title: A meta-analysis of placebo-controlled trials of omega-3 fatty acid augmentation in schizophrenia: Possible stage-specific effects.
abstract: BACKGROUND
  Omega-3 fatty acids have shown promise as an adjunctive treatment for schizophrenia. However, efficacy across studies has been inconsistent. We conducted a meta-analysis of published controlled studies with the goal of detecting different efficacy profiles at various stages of schizophrenia.
  
  
  METHODS
  An online search was conducted for randomized, double-blind, placebo-controlled clinical trials, and a meta-analysis was conducted.
  
  
  RESULTS
  Ten studies met the criteria for inclusion. Among patients in the prodromal phase of schizophrenia, omega-3 supplementation reduced psychotic symptom severity and lowered conversion rates to first-episode psychosis. In patients with first-episode schizophrenia, omega-3 decreased nonpsychotic symptoms, required lower antipsychotic medication dosages, and improved early treatment response rates. Omega-3 had mixed results in patients with stable chronic schizophrenia, with only some patients experiencing significant benefits. Among patients with chronic schizophrenia, use of omega-3 fatty acids both by those experiencing acute exacerbations and those who had discontinued antipsychotic medications resulted in worsening of psychotic symptoms.
  
  
  CONCLUSIONS
  The data suggest that omega-3 fatty acids may be efficacious in reducing clinical symptoms for patients in the earlier stages of schizophrenia (prodrome and first episode), while producing mixed results for patients in the chronic stages. Based on these results, omega-3 fatty acids would not be recommended for acute exacerbations in patients with chronic schizophrenia nor for relapse prevention after discontinuation of antipsychotics.
authors.affiliation: Department of Neurology and Psychiatry, Saint Louis University School of Medicine, St. Louis, MO USA. E-MAIL: chena@slu.edu.
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Chen
authors.forename: John T
authors.initials: JT
authors.lastname: Chibnall
authors.forename: Henry A
authors.initials: HA
authors.lastname: Nasrallah
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004357:Drug Synergism; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D010919:Placebos; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D015525:Fatty Acids, Omega-3; D010919:Placebos