A randomized, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia

Emsley, Robin; Chiliza, Bonginkosi; Asmal, Laila; Plessis, Stéfan du; Phahladira, Lebogang; Niekerk, Evette van; Rensburg, Susan J. van; Harvey, Brian H.

doi:10.1016/j.schres.2014.06.004

Cited by 62 publications

(59 citation statements)

References 27 publications

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“…Two exceptions are the studies published by Amminger [15] and Markulev [16], which considered patients at high risk for developing psychosis. Peet et al [17] and Emsley et al [18] designed trials with omega-3 HUFAs as a monotherapy, but in both cases, almost all patients needed to be treated also with an antipsychotic drug during the course of the trial. Only six RCTs [15,17,19,20,21,22] reported that HUFAs had a benefit on positive or negative symptoms.…”

Section: Methodsmentioning

confidence: 99%

“…On the contrary, combining EPA and the vitamins neutralized this detrimental effect. Emsley and colleagues [18] tested a combination of omega-3 polyunsaturated fatty acids (EPA 2 g/day and DHA 1 g/day) and a metabolic antioxidant, alpha-lipoic acid (α-LA 300 mg/day), as prevention treatment of relapse after antipsychotic discontinuation in subjects who were successfully treated for 2–3 years after a first-episode of schizophrenia or schizoaffective disorder. Unfortunately, this study was affected by a small sample size and by premature termination of recruitment due to the high relapse rates and the severity of the relapse episodes.…”

Section: Methodsmentioning

confidence: 99%

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Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data

Bozzatello

Brignolo

Borghi

et al. 2016

JCM

147

109

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A new application for omega-3 fatty acids has recently emerged, concerning the treatment of several mental disorders. This indication is supported by data of neurobiological research, as highly unsaturated fatty acids (HUFAs) are highly concentrated in neural phospholipids and are important components of the neuronal cell membrane. They modulate the mechanisms of brain cell signaling, including the dopaminergic and serotonergic pathways. The aim of this review is to provide a complete and updated account of the empirical evidence of the efficacy and safety that are currently available for omega-3 fatty acids in the treatment of psychiatric disorders. The main evidence for the effectiveness of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) has been obtained in mood disorders, in particular in the treatment of depressive symptoms in unipolar and bipolar depression. There is some evidence to support the use of omega-3 fatty acids in the treatment of conditions characterized by a high level of impulsivity and aggression and borderline personality disorders. In patients with attention deficit hyperactivity disorder, small-to-modest effects of omega-3 HUFAs have been found. The most promising results have been reported by studies using high doses of EPA or the association of omega-3 and omega-6 fatty acids. In schizophrenia, current data are not conclusive and do not allow us either to refuse or support the indication of omega-3 fatty acids. For the remaining psychiatric disturbances, including autism spectrum disorders, anxiety disorders, obsessive-compulsive disorder, eating disorders and substance use disorder, the data are too scarce to draw any conclusion. Concerning tolerability, several studies concluded that omega-3 can be considered safe and well tolerated at doses up to 5 g/day.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data

Bozzatello

Brignolo

Borghi

et al. 2016

JCM

147

109

View full text Add to dashboard Cite

show abstract

“…Concordant with these observations, n-3 PUFA supplementation failed to confer benefit to patients with first episode schizophrenia and in the prevention of the illness [243,244]. Meta-analyses similarly revealed no benefit of n-3 supplementation in those with established schizophrenia [245].…”

Section: Lipid Rafts Mlrs and N-3 Pufas In Schizophreniamentioning

confidence: 95%

The Deleterious Effects of Oxidative and Nitrosative Stress on Palmitoylation, Membrane Lipid Rafts and Lipid-Based Cellular Signalling: New Drug Targets in Neuroimmune Disorders

Morris¹,

Walder

Puri

et al. 2015

Mol Neurobiol

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Oxidative and nitrosative stress (O&NS) is causatively implicated in the pathogenesis of Alzheimer's and Parkinson's disease, multiple sclerosis, chronic fatigue syndrome, schizophrenia and depression. Many of the consequences stemming from O&NS, including damage to proteins, lipids and DNA, are well known, whereas the effects of O&NS on lipoprotein-based cellular signalling involving palmitoylation and plasma membrane lipid rafts are less well documented. The aim of this narrative review is to discuss the mechanisms involved in lipid-based signalling, including palmitoylation, membrane/lipid raft (MLR) and n-3 polyunsaturated fatty acid (PUFA) functions, the effects of O&NS processes on these processes and their role in the abovementioned diseases. S-palmitoylation is a post-translational modification, which regulates protein trafficking and association with the plasma membrane, protein subcellular location and functions. Palmitoylation and MRLs play a key role in neuronal functions, including glutamatergic neurotransmission, and immune-inflammatory responses. Palmitoylation, MLRs and n-3 PUFAs are vulnerable to the corruptive effects of O&NS. Chronic O&NS inhibits palmitoylation and causes profound changes in lipid membrane composition, e.g. n-3 PUFA depletion, increased membrane permeability and reduced fluidity, which together lead to disorders in intracellular signal transduction, receptor dysfunction and increased neurotoxicity. Disruption of lipid-based signalling is a source of the neuroimmune disorders involved in the pathophysiology of the abovementioned diseases. n-3 PUFA supplementation is a rational therapeutic approach targeting disruptions in lipid-based signalling.

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“…A randomised, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia (5) This study investigated whether a combination of omega-3 polyunsaturated fatty acids (ω-3 PUFAs) and a metabolic antioxidant, alpha-lipoic acid (α-LA), is effective in preventing relapse after antipsychotic discontinuation, in subjects who were successfully treated for 2-3 years after a first-episode of schizophrenia, schizoaffective or schizophreniform disorder.…”

Section: Omega-3 Fatty Acids In Psychological Disorders D Ariyasinghementioning

confidence: 99%

Omega-3 fatty acids in psychological disorders

Ariyasinghe

Williams

2016

Sri Lanka J. Psyc.

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A randomized, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia

Cited by 62 publications

References 27 publications

Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data

Supplementation with Omega-3 Fatty Acids in Psychiatric Disorders: A Review of Literature Data

The Deleterious Effects of Oxidative and Nitrosative Stress on Palmitoylation, Membrane Lipid Rafts and Lipid-Based Cellular Signalling: New Drug Targets in Neuroimmune Disorders

Omega-3 fatty acids in psychological disorders

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