Fish Oil Psychosis Prevention

There was a very interesting study published recently in the Archives of General Psychiatry looking at the possible role of fish oil in the prevention of overt psychosis in high risk individuals. Prevention of development of schizophrenic psychosis is an area of increasing interest in psychiatry due to the devastating nature of the disease. Schizophrenia is the most severe of the mental disorders which usually begins in late adolescence or early adulthood. It consists of a combination of hallucinations, delusional thinking, thought and behavior disorganization, cognitive deficits and extremely impaired interpersonal functioning. Anything that might prevent this disorder would be of very significant benefit.

Studies so far have looked at the role of antipsychotic medication given early, in high risk individuals before overt psychosis or loss of reality. But this involves using medication that can have significant adverse effects in people who don't have a mental disorder diagnosis which is very controversial. This study involved 81 patients aged 13-25 who were considered at high risk for psychosis due to intermittently hearing voices or feeling at times that someone might be trying to read their minds. Half of the study participants received a capsule containing usual doses of omega-3 polyunsaturated acids and vitamin E and the other half received capsules only containing coconut oil for a period of 12 weeks. The participants were evaluated weekly for 4 weeks, at 8 and 12 weeks and then again at 6 and 12 months. At the end of the 12 months the conversion rates to schizophrenia were 4.9% in the fish oil group and 27.5% in the placebo group.This is a very significant difference. The rate of adverse side effects was higher in the placebo group than the treatment group. of interest is that the benefits were seen at the end of 12 months although the fish oil was only given for a 3 month period.

The exact mechanism of action of the fish oil is unknown although it has been increasingly noted that dysfunctional fatty acid metabolism may play a role in the disease due to oxidative stress that may lead to neuronal cell degeneration. There is already enough evidence to suggest that adding omega-3 fatty acids in already established schizophrenia may reduce the doses of antipsychotic medication needed but to potentially prevent a problem by a readily available, low cost, natural substance with few adverse effects is amazing. I am sure that there will be follow-up studies with larger populations to see if this preventive effect can be replicated by other researchers.

Thought for the day

Prevention beats treatment.