Fish Oil May Aid Against Manic Depression, BY MARC KAUFMAN, THE WASHINGTON POST
Scientists believe they have found a surprising new ally in their efforts to understand and treat the sharp mood swings of manic depression -- the fatty acids of fish oil.
A Harvard University clinical trial of 44 patients suffering from manic, or bipolar, depression had such positive results with fish oil that the experiment was stopped after four months and all patients were put on a treatment of 14 capsules per day.
"The group taking the fish oil was performing strikingly better than the placebo group, including significantly longer periods of remission," said Andrew L. Stoll, director of the Psychopharmacology Research Laboratory at Harvard Medical School/McLean Hospital. "A decision was made to stop the trial on ethical grounds."
Based on those promising findings, Stoll said, the National Institutes of Health has given preliminary approval for a larger fish-oil trial starting this summer. That trial, at McLean and Baylor College of Medicine in Houston, would include 120 people suffering from manic depression and would last for three years.
"If this works, it would be one of the most exciting findings in psychiatry in the past 20 years," said Jerry Cott, chief of the psychopharmacology research program at the National Institute of Mental Health. "This is the first time we would be testing a nutritional supplement that appears to be having efficacy about to the degree of a synthetic medication."
"This could give us real insight into what is the basis of this psychiatric disorder," Cott said. "Right now, we have no clue what it's really about."
In the Harvard study, all the patients continued on their other medications. About half were also treated with fish-oil capsules, while the others got olive oil as a placebo. According to Stoll, 11 of the 15 patients taking the fish oil improved after four months, and only two had a recurrence. Six of 20 on the placebo responded positively, he said, and 11 had a relapse. Some patients were not counted because the trial was stopped before they had completed their four-month treatment.
Details of the study will be published in May in a major medical journal. Stoll presented his findings this month at a meeting of fatty-acid experts at NIH. Fish oil is especially high in omega-3 fatty acids, a family of long-chained polyunsaturated fats that have been associated with reduced cardiovascular disease and other health benefits.
The body's highest concentrations of omega-3 fatty acids are in the eyes and the brain, where neurobiologists believe they are essential to the proper functioning of cell membranes. If levels of omega-3 fatty acids are too low, they have theorized, then essential chemical pathways become overwhelmed and mental disorders can occur.
The Harvard study was the first significant scientific look at the effects of fish oil and its fatty acids on manic depression -- which is estimated to affect between 1 and 2 percent of Americans at some point in their lives. The disease produces swings from the abnormally high energy and mood levels of mania to deep depression, and is generally treated with different drugs than those prescribed for unipolar depression, the more common form of depression. (An estimated 20 percent of Americans suffer from some form of depression during their lifetimes.)
But some researchers believe omega-3 fatty acids play an equally important role in unipolar depression.
Joseph Hibbeln of the National Institute on Alcohol Abuse and Alcoholism has found a striking correlation between fish consumption and depression. Societies where people eat a lot of fish, he found, have markedly lower levels of depression than societies where people don't eat much fish. He calls his work "suggestive" rather than conclusive.
Stoll said he stumbled across fish oil as a possible treatment of manic depression when he surveyed the literature on compounds with effects similar to traditional drugs such as lithium and valproate. "Everywhere we looked, we came up with omega-3s," he said. "I had heard about omega-3s in medical school, but there hadn't been a lot of attention paid to them since." While fish oil has long been used as a safe dietary supplement, doctors warn that it can oxidize if not properly stored.