Omega-3 Polyunsaturated Fatty Acids Can Prevent Relapse in First-episode Schizophrenia: the Results of Offer Trial

Abstract

Introduction: Omega-3 polyunsaturated fatty acids (n3-PUFA) are major constituents of the neural membranes. N-3 PUFA take part in several neuronal mechanisms, including modulation and control of neurobiological processes, such as ion channel and receptor activity, neurotransmitter release, synaptic plasticity, second messenger pathways and neuronal gene expression. Deficiency in n-3 PUFA has been postulated in the etiology of schizophrenia. Intervention trials supplementing n-3 PUFA were conducted to assess the efficacy of n-3 PUFA in reducing symptom severity in exacerbations of chronic schizophrenia and acute phase of first-episode schizophrenia. The results were n-3 PUFA were found to prevent conversion to psychosis in clinical high risk populations. Objectives: To assess the efficacy n-3 PUFA as add-on treatment in relapse prevention in first-episode schizophrenia patients. Methods: We conducted a randomized, double-blind, placebo-controlled, parallel-group single-center 6 months augmentation trial of either 2,2 g per day of n-3 PUFA or placebo added on to an adjustable dose of antipsychotic medication in first-episode schizophrenia patients. Intervention was composed of either 1320 mg/day of eicosapentaenoic acid plus 880 mg/day of docosahexaenoic acid or placebo olive oil. The relapse rate was observed during a follow up period of 12 months. Results: 71 patients completed the study (41% female). Relapse was observed in 4 patients (11.4%) enrolled in n-3 PUFA group and 12 patients (33.3%) in placebo group over a period of 12 months. The difference was statistically significant (log rank test, p=0.0225). Conclusions: The results indicate, that n-3 PUFA add-on therapy can effectively prevent relapses in firstepisode schizophrenia patients.

Toward prevention of bipolar disorder in at-risk children: Potential strategies ahead of the data

“…The data on prevention of progression of the prodrome in schizophrenia are intriguing including on long term follow up of 6.8 years ( Amminger et al, 2015 ). A new study by McGorry et al (2017) did not replicate these finding, but there were many potential explanations including the high use of antidepressants, high rates of non-adherence, and the concomitant use of cognitive-behavioral interventions in both arms, Interestingly, Pawelczyka et al (2015) reported success of omega-3-FA.in decreasing the rate of relapse after a first episode of schizophrenia. Preliminary and open studies in the bipolar spectrum are promising ( Bozzatello et al, 2016 ; Fristad et al, 2015 ; Wozniak et al, 2007 ).…”