Fish Oil Helps Minimize Disorders for Those at Risk of Schizophrenia

The new research is the first to document rigorously the impact of fish oil supplements as a means of preventing severe psychiatric disease. The apparent effects of a brief regimen of fish oil capsules were both lasting and far-ranging in a population of young adults whose mental health is fragile, the Los Angeles Times reported on Wednesday.

Published this week in Nature Communications, the latest study adds further luster to fish oil's reputation as potentially powerful psychiatric therapy.

Omega-3 fatty acids--found plentifully in fatty fish such as salmon and mackerel but also available in fish oil capsules--have long been shown to boost the effectiveness of antidepressants and to improve attention both in those with ADHD and those without attention deficit hyperactivity disorder.

In the young and cognitively healthy, fish oil supplementation has been found to improve working memory performance as well.

In the new study, researchers focused on a population of young people who are uniquely vulnerable to developing severe mental illness. The trial drew subjects between the ages of 13 and 25 who were reporting low-level or transient hallucinations or delusional thinking, or who had a family history of severe mental illness and whose functioning at school, work or home had begun to deteriorate.

On average, young people who fall into one or more of these categories are thought to have a 35% to 40% chance of developing schizophrenia--a lifelong condition marked by disabling disturbances of thinking and perception. And nearly 7 in 10 will develop other psychiatric disorders, including major depression, bipolar disorder and substance dependency.

Psychiatrists are keenly interested in measures that might head off such outcomes. Once a psychotic break happens in a person's late teens or early 20s, his or her ongoing symptoms generally require medication that has a range of difficult side effects. And those medications fail to treat schizophrenia's other debilitating symptoms: difficulty in planning, organization, motivation and executive function.

Some research suggests that early treatment with antipsychotic medications might help prevent a person's conversion to psychotic disorder. But the risks of weight gain, metabolic disturbances and movement disorders that come with such medications are difficult to justify in young people who, while troubled, are not yet floridly delusional.

Of 81 young people in Vienna who had sought psychiatric treatment and were drawn into the study, 41 got a daily dose of fish oil that contained 700 milligrams of Eicosapentaenoic acid (EPA)  and 480 milligrams of Docosahexaenoic acid (DHA) for 12 weeks. Another 40 study subjects got a placebo capsule to take daily.

Roughly seven years later, researchers found clear differences in outcomes between the two groups. Among those who had gotten the placebo capsules, 40% had suffered a full-blown psychotic episode and were diagnosed as suffering psychotic disorder; among those who got the Omega-3s, just under 10% had progressed to psychotic disorder.  And those who got the placebo had converted to full-blown illness more quickly than subjects who had taken fish oil.

While 54% in the placebo group were found on follow-up to have been prescribed antipsychotic medication, 29% of those in the fish-oil group had had such medications prescribed. Of the placebo group, 83% had been diagnosed with some other psychiatric condition seven years later. Among those who got fish oil supplements, 53% had received another psychiatric diagnosis.

The findings, wrote the authors, offer "hope there may be alternatives to psychopharmacological treatment as early interventions in young people at risk for psychosis." Fish oil supplements sometimes cause fishy burps, but they appear to be very safe, and the Omega-3 fatty acids they contain are thought to help maintain cardiovascular and eye health as well.

The latest research also suggests that there may be a critical period of brain development, somewhere in mid- to late adolescence perhaps, in which a young person teetering on the edge of mental illness can be pushed back from the brink.

How Omega-3 fatty acids might do that has not been pinned down, the authors acknowledge. Fish oil supplementation appears to boost brain cell regeneration and the availability of a number of key neurotransmitters linked to mental well-being, as well as to tame inflammation and improve cell function.