COMMENTARY

Fish Oil to Fend Off Psychosis: New Evidence

Michael T. Compton, MD, MPH

Disclosures

October 28, 2010

In This Article

Dietary Supplementation and Psychosis

Mental healthcare providers continue to struggle with an inadequacy of treatment options for the most serious psychiatric illnesses, including schizophrenia and related psychotic disorders. Although diverse psychosocial treatments (eg, assertive community treatment, cognitive-behavioral therapy, cognitive remediation, family interventions, integrated substance abuse treatment, psychoeducation, social skills training, supported employment) are clearly beneficial in key outcome domains, diverse symptoms, and disabling psychosocial impairment continue to stand in the way of adequate remission and recovery for many affected individuals. While the armamentarium of antipsychotic agents is expanding, pharmacologic treatments for symptom clusters outside of the positive symptom domain (eg, negative symptoms, disorganization or formal thought disorder, neurocognitive deficits) remain largely elusive. Given the need for more effective treatments, the potential for symptom amelioration through dietary modification or dietary supplements represents an enticing possible treatment modality.

Along these lines, recent years have witnessed a growing interest in the possibility that polyunsaturated fatty acids, some of which feature prominently in fish oils, may be beneficial for psychiatric disorders. Attention has focused primarily on omega-3 fatty acids; these include eicosapentaenoic acid and docosahexaenoic acid (both thought to be beneficial in terms of reductions in risk for cardiovascular disease in addition to having other health benefits), which are most widely available in cold water oily fish such as salmon, herring, and mackerel. Omega-6 polyunsaturated fatty acids (found in plant oils including palm, soybean, rapeseed, and sunflower oils) have also been studied, although with perhaps less evidence in terms of health benefits. In fact, excesses of omega-6 fatty acids are believed to potentially interfere with the health-promoting effects of omega-3 fatty acids.

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