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Fish oil can head off first psychotic episodes

February 1, 2010 |  4:11 pm

In the lives of young people at high risk for developing serious mental illness, heading off that first psychotic episode can mean a world of difference. A new study has found that for a year after it was completed,12 weeks of dietary supplementation with Omega-3 fish oil reduced progression to full-blown psychosis in a large group of adolescents and young adults.

The study subjects were young people who did not yet meet the criteria for full-blown mental illness, but whose grip on reality had begun to come loose, prompting them to seek psychiatric care. 

At the same time, Omega-3 long-chain fatty acids--found in a range of ocean-going fish and edible sea life--improved many of the symptoms that identified these young patients as likely schizophrenics and bipolar disorder sufferers. Among the 81 young patients under observation for psychosis in an Austrian hospital, those taking fish oil supplements for two weeks showed fewer signs of disorganized or delusional thinking, more motivation, and better overall functioning than those in a comparison group, who got psychotherapy alone.

For as long as a year after their diets were supplemented by 12-weeks of fish oil capsules, patients in the intervention group continued to function better, have fewer symptoms, and were less likely to suffer a psychotic episode than those who did not get the fish oil. Roughly 5% of those on fish oil went on to develop full-blown psychosis during the study period, versus 28% of those who got psychotherapy alone.

Psychiatrists are actively debating how--and how aggressively--to treat patients with so-called "pro-dromal" signs of mental illness, or symptoms that are considered warning signs of full-blown illness to come. Studies, among them some funded by the companies that make antipsychotic medications, have found preliminary evidence that prescribing antipsychotic medication for early symptoms can head off full-blown psychosis. But, for adolescents especially, even brief use of the medications in question poses significant risks of weight gain and metabolic changes--not to mention the stigma associated with identification as a patient with a chronic mental condition.

In a measure of relative effectiveness, the present study found that fish oil supplements--which come with a wide range of unrelated health benefits (among them cardiovascular disease prevention) and no more serious side effects than "fish burps," were as effective at preventing psychotic episodes as antipsychotic medications.

-- Melissa Healy

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Comments (16)

Why limit the ingestion of fish oil like it was a prescription drug meant to be taken until symptoms abate? I've been taking six grams of fish oil a day for twenty years, for general health rather than mental health (you never know). The point is, like dieting, why limit yourself? I don't believe there are any serious contraindications to long-term use of fish oil.

Is it just fish oil? Or is it Omega-3? Has any testing been done with Flaxseed and other Omega-3 sources?

Good point, Frank. But if we don't start treating fish oil like a prescription drug, how will drug companies ever make a profit from it ;)

Why is it that every time a debate begins over treatment options, the psychopharmaceutical industry starts chirping about drugs? If fish oil (or Omega-3s) provide a benefit, isn't that an indication that "mental illness" isn't an illness at all, but rather a condition?

darenk, I don't have the information readily at hand, but I remember reading a number of years ago that excess fish oil ingestion could lead to stroke in people with certain conditions or irregularities in the circulatory system. You should consider doing some web research on this topic; there may be a good reason for a cautious approach to this supplement...

Omega fats in the right proportions are tremendously healthy, a fact the pet food industry has been waking up to for years. Our bodies, and our pets, need these essential nutrients for proper brain health.

The junk food, and I don't just mean fast food, that is on our market shelves for consumption is designed (unintentionally?) in large part to be addictive and/or destructive. Ironically, when the body begins to digest the more healthy fatty acids in whole foods it often begins to prefer those healthier foods.

It is so refreshing to see the medical community looking into dietary help for this problem. I wish ALL doctors would study more about nutrition and combatting many ailments not just mental disabilities. We as a people run to the doctor for meds first, then try other alternatives, when I think we should try natural alternatives first and run to the doctor as a last resort.

Fish burps? I found a "no burp" version of fish oil, its a heavily coated capsule meant to digest a bit lower in the gastro intestinal tract - or at least thats my guess. The other option is take it right before going to sleep - I don't know if it stops the burping, but I keep having dreams about walking through fields of bubbling mud pots in Yellowstone.

You might as well add the fact that fish oil has shown in some studies to increase cardiovascular health and some websites promote the following advantages (your mileage may vary):

The consumption of fish oil reduces the chances of all forms of cancer including breast, colon and prostate. The fatty acids found in the fish oil is quite helpful to stop the development of cancerous mass from quite a healthy cell, it inhibits the unwanted growth of cell and causes apoptosis or death or cancer cells.

Fish oil can be very significant in preventing the pregnancy complication like premature delivery and low birth weight. The consumption of fish oil during pregnancy reduces allergy in the newborns, helps in development of brain and reduce risk of post partum depression. It is better to take fish oil during the period of pregnancy.

The fish oil is very effective for the eyesight. It not only improves the eyesight but also decrease the dryness in the eyes. The fish oil helps to stop the eyesight decline with the increasing age.

The fish oil is very effective to prevent all types of depression including the schizophrenia, bipolar disorder, ADHD and anger caused depression. It is also helpful in treatment of the Huntington’s disease.

The fish oil is found effective in treatment of rheumatoid arthritis, inflammatory bowel disease, systemic lupus and other inflammatory conditions.

The recent scientific studies recognized the role of fish oil in weight regulation, it reduces craving caused by the fatty foods.

What dosage should children 11-15 years old take?

The health claims for fish oil, omega 3s and vitamin D keep getting wilder and wilder. They're beginning to sound "fishy" to me (apologies for the pun). Will be interesting to see if the pendulum swings the other way in a few years as more studies come in.

As a response to Dave--
I don't know how you're differentiating "disease" from "condition," because it's not really a meaningful distinction on the biological level, unless you're limiting "disease" to mean "infectious disease." Quite a number of genetic diseases (if we can agree to call them "disease") have nutritional triggers. In the absence of an enzyme, one type of molecule builds up instead of breaking down. The molecule itself may build up to toxic levels, or it may feed into a less-preferred chemical pathway, leading to a complex set of imbalances. Shift foods, and you can eat less of the molecule that's giving you problems, or reinforce some other pathway that's less damaging.

Perhaps unexpectedly, many single-enzyme disorders cause a distinctive set of behaviors, as well as more "traditional" disease symptoms. Google Lesch-Nyhan syndrome, for example, or porphyria. PKU is another severe metabolic genetic disease that can, to a large degree, be controlled by a diet low in a particular amino acid (thus the warnings on diet drinks, warning people with PKU not to drink them).

Mind you, I share some of your skepticism, but for a different reason. Sounds like bad study design. Only one group gets pills (and even if both got pills, only one group gets fish burps!). So the study is not effectively "double blind." That's a problem, because placebo effect can be so very strong--and no, we don't know why. Maybe trust in treatment causes bona fide relaxation, and relaxation is deeply curative for a range of ills.

Given the overfishing of so many of the oily fish species, I'm going to stick with some extra beans, nuts, whole grains and green veggies (all good omega-3 sources), long relaxing walks, and the occasional nice bit of fish. At minimum, the combination seems to be good for my digestion, my mood and my wallet. If it cures some other things at the same time, so much the better!

Way back in the seventies the sardines taht I purchased in the grocery store were packed in sardine oil. These are no loner available. Sardines are now packed in soy oil, spring water, olive oil, hot sauce, mustard, or tomato sauce, but not sardine oil. By the way, they tasted very good packed in sardine oil.

Interestingly, the Numbers Needed to Treat (NNT) to prevent one episode of psychosis is 4. That means that for every 4 people treated, one will benefit which is excellent. The confidence intervals are tight with 14 being the highest NNT. I'm impressed despite the fact that the study is very small. One problem could have been that the double blinding was violated as most people can taste the fish oil unless the tablets are frozen first.

Gee, Psychiatrists are finally starting to recognize that something other than drugs may help people. What, after what 20 years of research? Next thing you know, APA, the drug companies, & the Federal government may begin to stop scapegoating people with mental health labels as the source of most problems. One reason for so many homeless is that after one is given that label (now 25% of the U.S. Population can qualify as mentally ill, after which nearly all rights are stripped away: Take drugs, shut up and kiss our rear ...obey, obey obey, or we will punish you is still the effective policy in most places, including California - and especially in Los Angeles).

Gee, Psychiatrists are finally starting to recognize that something other than drugs may help people. What, after what 20 years of research? Next thing you know, APA, the drug companies, & the Federal government may begin to stop scapegoating people with mental health labels as the source of most problems. One reason for so many homeless is that after one is given that label (now 25% of the U.S. Population can qualify as mentally ill, after which nearly all rights are stripped away: Take drugs, shut up and kiss our rear ...obey, obey obey, or we will punish you is still the effective policy in most places, including California - and especially in Los Angeles).

I have done a lot of research on omega-3. There is more evidence for fish oil which contains the active metabolites. It is very good brain food. This is great news.



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