1. Home>
2. Specialties>
3. Psychiatry>
4. Summary and Comment

Omega-3 Fatty Acids in Bipolar Depression: Are You What You Eat?

The results are promising, but the study needs to be performed in a more typical population.

Successfully treating the depressive phase of bipolar illness remains the greatest challenge for clinicians caring for these patients. Omega-3 fatty acids have benefited patients with unipolar depression or bipolar illness in preliminary trials, and geographic rates of depression are inversely proportional to the amount of fish consumed. In a randomized, controlled, 12-week study in Germany, researchers compared the effects of adjunctive use of 1 mg and 2 mg of the omega-3 eicosapentaenoic acid (EPA) and placebo.

The 75 bipolar depressed participants (86% with bipolar I disorder) were not suicidal, had no substance dependence, and had minimum baseline scores of 10 (mean, 15) on the Hamilton Rating Scale for Depression (Ham-D). Length of the current depressive episode averaged 5.6 months. Medications were changed or adjusted in 26 patients (35%).

In preliminary comparisons, the two EPA doses produced similar results. The pooled EPA group demonstrated significantly greater improvement than the placebo group on the Ham-D from baseline to week 12 (mean difference, 3.3 points; effect size, 0.34), without aggravation of mania. Side effects were minimal, and subjects were not able to guess their group assignments at study end.

Comment: Consistent with smaller studies of unipolar and bipolar patients using similar EPA doses, these results suggest that EPA is beneficial for bipolar patients with depression. The baseline Ham-D scores were modest, but this scale does not measure hypersomnia and fatigue, which are prominent in bipolar depressed patients. Exclusion of patients with suicidality and substance abuse and the absence of patients with severe depression seriously limit this study’s generalizability. Still, the results are promising and argue for additional investigation.

— Peter Roy-Byrne, MD

Published in Journal Watch Psychiatry February 8, 2006

Citation(s):

Frangou S et al. Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: Randomised double-blind placebo-controlled study. Br J Psychiatry 2006 Jan; 188:46-50.

• Original article (Subscription may be required)
• Medline abstract (Free)