Eicosapentaenoic acid (EPA) as an adjunct in the treatment of schizophrenia

Shah, Sunil Kumar; Vankar, Ganpat; Telang, Santosh; Ramchand, C.N.; Peet, Max Minor

doi:10.1016/s0920-9964(97)88706-3

Cited by 22 publications

(5 citation statements)

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“…In addition, there was an inverse correlation between EPA and AA levels in red cell membranes suggesting that mainly EPA were responsible for its effect on the AA levels. Similar findings were also observed in another small open‐label study using 1 g of an EPA‐enriched oil (Kirunal ® ; EPA:DHA = 3 : 1) per day in 10 chronic, symptomatic patients with schizophrenia [130]. On the basis of these results Peet et al [131] randomly allocated symptomatic patients with chronic schizophrenia to an EPA enriched oil (Kirunal) and a DHA enriched oil (Doconal) or placebo.…”

Section: Methodssupporting

confidence: 66%

Implications of lipid biology for the pathogenesis of schizophrenia

Berger¹,

Wood

Pantelis

et al. 2002

Aust NZ J Psychiatry

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Peripheral blood cell, brain necropsy and 31P-MRS analysis reveal a disturbed lipid biology, suggesting generalized membrane alterations in schizophrenia. 31P-MRS data suggest increased membrane turnover at illness onset and persisting membrane abnormalities in established schizophrenia. Cellular processes regulating membrane lipid metabolism are potential new targets for antipsychotic drugs and might explain the mechanism of action of treatments such as eicosapentaenoic acid.

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Section: Methodssupporting

confidence: 66%

Implications of lipid biology for the pathogenesis of schizophrenia

Berger¹,

Wood

Pantelis

et al. 2002

Aust NZ J Psychiatry

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“…Whilst negative symptoms showed significant clinical improvement, no significant relationship to changes in fatty acid levels were found in this analysis. Similar findings were also observed in another small openlabel study using 1g of an EPA-enriched oil (Kirunal; EPA: DHA ¼ 3 : 1) per day in 10 chronic, symptomatic patients with schizophrenia (Shah, Vankar, Telang, Ramchchand, & Peet, 1998). The key limitation of all these studies was that they were not masked (double blind), however, the correlation between symptomatic improvement and normalization of EFA metabolites is suggestive that the effects are not only explained by rater bias or placebo effect.…”

Section: Efa Supplementation Studies In Schizophreniasupporting

confidence: 76%

Bioactive lipids in schizophrenia

Berger

Smesny

Amminger

2006

International Review of Psychiatry

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SummaryBioactive lipids, in particular arachidonic acid (AA), are vital for monoaminergic neurotransmission, brain development and synaptic plasticity. Phospholipases A2 (PLA2) are key-enzymes in AA metabolism and are activated during monoaminergic neurotransmission. Reduced membrane AA levels, and an altered activity of PLA2 have been found in peripheral membranes of drug-naïve patients with schizophrenia with some conflicting results in more chronic patient populations. Furthermore, in vivo brain phosphorus-31 magnetic resonance spectroscopy suggests reduced lipid membrane precursors (phosphomonoesters) and increased membrane breakdown products (phosphodiesters) in drug-naïve or early treated firstepisode schizophrenia patients compared to age-matched controls or chronic populations and these changes were correlated with peripheral red blood cell membrane AA levels. We postulate that processes modulating membrane lipid metabolism are associated with psychotic illnesses and might partially explain the mechanism of action of antipsychotic agents, as well as experimental agents such as purified ethyl-eicosapentaenoic acid (E-EPA). Recent supplementation trials suggest that E-EPA is a modestly effective augmentation treatment resulting in reduced doses of antipsychotic medication in acutely ill patients with schizophrenia (but not in residual-type schizophrenia). This review investigates the role of bioactive lipids in schizophrenia and its treatment, as well as its potential use in prevention.

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“…Puri et al (2000) have reported sustained remission of positive and negative symptoms over a 1-year period in a chronic schizophrenia patient treated with EPA alone. In another open-label study (Shah et al 2001), improvement of total scores on the Positive and Negative Syndrome Scale (PANSS) was noted in chronic schizophrenia patients following neuroleptic treatment in conjunction with EPA supplementation, with maximal response to EPA occurring in the first 6 months of treatment. Furthermore, in some of these patients, reductions in antipsychotic dose was possible.…”

Section: Discussionmentioning

confidence: 99%

Reduced Red Blood Cell Membrane Essential Polyunsaturated Fatty Acids in First Episode Schizophrenia at Neuroleptic-Naive Baseline

Reddy

Keshavan²,

Yao

2004

Schizophrenia Bulletin

143

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There is emerging evidence in schizophrenia of membrane abnormalities, primarily reductions in the essential omega-3 and omega-6 series of polyunsaturated fatty acids (PUFA). Because previous studies have largely been in chronic patients, it is not known whether these membrane abnormalities also occur early in illness. In the present study, red blood cell membrane fatty acid levels were determined by capillary gas chromatography from 24 neuroleptic-naive patients with first episode schizophrenia or schizoaffective disorder and 31 age-matched normal controls. Relative to normal subjects, patients had significant reductions in total PUFA (-13%) but not in monounsaturated or saturated fatty acids. Specifically, significant reductions were found in arachidonic acid (-18%), docosapentaenoic acid (-36%), and docosahexaenoic acid (-26%) concentrations. These reductions were not related to age, gender, smoking status, or cotinine levels. These results confirm previous findings of membrane deficits in schizophrenia and show that significant PUFA reductions occur early in the illness, prior to initiation of treatment, raising the possibility that these deficits are trait related. The findings also suggest that membrane fatty acid losses are quite specific to the highly unsaturated fatty acids.

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Eicosapentaenoic acid (EPA) as an adjunct in the treatment of schizophrenia

Cited by 22 publications

References 0 publications

Implications of lipid biology for the pathogenesis of schizophrenia

Implications of lipid biology for the pathogenesis of schizophrenia

Bioactive lipids in schizophrenia

Reduced Red Blood Cell Membrane Essential Polyunsaturated Fatty Acids in First Episode Schizophrenia at Neuroleptic-Naive Baseline

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