BOSTON, MASSACHUSETTS. Manic-depressive illness (bipolar disorder) is a common, severe mental illness involving repeated episodes of depression, mania (rapid mood changes, hyperactivity, and excessive cheerfulness) or both. It is usually treated with drugs such as lithium carbonate or valproate. Unfortunately, these drugs are not very effective and recurrence rates are high. It is generally believed that bipolar disorder involves an overactivity in the neuronal signal pathways. Omega-3 fatty acids are known to dampen this overactivity and the hypothesis has been advanced that they may be useful in the treatment of bipolar disorder. Medical scientists have now confirmed this in a landmark study just completed at the Harvard Medical School.
The double-blind, placebo-controlled study involved 30 patients (men and women 18 to 65 years of age) who had all been diagnosed with bipolar disorder. Half the patients were given seven fish oil capsules twice a day while the placebo group were given seven olive oil capsules twice a day. Each fish oil capsule contained 440 mg of eicosapentaenoic acid and 240 mg of docosahexaenoic acid. All of the participants except four in the fish group and four in the placebo group also continued to receive a standard mood-stabilizing drug prescribed previously. The mental state of the participants was measured using four scales (Clinical Global Impression Scale, Global Assessment Scale, Young Mania Rating Scale, and the Hamilton Rating Scale for Depression) at the start of the study and after two, four, six, eight, twelve and sixteen weeks. Twelve of the 14 participants in the fish group completed the four- month study without major episodes of mania or depression as compared to only six out of 16 participants in the placebo group. Also, while nine of the placebo group members experienced worsening depression none of the fish group members did. The four patients in the fish group who had not been prescribed mood-stabilizing drugs all completed the study without major episodes, but only one member in the placebo group not on mood-stabilizing drugs did. The average decline in depression rating on the Hamilton Scale was almost 50 per cent in the fish group as compared to an increase of 25 per cent in the control group. The Harvard researchers urge further trials of fish oils in the treatment of depression and manic-depressive illness.
Stoll, Andrew L., et al. Omega 3 fatty acids in bipolar disorder. Archives of General Psychiatry, Vol. 56, May 1999, pp. 407-12 and pp. 415-16 (commentary)
Calabrese, Joseph R., et al. Fish oils and bipolar disorder. Archives of General Psychiatry, Vol. 56, May 1999, pp. 413-14 (commentary)