A Placebo-Controlled Trial of Omega-3 Fatty Acid (Ethyl Eicosapentaenoic Acid) Supplementation for Residual Symptoms and Cognitive Impairment in Schizophrenia

Fenton, Wayne S.; Dickerson, Faith; Boronow, John; Hibbeln, Joseph R.; Knable, Michael B.

doi:10.1176/appi.ajp.158.12.2071

Cited by 282 publications

(130 citation statements)

References 11 publications

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“…Controlled clinical trials in established schizophrenia indicate that either sole or augmentation therapy with omega-3 fatty acids may be beneficial (Emsley et al, 2002;Joy et al, 2006;Mellor et al, 1996;Peet et al, 2001), with some conflicting results (Emsley et al, 2006;Fenton et al, 2001;Peet and Horrobin, 2002a, b). Furthermore, controlled clinical trials in treatment-resistant depression (Nemets et al, 2002;Peet and Horrobin, 2002a, b), bipolar depression (Keck et al, 2006), bipolar affective disorder (Stoll et al, 1999), borderline personality disorder (Zanarini and Frankenburg, 2003), incarcerated young males (Gesch et al, 2002), and children with developmental coordination disorders (Richardson and Montgomery, 2005) also suggest that omega-3 fatty acids may modulate mood, impulsivity, and aggression, while potential neuroprotective effects were found in Huntington's disease (Puri et al, 2002(Puri et al, , 2005.…”

Section: Introductionmentioning

confidence: 99%

Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study

Berger

Wood

Wellard

et al. 2008

Neuropsychopharmacol

108

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Ethyl-eicosapentaenoic acid (E-EPA) is an omega-3 fatty acid that has been used in a range of neuropsychiatric conditions with some benefits. However, its mechanism of action is unknown. Here, we investigate its effects on in vivo brain metabolism in first-episode psychosis (FEP). Proton magnetic resonance spectroscopy at 3 T was performed in the temporal lobes of 24 FEP patients before and after 12 weeks of treatment in the context of a larger double-blind, placebo-controlled E-EPA augmentation study. Treatment group effects for glutathione (F1,12 ¼ 6.1, p ¼ 0.03), and a hemisphere-by-group interaction for glutamine/glutamate (F1,20 ¼ 4.4, p ¼ 0.049) were found. Glutathione increased bilaterally and glutamate/glutamine increased in the left hemisphere following E-EPA administration. Improvement in negative symptoms correlated with metabolic brain changes, particularly glutathione (r ¼ À0.57). These results suggest that E-EPA augmentation alters glutathione availability and modulates the glutamine/glutamate cycle in early psychosis, with some of the metabolic brain changes being correlated with negative symptom improvement. Larger confirmatory studies of these postulated metabolic brain effects of E-EPA are warranted.

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Section: Introductionmentioning

confidence: 99%

Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study

Berger

Wood

Wellard

et al. 2008

Neuropsychopharmacol

108

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“…Their study could only show important and statistically significant beneficial effects of 2 g daily EPA in the presence of clozapine, while their placebo group receiving antipsychotics alone also showed a positive response. Further, Fenton and others, researching a relatively large cohort of 75 subjects with schizophrenia, could find no effect of 3 g daily ethyl-EPA on all ratings measured (84). As stated in a recent review by Joy and others (85), more results are urgently needed before fish oil or ethyl-EPA can be regarded as beneficial in the treatment of schizophrenia.…”

Section: Psychological Stressmentioning

confidence: 96%

Essential Fatty Acids and the Brain

2003

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Objective: To review the role of essential fatty acids in brain membrane function and in the genesis of psychiatric disease. Method: Medline databases were searched for published articles with links among the following key words: essential fatty acids, omega-3 fatty acids, docosahexanoic acid, eicosapentanoic acid, arachidonic acid, neurotransmission, phospholipase A2, depression, schizophrenia, mental performance, attention-deficit hyperactivity disorder, and Alzheimer's disease. Biochemistry textbooks were consulted on the role of fatty acids in membrane function, neurotransmission, and eicosanoid formation. The 3-dimensional structures of fatty acids were obtained from the Web site of the Biochemistry Department, University of Arizona (2001). Results: The fatty acid composition of neuronal cell membrane phospholipids reflects their intake in the diet. The degree of a fatty acid's desaturation determines its 3-dimensional structure and, thus, membrane fluidity and function. The ratio between omega-3 and omega-6 polyunsaturated fatty acids (PUFAs), in particular, influences various aspects of serotoninergic and catecholaminergic neurotransmission, as shown by studies in animal models. Phospholipase A2 (PLA2) hydrolyzes fatty acids from membrane phospholipids: liberated omega-6 PUFAs are metabolized to prostaglandins with a higher inflammatory potential, compared with those generated from the omega-3 family. Thus the activity of PLA2 coupled with membrane fatty acid composition may play a central role in the development of neuronal dysfunction. Intervention trials in human subjects show that omega-3 fatty acids have possible positive effects in the treatment of various psychiatric disorders, but more data are needed to make conclusive directives in this regard. Conclusion: The ratio of membrane omega-3 to omega-6 PUFAs can be modulated by dietary intake. This ratio influences neurotransmission and prostaglandin formation, processes that are vital in the maintenance of normal brain function.

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“…Alternatively, the 'cAMP signal transduction hypothesis' suggests depression to be caused by impaired phospholipid metabolism and impaired FA-related signal transduction (due to inadequate intake of fish and n-3 FA) and may also explain the association between depression and CVD (46) . There have been small clinical trials based in developed countries (USA, Israel and the UK) examining the impact on depressed patients of FA supplementation but results are varied, with some studies showing an improvement in depressive symptoms following FA supplementation (47)(48)(49) and others not (50) .…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 99%

Psychological distress, gender and dietary factors in South Asians: a cross-sectional survey

Bhattacharyya

Marston

Walters

et al. 2013

Public Health Nutr.

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Objective: Psychological distress, defined as symptoms of depression and anxiety, is an increasingly important public health issue in developing countries. Little is known about the extent to which adverse dietary factors are associated with psychological distress in South Asians. Our aim was to compare the associations of diet and psychological distress in men and women in Goa, India. Design: Cross-sectional study of consecutive attendees in nine urban and rural general practices in Goa, India in 2004-2005. All participants completed an FFQ on their dietary intake in a typical week. Psychological distress was measured using the Kessler Psychological Distress Scale (K10), a WHO-validated screening instrument. Results: Consecutive attendees (n 1512; 601 men and 911 women) aged 30 to 75 years participated. Moderate and high scores of psychological distress were detected in significantly more women than men (eighty-eight men v. 264 women, unadjusted OR 5 0?39; 95 % CI 0?29, 0?52). Those who ate one or more portions of fish weekly had nearly half the prevalence of distress in both sexes (women, OR 5 0?52; 95 % CI 0?29, 0?91; men, OR 5 0?50; 95 % CI 0?25, 0?99) and this was independent of age, marital status, education, income, religion and living alone. Conclusions: Psychological distress is significantly lower with fish intake in both sexes. Further longitudinal work is needed to establish temporal relationships. Addressing psychological distress is becoming an increasingly significant public health priority in both high-and low-income countries.

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A Placebo-Controlled Trial of Omega-3 Fatty Acid (Ethyl Eicosapentaenoic Acid) Supplementation for Residual Symptoms and Cognitive Impairment in Schizophrenia

Abstract: For schizophrenia patients treated with 3 g/day of ethyl EPA, improvement in residual symptoms and cognitive impairment was no greater than for schizophrenia patients treated with placebo.

Cited by 282 publications

References 11 publications

Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study

Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study

Essential Fatty Acids and the Brain

Psychological distress, gender and dietary factors in South Asians: a cross-sectional survey

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