Another Reason for Maintenance Supplementation
Omega-3 Fish Oil for Mood Swings

We know that omega-3 fish oil is good for supporting cardiovascular health [see Omega-3 Fish Oils Promote Cardiovascular Health - June 1999] because it helps to prevent plaque formation and blood clotting. It also helps heart function by guarding against arrhythmias and by reducing the incidence of ischemia (insufficient blood flow). Moreover, there is evidence that omega-3 fish oil can directly benefit certain muscle cells of the heart, protect the kidneys, alleviate rheumatoid arthritis, abate inflammatory bowel diseases, reduce episodes of transplant rejection, and even provide protection from infection.

Now, in a dramatic expansion of its already known abilities to influence desirable membrane characteristics in the brain, omega-3 fish oil has been found to ameliorate a certain type of depression that may be more common than you think.

A type of depression characterized by wide and often frightening mood swings - bipolar disorder, also known as manic-depressive illness - has been found to be significantly improved by  intake of omega-3 fatty acids, which are commonly derived from fish oil.1 In a double-blind, placebo-controlled study published in the May issue of the Archives for General Psychiatry, 30 patients suffering from bipolar disorder were given two omega-3 fatty acids - eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) - as supplements for a 4-month period. This regimen produced significant reductions in depressive symptoms in the experimental group. According to the lead author, Dr Andrew Stoll of Harvard Medical School, "This study may represent the first demonstration of an effective therapy for bipolar disorder."2
 

Fear of Flying
One moment you're calm. You feel safe and warm. Suddenly, for no discernible reason, your emotional state turns to the blues, and then you sink deep. You go lower still with the recognition that the bottom is yet to come. In another moment, a sudden shift occurs, followed by the equivalent of a LOUD explosion and the feeling that you've been shot out of the barrel of a cannon. Hurtling through the air, you feel exhilaration and fear at the same time.

If you've ever experienced anything like this, you may have had a bipolar episode. Bipolar disorder is extremely stressful. Sometimes you're happy, sometimes you're sad. And sometimes the shift from one mood to the other happens too fast. People may suffer from bipolarism intermittently or constantly, and sometimes at a subdued level (usually referred to as hypomania). It's similar to the mood swings commonly reported by women in PMS or menopause. This is because the mechanisms of neurological decline are similar for both bipolar disorder and age-related degenerative disorders; they both involve the degradation of signal-transduction (energy-conversion) mechanisms in our brains. Some psychopharmacological researchers believe that we are all increasingly prone to every neurological syndrome as we age.3

Bipolar disorder, also known as manic-depressive illness, has been found to be significantly improved by intake of omega-3 fatty acids commonly derived from fish oil. 

Searching for New Solutions
Bipolar disorder is an on-again, off-again episodic condition of fluctuation between mania (exalted feelings, excessive excitement) and depression; it generally lasts a lifetime.4 As many as four million Americans are affected by this disorder in its severest form, and perhaps another eight million in a milder form. Unfortunately, many fail to respond to the typical medications used for treatment, because the drugs aren't effective, the side effects are too great, or the patients are noncompliant. For this reason, some researchers have been looking far afield, into the realm of nutriceuticals, for new solutions.

Omega-3 Fish Oils May Correct Nutritional Lipid Deficiencies in  the Brain
Dr Stoll and his associates searched the medical literature and found that omega-3 fatty acids shared similar biochemical mechanisms with currently used mood stabilizers. Among the effects these compounds produce are:

  • Buffering action on the energy-conversion mechanisms in the brain's signaling system.
  • Blocking action on the calcium channel, helping to prevent cell death and loss of brain function.
  • Inhibition of the protein kinase C, an enzyme involved in excessive neuronal signaling.
  • Antikindling action, or the prevention of repeated electrochemical effects that can alter brain function negatively.

The end of the study found a significant reduction in depressive symptoms in the omega-3 fatty acid group. 

Because Western diets are low in essential omega-3 fatty acids, the researchers reasoned, it is possible that these compounds provide beneficial effects by reversing nutritional deficiencies in lipids that are crucial to proper brain function.

The patients in the study ranged in age between 18 and 65 years and had been diagnosed with bipolar depressive disorder. Enrollment criteria included at least one manic or hypomanic episode in the preceding year. The protocol provided for patients to continue on any existing medication regimens (including the antidepressants lithium carbonate or valproate) in use prior to the study, in addition to either omega-3 fatty acid capsules or placebo. The amount used in the trial was rather high, but it was thought to be safe. Patients took seven capsules of omega-3 fatty acids twice daily, for a combined daily total of 6.2 g of EPA and 3.4 g of DHA.

"This study may represent the first demonstration of an effective therapy for bipolar disorder."

"Improvement was significantly greater in the omega-3 fatty acid group than the [placebo] control group on almost every assessment measure. The striking difference in relapse rates and response appeared to be highly clinically significant," the authors wrote.5

More Studies to Come
One of the study's coauthors, Dr Lauren B Marangell, Baylor College of Medicine in Houston, announced that a larger trial would be launched this summer, comparing omega-3 fatty acids to placebo in patients who are taking only lithium to control their bipolar disorders.

Because many patients knew (or could guess) what they were getting by the presence or absence of the fishy after-taste, the double-blind aspect of the study was somewhat compromised. In future studies, the researchers will attempt to solve this problem by imparting a fishy taste to the placebo.


Some researchers have been looking far afield, into the realm of nutriceuticals, for new solutions. 

High Praise Even from the Critics
Although the Stoll study could be reproached for the above reason and for its duration of only 120 days, it drew praise even from its critics. In an editorial commentary about the report, also published in Archives for General Psychiatry, Dr Joseph R Calabrese wrote that this study "... represents a landmark attempt in drug development for bipolar disorder because a naturally occurring dietary component was evaluated for its mood-stabilizing efficacy."

Finally, and quite significantly, there was a clear desire for the salutary effects of the omega-3 fatty acids by the subjects who had been receiving them. When in the end the study was unblinded, virtually all of them opted to continue to take these supplements as part of their long-term treatment. High praise indeed. Those who stayed with omega-3 fatty acids continue to do well, according to Dr Marangell. 



References
  1. Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK, Marangell LB. Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial. Arch Gen Psychiatry 1999 May;56(5):407-12.
  2. Stoll A et al. Comment in Arch Gen Psychiatry 1999 May;56(5):413-16.
  3. Naranjo CA, Herrmann N, Mittmann N, Bremner KE. Recent advances in geriatric psychopharmacology. Drugs Aging 1995 Sep;7(3):184-202 .
  4. Tohen M, Grundy S. Management of acute mania. J Clin Psychiatry 1999;60 Suppl 5:31-4; discussion 35-6.
  5. Fish oil supplement reduces bipolar symptoms and improves outcome in pilot study. Reuters Health wire service, 7 May 1999;http://www.reutershealth.com.

© Copyright 1999 Life Enhancement Products, Inc. All Rights Reserved. 

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