Omega-3 Eicosapentaenoic Acid in Bipolar Depression: Report of a Small Open-Label Study
J Clin Psychiatry 2005;66(6):726-729
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Introduction: Epidemiologic studies have
suggested that consumption of cold water fish oils may have some
protective function against depression. This proposition is
supported by a series of biochemical and pharmacologic studies
that have suggested that fatty acids may modulate
neurotransmitter metabolism and cell signal transduction in
humans and that abnormalities in fatty acid and eicosanoid
metabolism may play a causal role in depression. Aware of the
critical need for antidepression treatments that might not carry
the risk of precipitating a manic episode in bipolar patients, we
decided to conduct an open-label add-on trial of eicosapentaenoic
acid (EPA) in bipolar depression.
Method: Twelve bipolar I outpatients with
depressive symptoms diagnosed by DSM-IV were treated with 1.5 to
2 g/day of the omega-3 fatty acid EPA for up to 6 months. The
study was conducted between September 2001 and January 2003.
Results: Eight of the 10 patients who
completed at least 1 month of follow-up achieved a 50% or greater
reduction in Hamilton Rating Scale for Depression scores within 1
month. No patients developed hypomania or manic symptoms. No
significant side effects were reported.
Limitations: This study is limited both
by the open-label design and by the small sample size. As in all
previous reported studies, patients in this study were treated in
an outpatient setting, so that the most severely depressed
bipolar patients (requiring hospitalization) are not represented.
Conclusions: Although the ultimate
utility of omega-3 fatty acids in bipolar depression is still an
open question, we believe that these initial results are
encouraging, especially for mild to moderate bipolar depression,
and justify the continuing exploration of its use.