A randomized trial of omega-3 fatty acids plus inositol versus N-acetylcysteine for the treatment of depression and mania in emotionally dysregulated youth age 5-17 with and without autism traits.

Open-label randomized trial in youth aged 5-17 with emotional dysregulation, with and without autism traits. One arm took omega-3 fatty acids plus inositol: 1020 mg EPA plus 1000-2000 mg inositol daily. The other took N-acetylcysteine 1800-2700 mg daily. Duration was 6 weeks. Both groups improved modestly on mania and depression. Between-group comparisons found no significant difference in effectiveness. Within-group, the omega-3 arm improved significantly on parent-rated depression (Children's Depression Inventory). The NAC arm improved significantly on social responsiveness and executive functioning measures. In participants with autism traits, NAC was more effective than omega-3 for mania but not depression. Limitations: open-label design, no placebo arm, participant count not stated in the abstract, 6-week duration. This is a psychiatric population, not an adult longevity cohort. It does not change omega-3 evidence for aging outcomes.

These results suggest that O3I and NAC may be beneficial for mania and depression in youth, with trends towards O3I more effective for depression and NAC more effective for mania.