Med-Psych.com

Potentially big news today with an article in Archives of General Psychiatry about omega 3 fatty acids and reduction in rates of psychosis. I haven't read the whole article yet but it sounds very promising assuming it is a well controlled study. The large scale study should definitely confirm or refute the findings but this is great news for several reasons.

1. This is the first study I can recall that shows there is something that will prevent (or at least significantly delay) severe mental illness. Perhaps the research on illicit drug use increasing risks for mental illness also point to things that can cause mental illness, and I'll try to dig some of that info up later.

2. Fish oil is cheap.

3. Fish oil has no significant side effects, at least not that I know of. Perhaps the fishy taste some people burp up could be considered, but that is so minor compared to most psychotropic side effects.

4. Fish oil is also probably good for other things like heart disease.

I do remember reading an article many years ago on fish oil in borderline personality disorder and it actually had a positive impact - it'll be very interesting to see if this line of prevention plays out and if we can start to better understand the causes of severe mental illness.

Here's a copy of the abstract for the article on fish oil in psychosis:

Vol. 67 No. 2, February 2010

Long-Chain -3 Fatty Acids for Indicated Prevention of Psychotic Disorders

A Randomized, Placebo-Controlled Trial

Arch Gen Psychiatry. 2010;67(2):146-154.

Context
The use of antipsychotic medication for the prevention of psychotic disorders is controversial. Long-chain -3 (omega-3) polyunsaturated fatty acids (PUFAs) may be beneficial in a range of psychiatric conditions, including schizophrenia. Given that -3 PUFAs are generally beneficial to health and without clinically relevant adverse effects, their preventive use in psychosis merits investigation.

Objective
To determine whether -3 PUFAs reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis.

Design
Randomized, double-blind, placebo-controlled trial conducted between 2004 and 2007.

Setting
Psychosis detection unit of a large public hospital in Vienna, Austria.

Participants
Eighty-one individuals at ultra-high risk of psychotic disorder.

Interventions
A 12-week intervention period of 1.2-g/d -3 PUFA or placebo was followed by a 40-week monitoring period; the total study period was 12 months.

Main Outcome Measures
The primary outcome measure was transition to psychotic disorder. Secondary outcomes included symptomatic and functional changes. The ratio of -6 to -3 fatty acids in erythrocytes was used to index pretreatment vs posttreatment fatty acid composition.

Results
Seventy-six of 81 participants (93.8%) completed the intervention. By study's end (12 months), 2 of 41 individuals (4.9%) in the -3 group and 11 of 40 (27.5%) in the placebo group had transitioned to psychotic disorder (P = .007). The difference between the groups in the cumulative risk of progression to full-threshold psychosis was 22.6% (95% confidence interval, 4.8-40.4). -3 Polyunsaturated fatty acids also significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01) and improved functioning (P = .002) compared with placebo. The incidence of adverse effects did not differ between the treatment groups.

Conclusions
Long-chain -3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with subthreshold psychotic states.