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provocative but preliminary study reported in the Archives
of General Psychiatry earlier this year has stimulated interest
in the use of omega-3 fatty acids found in fish oil as potential
mood stabilizers in bipolar disorder.
Thirty
studyparticipants with bipolar disorder who had experienced
a manic or hypomanic episode within the previous year were
randomly assigned to receive either fish oil fatty acids or
olive oil in addition to their regular medications. One-third
had four or more manic or depressive episodes in the prior
year (rapid cycling). The fish oil (consisting of 6.2 grams
of so-called EPA and 3.4 grams of DHA) or the olive oil was
given as 14 capsules, divided into two doses.
Over a
four-month period, only three of 14 (21 percent) of the participants
receiving the fish oil capsules in addition to regular medications
had an episode of illness that required changing medications
and leaving the study. In contrast, 10 of 16 (62 percent)
participants receiving olive oil in addition to regular medications
had such an episode and had to change medications and leave
the study. Side effects of the fish oil fatty acids were primarily
gastrointestinal, usually loose stools, which occurred in
two-thirds of the participants and occasionally required lowering
the dose. The fish oils often produced a fishy aftertaste.
There
are several theories about how fatty acids act to stabilize
mood, including affecting the transmission of nerve signals,
correcting a deficiency in brain fatty acids, or stimulating
neurotransmitters such as serotonin. Although there have been
a few other small studies suggesting similar benefits, all
studies to date have had design flaws, and larger trials are
needed to establish a convincing case for the use of omega-3
fatty acids in bipolar illness. Because of several case reports
of similar improvements in people with schizophrenia, the
Stanley Foundation/NAMI Research Institute is also funding
a study of omega-3 fatty acids in consumers with this disorder.
If you
decide to try fish oil as a treatment for bipolar illness
before the results are in from larger studies, you should
add it to your standard medications rather than substitute
it for them. And as always, please consult your doctor before
making any medication change.
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