Treating Psychiatric Disorders – Something Smells Fishyby Jennifer Gibson, PharmD | July 3, 2008
Could the treatment of psychiatric and mood disorders be as simple as eating more fish? Fish oil contains, specifically docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA), which are known to have positive cardiovascular outcomes. Fish oil intake, through diet or supplementation, has noteworthy effects on lowering total cholesterol, lowering LDL (“bad” cholesterol), and increasing HDL (“good” cholesterol). In addition to the cardiovascular benefits of fish oil, there may be neurological, psychiatric, and emotional benefits, as well.
Omega-3 fatty acids are components of the cell membranes of the brain and central nervous system. These fatty acids promote cellular function, maintain membrane structure, and act as messengers in the nervous system. DHA is essential for physical brain growth and development and EPA corresponds to the evolution of mood and behaviors. Consequently, adequate levels of omega-3 fatty acids are vital to optimal neurological functioning.
Fatty acids are essential to brain growth as early as the pre- and postnatal period, and are particularly important in behavior management, mood development, and sensory functioning in infants. These fatty acids, available naturally in colostrum and breast milk, are now added to many infant formulas to support brain and visual function.
Western diets are traditionally low in omega-3 fatty acid consumption. A review of studies relating to diet and psychological development concludes that this may, in part, contribute to the incidence and prevalence of psychiatric and neurodegenerative conditions in today’s society. The mechanism has not been clearly deciphered, but many psychiatric illnesses are associated with increased oxidative stress and pro-inflammatory conditions in the central nervous system. DHA and EPA have anti-inflammatory and antioxidant properties that may confer the neurological benefits of fatty acids.
Many studies have reported that depression is associated with low levels of omega-3 fatty acids, including perinatal and postpartum depression in mothers. Treatment of these disorders with fatty acid supplementation has elicited positive outcomes and shows promise as a viable treatment option for depressive disorders. Additionally, DHA and EPA supplementation benefits ADHD, autism, dyslexia, premenstrual syndrome, dysmenorrhea, bipolar disorder, schizophrenia, and borderline personality disorder.
Some research has shown a connection between low omega-3 fatty acid levels and substance abuse patients, as well as domestic violence perpetrators. A recent study reported that substance abusers showed a strong correlation between low levels of omega-3 fatty acids and anger and anxiety. When these substance abusers received fatty acid supplements, their anger and anxiety levels were reduced. Interestingly, an increase in EPA correlated to decreased anxiety, and increased DHA levels correlated to reduced anger. In a similar study, substance abusers treated with fatty acid supplements experienced reduced anger up to 3 months after the treatment was stopped. Omega-3 fatty acids also decrease the amount of corticotropin-releasing hormone in the central nervous system. This hormone plays a key role in fear and anxiety, components of violent behavior in perpetrators of domestic violence. Low levels of omega-3 fatty acids lead to increased hormones that play a role in violent behavior.
Additionally, omega-3 fatty acids may have a protective effect in acute and chronic neurological injury and diseases, possibly resulting from the anti-inflammatory and antioxidant effects of the fatty acids and their metabolites. Cognitive impairment and decline are also associated with low levels of DHA and EPA, and mental functioning was maintained in middle-aged patients when adequate levels of fish oils were consumed. Increased levels of EPA and DHA are also linked to a decreased incidence of dementia, including a decreased risk of Alzheimer’s disease.
Omega-3 fatty acid supplementation may prove to be effective treatment for many groups of patients suffering from psychiatric and emotional disorders, as well as neurological injury. Supplementation offers very few risks or adverse effects, and may be a safe treatment option for children, pregnant women, and patients with treatment-resistant psychiatric and mood disorders. More research is needed to further clarify the widespread clinical value of fish oil and omega-3 fatty acids.
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