The Omega – 3 supplementation story seems to take many twists and turns.
At one point, based on double blinded controlled study published by Andy Stoll, et al, from Harvard, in JAMA Psychiatry in 1999, it looked as though omega 3 fatty acids would turn out to be a very effective treatment for bipolar, with almost no side effects. Subsequent research has been more mixed, but a number of researchers have been interested in omega 3 fatty acids as a way of preventing psychosis in those adolescents at high risk.
Barbara Geller reviewed a follow-up study lasting almost 7 years which had robust findings favoring supplementation to prevent psychosis.
The study she reviews was a follow up of randomized, placebo-controlled study of 81 teenagers and young adults at high risk for schizophrenia who received 12 weeks of omega 3 fatty acid supplementation to see if that supplementation reduced the risk for developing psychosis in the following 12 months (NEJM JW Psychiatry Apr 2010 and Arch Gen Psychiatry 2010; 67:146).
Now that same group reports the results in the following 6 years.
In the follow up study, almost 90% of the original participants had a comprehensive follow up evaluation. Of the group who received omega-3 fatty acids, 10% had psychotic symptoms compared with 40% of the controls.
Barbara Geller, MD, reviewing this study in Journal Watch Psychiatry had this to say –
These robust findings of a markedly lower conversion rate to psychosis in the omega-3 group strongly support instituting omega-3 supplementation in individuals at high risk for psychosis. The results add to similar reports for the benefits of omega-3 in multiple other psychiatric disorders (e.g., NEJM JW Psychiatry Nov 2014 and J Child Psychol Psychiatry 2015; 56:509)
Do these accumulating data support prescribing omega-3 supplements to all psychiatric patients? That approach would be consistent with dietary changes over past centuries that eventuated in progression from diets with an approximately 50:50 ratio of omega-3 to omega-6 to current diets with 15:1 or 16:1 omega-6 to omega-3 ratios — that is, present-day diets are less healthy than those eaten by our distant ancestors (Biomed Pharmacother 2006; 60:502).
Amminger GP et al. Longer-term outcome in the prevention of psychotic disorders by the Vienna omega-3 study. Nat Commun 2015 Aug 11; 6:7934. (http://dx.doi.org/10.1038/ncomms8934)
NEJM Journal Watch Psychiatry. Omega-3 Prevents Conversion to Psychosis. September 7, 2015 review by Barbara Geller, MD