Ethyl-eicosapentaenoic acid in first-episode psychosis. A 1H-MRS study.
Ethyl-eicosapentaenoic acid (E-EPA) is an omega-3 fatty acid that has been used in a range of neuropsychiatric conditions with some benefits. However, its mechanism of action is unknown. Here, we investigate its effects on in vivo brain metabolism in first-episode psychosis (FEP). Proton magnetic resonance spectroscopy at 3 T was performed in the temporal lobes of 24 FEP patients before and after 12 weeks of treatment in the context of a larger double-blind, placebo-controlled E-EPA augmentation study. Treatment group effects for glutathione (F1,12=6.1, p=0.03), and a hemisphere-by-group interaction for glutamine/glutamate (F1,20=4.4, p=0.049) were found. Glutathione increased bilaterally and glutamate/glutamine increased in the left hemisphere following E-EPA administration. Improvement in negative symptoms correlated with metabolic brain changes, particularly glutathione (r=-0.57). These results suggest that E-EPA augmentation alters glutathione availability and modulates the glutamine/glutamate cycle in early psychosis, with some of the metabolic brain changes being correlated with negative symptom improvement. Larger confirmatory studies of these postulated metabolic brain effects of E-EPA are warranted.
Berger
Gregor E
GE
Department of Psychiatry, ORYGEN Research Centre, University of Melbourne, Parkville, Australia. bergerg@mac.com
Wood
Stephen J
SJ
Wellard
R Mark
RM
Proffitt
Tina M
TM
McConchie
Mirabel
M
Amminger
G Paul
GP
Jackson
Graeme D
GD
Velakoulis
Dennis
D
Pantelis
Christos
C
McGorry
Patrick D
PD
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000378:metabolism* / Q000503:physiopathology; D001923:Brain Chemistry / Q000187:drug effects* / Q000502:physiology; D001931:Brain Mapping; D019587:Dietary Supplements; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D005978:Glutathione / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology; D010919:Placebos; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D013702:Temporal Lobe / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation / Q000187:drug effects / Q000502:physiology
D010919:Placebos; D005973:Glutamine; D018698:Glutamic Acid; C035276:eicosapentaenoic acid ethyl ester; D015118:Eicosapentaenoic Acid; D005978:Glutathione