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Are ω3 Fatty Acids Beneficial in Depression but Not Mania?

Kuan-Pin Su, MD; Winston W. Shen, MD; Shih-Yi Huang, PhD
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Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

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Arch Gen Psychiatry. 2000;57(7):716-716. doi:10.1001/archpsyc.57.7.716
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In their innovative preliminary trial, Stoll et al1 concluded that ω3 fatty acids were well tolerated and improved the short-term course of illness in patients with bipolar disorder. Although only 120 days in the blind phase, this study was reasonably well-designed. The primary outcome measure was the length of time to complete the blind phase of the study without any treatment-emergent mood episodes, but the results as shown in Table 21 also showed that all of the "noncompleted" cases (3 of 14 cases) in the ω3 group developed a manic episode (mania, hypomania, and worsening of mixed state), whereas the depressive symptoms of all of the noncompleted cases (10 of 16 cases), except 1 in the placebo group, worsened! The aforementioned observation might suggest the hypothesis that ω3 fatty acids could prevent depression but not mania among the bipolar patients. To test this hypothesis, future research should design a way to compare the ω3 fatty acid treatment effectiveness between depressive and manic phases of patients with bipolar disorder.

In addition, we suggest that the patients in the placebo group should also receive tertiary butylhydroquinone and tocopherols as they did in the ω3 fatty acids group, to avoid the possible therapeutic effect from this compound as a confounding factor, and that the concern of having a "fishy" aftertaste in the ω3 fatty acids group can be amended by blending an orange flavor into the gelatin capsules for the ω3 fatty acids and placebo groups.2

REFERENCES

Stoll  AL, Severus  WE, Freeman  MP, Rueter  S, Zboyan  HA, Diamond  E, Cress  KK, Marangell  LB. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1999;56407- 412
Sellmayer  A, Witzgall  H, Lorenz  RL, Weber  PC. Effects of dietary fish oil on ventricular premature complexes. Am J Cardiol. 1995;76974- 977

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Stoll  AL, Severus  WE, Freeman  MP, Rueter  S, Zboyan  HA, Diamond  E, Cress  KK, Marangell  LB. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry. 1999;56407- 412
Sellmayer  A, Witzgall  H, Lorenz  RL, Weber  PC. Effects of dietary fish oil on ventricular premature complexes. Am J Cardiol. 1995;76974- 977

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