09.09.08
Omega-3 fatty acids are essential to human survival, but ironically are not synthesizable by the body, thus must be obtained through dietary sources. Unfortunately, dietary consumption in today’s society has drastically changed, and often is hampered by a low content of essential fats and nutrients such as vitamin B12, thiamine, folate and EFAs (Simopolous, 1991).
EFAs are of particular interest in light of recent research demonstrating that they are selectively concentrated in neuronal membranes, and regulate both vascular and immune system related functions (Salem, Litmen, Kim et al, 2001).
Recently the use of EFAs to prevent and improve psychiatric disorders has grown in popularity. Omega-3s regulate corticotrophin factor, increase seretonergic function, increase dentritic arborization, prevent neural apoptosis, improve cerebral blood flow and regulate gene expression (Freeman & Stoll, et al. 2006). The human brain is composed of 60% fat, and omega-3 fatty acids are the most efficient type for developing adequate brain cell membranes, and intercellular neuronal connections (London, Stoll, & Manning, 2006). A lack of omega-3, results in the use of other types of fatty acids, which weakens cellular networks and brain stability leading to several types of mental illnesses (Peet & Stokes, 2005).
Population studies have been used to assess whether or not a diet deficient in Omega-3s results in neuropsychiatry disorders. As predicted, countries with lower per capita fish consumption, showed an increase in prevalence rates for depression, bipolar disorder, and post-partum depression. Schizophrenic patient populations have also been examined, and those who resided in countries with a lower consumption of fish, showed a poorer course of illness.
The applicability of Omega3s in the prevention, and improvement of psychiatric disorders has been extensively investigated. To date EFAs have successfully reduced the Hamilton Rating Scale of Depression in subjects who have major depression disorder (Marangell, Martinez, Aboyan et al; 2003), prevented depressive episodes in subjects with bipolar disorder (Stoll, Severus, Freeman et al, 1999) and reduced subjective feelings of depression in mothers who had recently given birth (Freeman, Hibblen, Wisner et all, 2006). EFAs have also been used to successfully treat the mania associated with bipolar disorder. In a study conducted by Stoll, Locke, Marangell and Severus (1999) patients with bipolar disorder were given an EPA/DHA combination capsule, or olive oil as a placebo control. Patients receiving the dose of EFAs no longer met the criteria for a manic mood episode, showed a lack of recurrence, and a significant reduction in psychiatric symptoms, based on the Psychiatric Symptom Rating Scale.
The therapeutic utility of EFAs for schizophrenia has also been investigated. Schizophrenic patients have been found to portray increased concentrations of inflammatory cytokines in both their cerebrospinal fluid, and circulation, and lower amount of EPA and DHA in their plasma (Aravindakshan, Ghate, Ranjekar et al (2003). A study conducted by Peet et al in 2001, ascertained that when EPA and DHA were administered, schizophrenic subjects demonstrated lower scores on both positive and negative symptom scales.
Several animal studies have concluded that omega-3 fatty acid intake improves cognitive performance on several learning and memory tasks (Farkas, Gerrits et al 2002). A study performed by Song and Horrobin (2001) found that rats given an enriched diet of EPA successfully acquired spatial memory after being given cytokine (IL)-1, a proinflammatory cytokine known to cause memory and cognitive impairment.
The applicability of omega-3s to Alzheimer’s disease has also been extensively examined. Post-mortem studies have shown that Alzheimer’s diseased (AD) brains have a lower concentration of omega-3 content, relative to controls (Simopolous, 2006). Consistent with this finding, Morriss et al in 2003 found that subjects who consumed fish once a week had a 60% lower risk of developing AD. Das and Vaddadi in 2004 demonstrated that Huntington transgenic mice show increased survival rates, and reduced neurological deficits when given EPA.
Omega-3s have also been used to successfully attenuate the motor dysfunctions seen in Huntington’s disease.
Interestingly, omega-3s may also have implications in impulsivity and borderline personality disorder. Countries with lower fish consumption have a higher mortality rate due to homicide, and individuals with borderline personality disorder who were given EFAs showed a marked decrease in aggressive and hostile behaviors (Harayama, Hamazaki, and Terasawa, 2004).
Finally, several studies have found that children with attention problems and hyperactivity have a decreased amount of neural EFA relative to controls (Stevens, Zental, Abate et al, 1996). Puri, in 2002 found that children with ADHD given an omega-3 supplement demonstrated a significant decrease in hyperactivity, and showed improved attention.
It is apparent from the vast amount of research conducted, that Omega-3, and essential fatty acids are applicable to a wide array of psychiatric disorders. EFAs provide several health benefits for the heart, lungs, immune system as well as the brain, and have also been shown to enhance cognition. Given this, it appears that omega-3 fish oil supplements are not only useful for our general health but also show prospect in becoming a useful treatment option for several neurological and psychiatric disorders.
References
Aravindakshan, M., Ghate, M., Ranjekar, P.K., Evans, D.R., Mahadik, S.P. Supplementation with a combination of omega-3 fatty acids and antioxidants (vitamins E and C) improves the outcome of schizophrenia. Schizophrenia, 62, 195-204.
Das, UN, Vaddadi KS. (2004). Essential fatty acids in Huntington’s disease. Nutrition, 20, 942-947.
De Wilde, M.C., Farkas, E. Gerrits, M., Kiliaan, A.J., Luiten, P.G. (2002). The effect of n-3 polyunsaturated fatty acid-rich diets on cognitive and cerebrovascular parameters in chronic cerevral hypoperfusion. Brain Research, 30, 166-73.
Freeman MP, Hibbeln JR, Wisner KL, Davis JM, Mischoulon D, Peet M, Keck PE Jr, Marangell LB, Richardson AJ, Lake J, Stoll AL. (2006). Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry. J Clin Psychiatry, 67, 1954-67.
Harris WS, O'Keefe JH Jr. (2003). Preventive use of N-3 fatty acids. Circulation, 108, 139.
Leitzmann MF, Stampfer MJ, Michaud DS, Augustsson K, Colditz GC, Willett WC, Giovannucci EL. (2004). Dietary intake of n-3 and n-6 fatty acids and the risk of prostate cancer. Am J Clin Nutr, 80, 204-16.
London, DS, Stoll, AL, Manning, BB. (2006). Psychiatric agriculture: systemic nutritional modification and mental health in the developing world. Medical Hypotheses, 66, 1234-1239.
Marangell LB, Bauer MS, Dennehy EB, Wisniewski SR, Allen MH, Miklowitz DJ, Oquendo MA, Frank E, Perlis RH, Martinez JM, Fagiolini A, Otto MW, Chessick CA, Zboyan HA, Miyahara S, Sachs G, Thase ME.. (2006). Prospective predictors of suicide and suicide attempts in 1,556 patients with bipolar disorders followed for up to 2 years. Bipolar Disord, 8, 566-75.
Morriss, M.C. Evans, D.A. Bienias, J.L. et al (2003). Consumption of fish and n-3 fatty acids and risk of Alzheimer disease. Arch Neurol, 60, 940-946. (Harayama, Hamazaki, and Terasawa, 2004).
Peet M, Brind J, Ramchand CN, Shah S, Vankar GK..Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia. Schizophr Res. 2001 Apr 30;49(3):243-51.
Peet M, Stokes C. Omega-3 fatty acids in the treatment of psychiatric disorders. Drugs 2005;65:1051–9.
Puri BK, Bydder GM, Counsell SJ, Corridan BJ, Richardson AJ, Hajnal JV, Appel C, Mckee HM, Vaddadi KS, Horrobin DF. (2002). MRI and neuropsychological improvement in Huntington disease following ethyl-EPA treatment. Neuroreport, 13, 123-6.
Salem, N., Litmen, B., Kim, H.Y., Gawrisch, K. (2001). Mechanisms of action of docosahexaenoic acid in the nervous system. 36, 945-959.
Simopolous,A.P. (1991). Omega-3 fatty acids in health and disease and in growth and development. Am J Clin Nutr., 54(3):438-63.
Song, C., Horrobin, B. (2004) Omega-3 fatty acid ethyl-eicosapentaenoate, but not soybean oil, attenuates memory impairment induced by central IL-1 administration. Journal of lipid research, 45, 1112-1121.
Stoll, AL, Locke, C.A., Marangell, L.B. (1999). Omega-3 fatty acids and bipolar disorder; a review. Prostaglandins Leukot Essent Fatty Acids, 60, 329-337.
Stevens, L.J., Zental S.S., Abate, M.L. (1996). Omega-3 fatty acids in boys with behavior, learning and health problems. Physiol Behav, 59, 915-920.
Williams AL, Katz D, Ali A, Girard C, Goodman J, Bell I.. (2006). Do essential fatty acids have a role in the treatment of depression? J Affect Disord, 93, 117-23.