Eicosapentaenoic Acid (EPA): Benefits, Dosage, Contraindications
Other name(s)
Omega-3
Scientific name(s)
EPA, PUFA
Family or group:
Fatty Acids
Indications
Rating 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 intake of ethyl-EPA at 500 mg to 1 gram twice daily alongside standard treatment improves symptoms of recurrent major depression. Meta-analyses of clinical research show that pure EPA or omega-3 fatty acids enriched with EPA (at least 60%) moderately reduce depressive symptoms in patients with major depressive disorder (MDD). Further preliminary research suggests that oral intake of ethyl-EPA at 500 mg to 1 gram twice daily alongside 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) recommend that omega-3 fatty acids providing 1 to 2 grams of EPA are advised for complementary use in patients with major depressive disorder. However, omega-3 fatty acids are not recommended as monotherapy, and products containing other EPA dosages are not recommended as complements or monotherapy in these patients.
Posologie
Orally
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 ethyl-EPA-based product at a dose of 4g per day in two divided doses for 12 weeks resulted in a 33% reduction in triglycerides, 16% in total cholesterol, 29% in very low-density lipoprotein (VLDL) cholesterol, and 9% in apolipoprotein B, compared to 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 levels by 12.5% but did not reduce LDL cholesterol levels compared to placebo. Moreover, there is no solid evidence that EPA supplements alone reduce triglyceride levels in patients with hypertriglyceridemia.
Posologie
Orally
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 accidents by 25% compared to placebo after a median follow-up of 4.9 years, among patients treated with statins and having hypertriglyceridemia combined with 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 treatment reduced major vascular events by 19% during a mean follow-up of 4.6 years.
Posologie
Orally
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 research shows that taking EPA slightly reduces total cholesterol and LDL cholesterol levels compared to placebo. However, not all patients in these studies suffered from hyperlipidemia and EPA was generally supplied in oils also containing docosahexaenoic acid. Another study has shown that taking EPA in type 2 diabetic patients increases high-density lipoprotein (HDL) cholesterol level by about 12%.
Posologie
Oral route
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.
Hypertension ✪✪✪✪✪
A meta-analysis of clinical research conducted in adults with dyslipidemia shows that an EPA supplement reduces the systolic blood pressure but not diastolic compared to placebo.
Posologie
Oral route
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's not known if taking EPA supplements can treat or prevent ADHD.
Posologie
Oral route
1 - 2 g
Properties
Neurological
Fatty acids are major components of the brain and are found at high concentration 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 b2-oxidized upon entry. Omega-3 fatty acids play an active role in the function and fluidity of neuronal membranes and in the control of neuronal growth factors. They potentially influence every stage of biogenic amine function, including the synthesis, breakdown, release, reuptake, and attachment of neurotransmitters.
Usages associés
Anti-inflammatory
EPA has been shown to reduce markers of inflammation such as inflammatory cytokines and C-reactive protein. Moreover, 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 atheroma plaque stability and helps reduce the risk of myocardial infarction after a percutaneous coronary intervention.
Usages associés
Lipid-lowering
Research has shown that pure EPA reduces serum triglyceride concentrations in subjects with hypercholesterolemia, but has no effect on total cholesterol and low-density lipoprotein (LDL) cholesterol. Another study found that EPA reduces very-low-density lipoprotein (VLDL) lipoprotein and total cholesterol levels in normolipidemic individuals but had no effect on triglyceride or LDL cholesterol levels.
Usages associés
Safety 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/Anticoagulant: moderate interaction
Human research has shown that taking EPA inhibits platelet aggregation.
Antihypertensive: moderate interaction
Fish oils containing EPA can lower blood pressure and have additive effects in patients on antihypertensive treatment.
Precautions
Pregnant women: avoid
Avoid use due to lack of sufficient reliable information.
Breastfeeding women: avoid
Avoid use due to lack of sufficient reliable information.
Heart disorders: use with caution
Taking EPA, particularly at high doses, can increase the risk of arrhythmias.
