A randomized trial of polyunsaturated fatty acids for refractory epilepsy.
OBJECTIVE
Though polyunsaturated fatty acids (PUFA) reduce seizures in several animal models, results have been inconsistent in humans. The goal of the present study was to assess the effectiveness of a PUFA supplement as adjunctive treatment for intractable focal or generalized epilepsy in humans.


METHODS
Adults with uncontrolled epilepsy were randomized to either mineral oil placebo or a PUFA supplement (eicosapentanoic acid (EPA) plus docosahexanoic acid (DHA), 2.2 mg/day in a 3:2 ratio). Following a 4-week prospective baseline and 1-week titration, subjects entered a 12-week treatment period, followed by an optional 4-week open-label phase.


RESULTS
Of 21 subjects (12 PUFA and 9 placebo), 0 on PUFA versus 2 on placebo had at least a 50% decrease in seizure frequency from baseline (P=0.17). Overall, seizure frequency increased 6% on PUFA and decreased 12% on placebo (P=0.21). During optional open-label administration, however, 15 of 19 subjects had fewer seizures than during baseline (P=0.02).


CONCLUSIONS
Based on the randomized, blinded portion of this study, the PUFA preparation used was not superior to placebo as adjunctive treatment for intractable epilepsy. It is not known whether different doses or different EPA:DHA ratios would be effective.
Bromfield
Edward
E
Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. ebromfield@partners.org
Dworetzky
Barbara
B
Hurwitz
Shelley
S
Eluri
Zina
Z
Lane
Lara
L
Replansky
Sonia
S
Mostofsky
David
D
D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D004281:Docosahexaenoic Acids / Q000008:administration & dosage; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000927:Anticonvulsants; D005231:Fatty Acids, Unsaturated; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid