title: Omega-3 fatty acids in bipolar disorder: clinical and research considerations.
abstract: Several lines of evidence suggest that omega-3 fatty acids may be important in the pathophysiology, treatment or prevention of bipolar disorder (BD). Electronic and manual searches were conducted in order to review the literature relevant to the etiology and treatment of BDs with omega-3 fatty acids. We also present data from a randomized, double-blind, placebo-controlled pilot study conducted at three sites (N = 10) comparing an omega-3 fatty acid (docosahexaenoic acid, DHA) versus placebo, added to psychosocial treatment for women with BD who chose to discontinue standard pharmacologic treatment while attempting to conceive. While some epidemiologic and preclinical data support the role of omega-3 fatty acids in BD, clinical trials to date have yielded conflicting results. In our pilot study of 10 Caucasian women taking DHA while attempting to conceive (BP1 = 9, BPII = 1), age 27-42 years, DHA was well tolerated and suggests that a larger study would be feasible. The elucidation of the potential role of omega-3 fatty acids as a treatment for BD requires further study. The current data are not sufficient to support a recommendation of monotherapy treatment as a substitute for standard pharmacologic treatments. However, judicious monotherapy in selected clinical situations, or adjunctive use, may be warranted pending further data from adequately powered controlled clinical trials. Our pilot trial of DHA in women who plan to stop conventional psychotropics in order to conceive suggests that such trials are feasible.
authors.affiliation: Mood Disorders Center, Menninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA. laurenm@bcm.tmc.edu
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Marangell
authors.forename: Trisha
authors.initials: T
authors.lastname: Suppes
authors.forename: Terence A
authors.initials: TA
authors.lastname: Ketter
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Dennehy
authors.forename: Holly
authors.initials: H
authors.lastname: Zboyan
authors.forename: Barbara
authors.initials: B
authors.lastname: Kertz
authors.forename: Andrew
authors.initials: A
authors.lastname: Nierenberg
authors.forename: Joseph
authors.initials: J
authors.lastname: Calabrese
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Wisniewski
authors.forename: Gary
authors.initials: G
authors.lastname: Sachs
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000502:physiology / Q000627:therapeutic use*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010865:Pilot Projects; D010919:Placebos; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D010919:Placebos