the brain and is rapidly β-oxidized upon entry. Omega-3 fatty acids play an active role in the function and fluidity of neuronal membranes and in the regulation of neuronal growth factors. They also potentially influence every step of biogenic amine function, including the synthesis, degradation, release, reuptake and binding of neurotransmitters.
Usages associés
Anti-inflammatory
It has been shown that EPA reduces markers of inflammation such as inflammatory cytokines and C-reactive protein. In addition, resolvin E1, a lipid mediator derived from EPA, exerts potent anti-inflammatory actions both in vitro and in vivo.
Cardiovascular
Research suggests that EPA improves the stability of atherosclerotic plaque and helps reduce the risk of myocardial infarction after percutaneous coronary intervention.
Usages associés
Lipid-lowering
Research has shown that purified EPA reduces serum triglyceride concentrations in subjects with hypercholesterolemia, but has no effect on total cholesterol and low-density lipoprotein (LDL) cholesterol. Another study showed that EPA reduces very-low-density lipoprotein (VLDL) and total cholesterol levels in normolipidemic individuals, but had no effect on triglyceride or LDL cholesterol levels.
Usages associés
Safe dosage
Adult: 1 g - 2 g
EPA is generally used at doses of 1 to 2 grams per day for a maximum of 6 months. Ethyl-EPA is used at doses of 4 grams per day.
Interactions
Médicaments
Antiplatelet agents/Anticoagulants: moderate interaction
In human research, taking EPA has been shown to inhibit platelet aggregation.
Antihypertensive: moderate interaction
Fish oils containing EPA may lower blood pressure and have additive effects in patients receiving antihypertensive treatment.
Precautions
Pregnant women: avoid
Avoid use due to insufficient reliable information.
Breastfeeding: avoid
Avoid use due to lack of sufficient reliable information. nn
Heart disorders: use with caution
Taking EPA, especially at high doses, may increase the risk of arrhythmias.nn
