Omega-3 fatty acid supplementation for perinatal depression and other subpopulations?

While standard antidepressant medications are considered first-line treatments for moderate to severe major depressive disorder (MDD) in pregnant and postpartum women, many clinicians might be surprised to learn that there have been very few randomised, placebo-controlled trials of antidepressant exposure in utero and during breastfeeding has driven patients and clinicians to seek alternatives for treatment. While psychotherapies have received the most systematic study, omega-3 fatty acids (O3) have been rigorously studied in far more trials than antidepressants in either depression during pregnancy or postpartum depression. What is also notable about the study of O3 in perinatal depression in that in this population, O3 have usually been used as monotherapy, while in most studies of O3 for MDD in general, they have been studied adjunctively with standard antidepressants.