title: First-episode bipolar disorder is associated with erythrocyte membrane docosahexaenoic acid deficits: Dissociation from clinical response to lithium or quetiapine.
abstract: Deficits in long-chain omega-3 (LCn-3) fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may be associated with the pathophysiology of bipolar disorder. However, LCn-3 fatty acid status at the initial onset of mania and its association with treatment response are not known. Erythrocyte membrane fatty acid composition was determined in first-episode bipolar manic or mixed (n=40) and healthy (n=40) subjects. Mood symptom ratings were obtained with the Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HDRS). Erythrocyte fatty acid composition and clinical ratings were also determined within a sub-group of bipolar subjects following 8-week (n=19) or 52-week (n=11) open-label treatment with lithium or quetiapine. At baseline bipolar subjects exhibited significantly lower erythrocyte docosahexaenoic acid (DHA, 22:6n-3) composition compared with healthy subjects (-23%, p<0.0001). EPA (20:5n-3) and docosapentanoic acid (22:5n-3), and LCn-6 fatty acids including arachidonic acid were not different. Following 8- or 52-week treatment with lithium or quetiapine, YMRS and HDRS total scores decreased significantly whereas erythrocyte fatty acids including DHA did not change. These data indicate that selective erythrocyte DHA deficits coincide with the initial onset of manic symptoms, and reductions in mood symptoms following treatment are not mediated by changes in fatty acid status.
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA. Electronic address: robert.mcnamara@uc.edu.
authors.forename: Robert K
authors.initials: RK
authors.lastname: McNamara
authors.affiliation: Department of Pathology, University of Cincinnati, Cincinnati OH 45237, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Jandacek
authors.affiliation: Department of Pathology, University of Cincinnati, Cincinnati OH 45237, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Tso
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Blom
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Welge
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Strawn
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Caleb M
authors.initials: CM
authors.lastname: Adler
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Melissa P
authors.initials: MP
authors.lastname: DelBello
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience, Division of Bipolar Disorders Research, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Strakowski
mesh_terms: D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000097:blood*; D004281:Docosahexaenoic Acids / Q000097:blood / Q000172:deficiency*; D015118:Eicosapentaenoic Acid / Q000097:blood; D004910:Erythrocyte Membrane / Q000737:chemistry*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D011581:Psychological Tests; D000069348:Quetiapine Fumarate / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D005231:Fatty Acids, Unsaturated; D004281:Docosahexaenoic Acids; D000069348:Quetiapine Fumarate; D008094:Lithium; D015118:Eicosapentaenoic Acid
keywords: Arachidonic acid; Bipolar disorder; Lithium; Mania; Quetiapine