Omega-3 fatty acids in bipolar disorder: Clinical and research considerations

Marangell, Lauren B.; Suppes, Trisha; Ketter, Terence A.; Dennehy, Ellen B.; Zboyan, Holly A.; Kertz, Barbara; Nierenberg, Andrew A.; Calabrese, Joseph R.; Wisniewski, Stephen R.; Sachs, Gary S.

doi:10.1016/j.plefa.2006.07.008

Cited by 27 publications

(26 citation statements)

References 46 publications

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“…Wozniak et al [45] found that monotherapy with EPA plus DHA was associated with modest improvements in manic symptoms in an 8-week study for pediatric bipolar disorder. The results of a randomized, double-blind, placebo-controlled pilot study of DHA for medication-free patients (n = 10) suggest that, although results of the trial are not sufficient to support a recommendation of monotherapy treatment as a substitute for standard pharmacological treatments, DHA was well tolerated and a larger study of monotherapy would be feasible [46]. However, a previous 16-week randomized controlled trial of n–3 augmentation for pediatric (ages 6– 17 years) bipolar disorder demonstrated that flax oil containing ALA (a dietary precursor of n–3 fatty acids with inefficient conversion to EPA and DHA) as adjunctive treatment or monotherapy did not demonstrate better mood stabilization than placebo (olive oil) in patients with bipolar I or II disorder (n = 51) [47].…”

Section: Resultsmentioning

confidence: 99%

Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review

Sylvia

Peters

Deckersbach

et al. 2012

Psychother Psychosom

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Background: Pharmacotherapy is the first line of treatment for bipolar disorder, but many patients continue to experience persistent subthreshold symptoms. Alternative adjunct treatments, including nutritional therapies, may have the potential to alleviate residual symptoms and improve the outcomes of standard pharmacotherapy. The aim of this paper is to critically review the current clinical evidence and mechanisms of action of nutrient-based therapies alone or in combination with commonly used pharmacotherapies for mania and bipolar depression. Methods: We conducted a Medline search for clinical trials conducted with humans, published in English from 1960 to 2012 using nutritional supplements such as n–3, chromium, inositol, choline, magnesium, folate and tryptophan alone or in combination with pharmacotherapies for the treatment of bipolar disorder. Results: Preliminary data yields conflicting but mainly positive evidence for the use of n–3 fatty acids and chromium in the treatment of bipolar depression. Limited evidence found that inositol may be helpful for bipolar depression, but larger sample sizes are needed. Preliminary randomized, controlled trials suggest that choline, magnesium, folate and tryptophan may be beneficial for reducing symptoms of mania. Conclusions: Given the potential public health impact of identifying adjunct treatments that improve psychiatric as well as physical health outcomes, nutritional treatments appear promising for the management of bipolar disorder but require further study.

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Section: Resultsmentioning

confidence: 99%

Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review

Sylvia

Peters

Deckersbach

et al. 2012

Psychother Psychosom

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“…Studies on pediatric patients have shown promising results, although they are limited due to being open label and with a limited sample size (76)(77)(78)(79)(80). Fragou (81) conducted a placebo-controlled study in adults using 1-2 g/d of E-EPA and observed a modest improvement in severity of illness.…”

Section: Bipolar Disordermentioning

confidence: 99%

(N-3) Fatty Acids: Molecular Role and Clinical Uses in Psychiatric Disorders

Prior¹,

Galduróz

2012

Advances in Nutrition

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New discoveries in the field of neurophysiology and neuropharmacology have revealed the role of (n-3) fatty acids in controlling inflammation and protecting neuron cells from oxidative damage, preserving their function. It has also been thought that their psychoactive properties could be beneficial in certain psychiatric illnesses. This article discusses the newest discoveries of the affected activities by these fats in the cerebral cortex and the efforts that have been made to put them in practice in clinical trials in humans. In general, we were able to detect certain discord in the scientific community when designing placebo-based studies (mainly in establishing the appropriate therapeutic dose of (n-3) fatty acids, varying from the recommended dietary dose to an amount that may be 3 or 4 times higher), and in interpreting results. Although many studies have had the validity of their results questioned because of their small sample size, several studies seem to indicate that the (n-3) fatty acids are useful therapeutic tools in treating psychiatric conditions such as major depression, bipolar disorder, and several other disorders. Larger sample size studies are still required to better analyze the treatment potential of these agents.

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“…However, the Tinbergens could have been closer to the truth than Kruuk acknowledges, not concerning a vitamin deficiency (although that is possible; see Carney, 1990), but because of a lack of fatty acids (Assies et al, 2004;Freeman et al, 2006;Frasure-Smith, Lespérance and Julien, 2004;Marangell et al, 2006;McNamara, 2006;Nemets et al, 2006;Peet and Horrobin, 2002;Sears, 2002;Stoll, 2001;Stoll et al, 1999;Su et al, 2003;Tiemeier et al, 2003). Actually, Niko's whole behaviour and disease is consistent with such a possibility (see below).…”

Section: Depressionmentioning

confidence: 95%

Niko Tinbergen's life and work: a new approach to biology

Mysterud¹

2007

Social Science Information

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The life and work of the eminent ethologist and Nobel laureate Nikolaas Tinbergen played an essential role in the introduction of a new approach that is transforming the scientific understanding of animal behaviour, human nature and evolution. This article focuses on an extremely well-written biography of him, Niko's Nature, by Hans Kruuk, one of Tinbergen's former students. Niko's Nature is more than a biography: it is a presentation and an evaluation of the main lines of European ethology and behaviour research in the 20th century up to the 1980s. Tinbergen suffered from depression most of his adult life, and if he had been a child today, he probably would have been diagnosed as hyperactive (ADHD). Tinbergen fits into a pattern of lifelong fatty-acid deficiency. I also discuss other possible causes of his problems (like protein intolerance, vitamin deficiency, genetics and novel environmental factors) andspeculate how Tinbergen would have approached such issues if he were alive today.

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Omega-3 fatty acids in bipolar disorder: Clinical and research considerations

Cited by 27 publications

References 46 publications

Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review

Nutrient-Based Therapies for Bipolar Disorder: A Systematic Review

(N-3) Fatty Acids: Molecular Role and Clinical Uses in Psychiatric Disorders

Niko Tinbergen's life and work: a new approach to biology

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