N-3 fatty acids for hypertriglyceridemia in patients taking second-generation antipsychotics.
OBJECTIVE
Cardiovascular disease is a frequent cause of early disability and death in patients with severe mental illness (SMI). Second-generation antipsychotic medications may cause increased risk of cardiovascular disease in some patients by elevating serum triglyceride levels. Idiopathic hypertriglyceridemia can be effectively treated with N-3 fatty acid (N-3 FA) supplementation, but little research has evaluated this treatment for hypertriglyceridemia that can occur in patients using second-generation antipsychotics.


METHODS
A six-week, open-label pilot study of N-3 FA, two grams twice daily, was performed to assess efficacy of this supplement in patients with SMI who were being treated with second-generation antipsychotics. Serum triglyceride levels (the main endpoint) were assessed at baseline and six weeks. Levels of C-reactive protein (CRP), cholesterol (total, high density lipoprotein [HDL] and low density lipoprotein [LDL]), fasting glucose, and fasting insulin (to calculate the Homeostatic Model Assessment for Insulin Resistance [HOMA-IR]), as well as weight and blood pressure, were also assessed.


RESULTS
Mean triglyceride levels decreased by 70.4±50.4 mg/dL (p=0.001). Among secondary endpoints, mean HDL increased by 2.6±3.5 (p=0.03). However, LDL and total cholesterol, blood pressure, HOMA-IR and CRP did not significantly change.


CONCLUSIONS
In this pilot study, treatment with N-3 FA was associated with improvements in triglyceride and HDL levels. Further study is warranted to assess more completely whether this prescription dietary supplement can reduce triglycerides in patients taking second-generation antipsychotics.
Concord Hospital-Psychiatry, Concord, NH 03301, USA. jfetter@crhc.org
Jeffrey Charles
JC
Fetter
Mary
M
Brunette
Alan I
AI
Green
D000328:Adult; D014150:Antipsychotic Agents / Q000097:blood*; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002097:C-Reactive Protein / Q000187:drug effects; D002784:Cholesterol / Q000097:blood; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000097:blood* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood* / Q000188:drug therapy*; D007328:Insulin / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000188:drug therapy*; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D014150:Antipsychotic Agents; D001786:Blood Glucose; D015525:Fatty Acids, Omega-3; D007328:Insulin; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol