title: Fish oil (n-3 fatty acids) in drug resistant epilepsy: a randomised placebo-controlled crossover study.
abstract: BACKGROUND
  n-3 fatty acids inhibit neuronal excitability and reduce seizures in animal models. High-dose fish oil has been explored in two randomised trials in drug resistant epilepsy with negative results. We performed a phase II randomised controlled crossover trial of low-dose and high-dose fish oil in participants with drug resistant epilepsy to explore whether low-dose or high-dose fish oil reduces seizures or improves cardiovascular health.
  
  
  METHODS
  Randomised placebo-controlled trial of low-dose and high-dose fish oil versus placebo (corn oil, linoleic acid) in 24 participants with drug resistant epilepsy. A three-period crossover design was utilised lasting 42 weeks, with three 10-week treatment periods and two 6-week washout periods. All participants were randomised in double-blind fashion to receive placebo, high dose or low dose in different sequences. The primary outcome was per cent change in total seizure frequency.
  
  
  RESULTS
  Low-dose fish oil (3 capsules/day, 1080 mg eicosapentaenoic acid+docosahexaenoic acid) was associated with a 33.6% reduction in seizure frequency compared with placebo. Low-dose fish oil was also associated with a mild but significant reduction in blood pressure. High-dose fish oil was no different than placebo in reducing seizures or improving cardiac risk factors.
  
  
  CONCLUSIONS
  In this phase II randomised crossover trial, low-dose fish oil was effective in reducing seizures compared with placebo. The magnitude of improvement is similar to that of recent antiepileptic drug trials in drug resistant epilepsy (DRE). The results indicate that low-dose fish oil may reduce seizures and improve the health of people with epilepsy. These findings justify a large multicentre randomised trial of low-dose fish oil (n-3 fatty acids <1080 mg/day) in drug resistant epilepsy.
  
  
  BACKGROUND
  NCT00871377.
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: DeGiorgio
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Miller
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Harper
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gornbein
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Lara
authors.initials: L
authors.lastname: Schrader
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Soss
authors.affiliation: Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
authors.forename: Sheba
authors.initials: S
authors.lastname: Meymandi
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018592:Cross-Over Studies; D004281:Docosahexaenoic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004351:Drug Resistance / Q000187:drug effects*; D004359:Drug Therapy, Combination; D015118:Eicosapentaenoic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D004827:Epilepsy / Q000178:diet therapy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: Anticonvulsants; Epilepsy; Pharmacology