{"title":"Can Omega-3 fatty acid supplementation support the clinical management of drug-resistant epilepsy? A meta-analysis of randomized controlled trials","authors":"Xianghong Meng , Wu-Chen Wu , Kequan Zhou","doi":"10.1016/j.seizure.2025.03.003","DOIUrl":null,"url":null,"abstract":"<div><div>Approximately 30-40% of individuals with epilepsy develop drug-resistant epilepsy (DRE), a condition associated with substantial socioeconomic and psychological burdens for patients and their families. As standard anti-epileptic therapies often prove insufficient, alternative treatments have become a critical area of research. Dietary interventions, such as the ketogenic diet, have shown promise, and emerging evidence highlights the potential role of omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), due to their neuroprotective and anticonvulsant properties. However, the clinical application of omega-3 fatty acids for DRE remains uncertain due to limited high-quality randomized controlled trials (RCTs). To address this gap, we conducted a meta-analysis incorporating newly published RCTs to evaluate the clinical efficacy of omega-3 fatty acid supplementation as an adjunct to standard anti-epileptic medications in both children and adults with DRE. Our meta-analysis, incorporating high-quality RCTs, provides moderate-certainty evidence that omega-3 fatty acid supplementation, particularly at doses between 0.3 and 1.7 g/day, is associated with a reduction in seizure frequency in individuals with DRE. Notably, larger RCTs (sample size >30) demonstrated more consistent favorable outcomes. However, the evidence primarily reflects short-term effects, as the majority of included studies were of limited duration. These findings underscore the potential role of omega-3 fatty acids as an adjunctive therapy for DRE while highlighting the need for larger, long-term trials to better understand their clinical utility.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"127 ","pages":"Pages 77-87"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seizure-European Journal of Epilepsy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1059131125000652","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Approximately 30-40% of individuals with epilepsy develop drug-resistant epilepsy (DRE), a condition associated with substantial socioeconomic and psychological burdens for patients and their families. As standard anti-epileptic therapies often prove insufficient, alternative treatments have become a critical area of research. Dietary interventions, such as the ketogenic diet, have shown promise, and emerging evidence highlights the potential role of omega-3 fatty acids, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), due to their neuroprotective and anticonvulsant properties. However, the clinical application of omega-3 fatty acids for DRE remains uncertain due to limited high-quality randomized controlled trials (RCTs). To address this gap, we conducted a meta-analysis incorporating newly published RCTs to evaluate the clinical efficacy of omega-3 fatty acid supplementation as an adjunct to standard anti-epileptic medications in both children and adults with DRE. Our meta-analysis, incorporating high-quality RCTs, provides moderate-certainty evidence that omega-3 fatty acid supplementation, particularly at doses between 0.3 and 1.7 g/day, is associated with a reduction in seizure frequency in individuals with DRE. Notably, larger RCTs (sample size >30) demonstrated more consistent favorable outcomes. However, the evidence primarily reflects short-term effects, as the majority of included studies were of limited duration. These findings underscore the potential role of omega-3 fatty acids as an adjunctive therapy for DRE while highlighting the need for larger, long-term trials to better understand their clinical utility.
期刊介绍:
Seizure - European Journal of Epilepsy is an international journal owned by Epilepsy Action (the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.