|  Fish Oil Improves Outcome for Bipolar Disorder Patients

Fish Oil Improves Outcome for Bipolar Disorder Patients

This was a groundbreaking study at the time, and further research has been carried out since that time– see below.

ABSTRACT: A 4-month, double-blind, placebo-controlled study was conducted comparing omega-3 fatty acids (9.6 g/d) vs placebo (olive oil), in addition to usual treatment, in 30 patients with bipolar disorder. A Kaplan-Meier survival analysis of the cohort found that the Omega-3 fatty acid patient group had a significantly longer period of remission than the placebo group (P = .002; Mantel-Cox). In addition, for nearly every other outcome measure, the omega-3 fatty acid group performed better than the placebo group. Omega3 fatty acids were well tolerated and improved the short-term course of illness in this preliminary study of patients with bipolar disorder.

Dr. Cass Comments on the Study:
This study is a step in the right direction, treating underlying cause in a natural way, to replace the standard practice of medicating as the first (usually, only) step in treatment. An implication of this study is that the fish oil acts on a physiological level to balance a biochemical deficiency, moving toward the (ortho)molecular model of psychiatry as opposed to merely treating symptoms, and has none of the drugs’ side effects including inducing mania in depressed bipolar patients. The results are not surprising to those of us who practice orthomolecular medicine, which looks for specific deficiencies and supplies the missing nutrients. The brain, and nervous system in general has a large fatty acid component, so replenishing deficiencies in this particular essential nutrient is likely to help restore normal function. In my own practice, I find that lower doses of fish oil will work when combined with other supplements, such as vitamins, minerals, and amino acids that are often deficient in these cases, and work together to help restore balance. Omega-3 fatty acids have also proved useful in treating attention deficit disorder (ADD) and ADHD (attention deficit hyperactivity disorder), which has great relevance to the current excessive use of stimulant medications such as Ritalin (methylphenidate) used in treating these (mostly young) patients.

  1. Stoll AL, Severus WE, Freeman MP, Rueter S et al. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry 1999 May;56(5):407-12.

Update 2011:

Therapeutic Use of Omega-3 Fatty Acids in Bipolar Disorder

Abstract: Bipolar disorder (BD) is a severe chronic affective disorder, associated with significant disability, morbidity and premature mortality. Omega-3 polyunsaturated fatty acids (PUFAs) play several important roles in brain development and functioning. Evidence from animal models of dietary omega-3 (n-3) PUFA deficiency suggest that these fatty acids are relevant to promote brain development and to regulate behavioral and neurochemical aspects related to mood disorders, such as stress responses depression and aggression, as well as dopaminergic content and function. Preclinical and clinical evidence suggests roles for PUFAs in BD. n-3 PUFAs seem to be an effective adjunctive treatment for unipolar and bipolar depression, but further large-scale, well-controlled trials are needed to examine its clinical utility in BD. The use of n-3 as a mood stabilizer among BD patients is discussed here. This article summarizes the molecular pathways related to the role of n-3 as a neuroprotective and neurogenic agent, with a specific focus on BDNF. It is proposed that the n-3–BDNF association is involved in the pathophysiology of BD and represents a promising target for developing a novel class of rationally devised therapies.

Conclusion: Epidemiological, biochemical, experimental and intervention evidence is still limited, but support the hypotheses that low PUFA status is involved in the pathogenesis of BD and that n-3 supplementation is useful for BD, especially to treat depressive symptoms. Longer-term, well-controlled RCTs are justified to confirm this efficacy and establish the minimum dose and length of supplementation required to significantly improve intermediate and clinical outcomes in BD. It is proposed that the n-3–BDNF connection is involved in the pathophysiology of BD and represents a promising target for developing a novel class of rationally devised therapies.

Bipolar disorder is a severe disorder, which is frequently associated with chronic conditions, such as CVD and MetS. Benefits of n-3 fatty acids have been shown for these disorders.[217] n-3 PUFAs are safe and well-tolerated nutrients[218] and only mild, transient adverse events, such as nausea, are likely to occur.[116,183] Moreover, they represent an appealing option for patients their relatives and clinicians because they are relatively cheap and perceived as a ‘natural remedy’. Altogether, it is predicted that supplementation with n-3 PUFAs will benefit the physical health of BD patients. To our knowledge, this hypothesis has not been tested to date.