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Fish Oil: Summary of studies related to bipolar

Hi,
Waves mentioned the two fatty acids in fish oil in other thread. That inspired this post here.

This page was updated Jan 1, 2011. It has a chart showing of studies the past ten years.

http://www.psycheducation.org/depres...ds/Omega-3.htm

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Bottom line: the research is clear. This stuff works. Not very powerfully, and it takes a while to get in there. So if you're going to do it, give it two months to evaluate.

Fish oil contains fatty acids: EPA (eicosapentaenoic) and DHA (docusahexaenoic)

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Many of the other studies shown below, including the first one from Harvard, used fish oil tablets which provided both EPA and DHA. For now it seems safe to conclude that having both does not interfere with the antidepressant and mood stabilizing actions; and that EPA alone might be sufficient.

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Note also that their patients were also taking mood stabilizers, so this is fish oil as an add-on, not by itself as in the original study by Stoll that started this whole thing. Nevertheless, it suggests that a manageable dose of EPA might be sufficient

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Update 2007: a recent study indicates that people with severe Major Depression had less omega-three in a region of the brain associated with mood problems (frontal cortex).McNamara Interestingly, only DHA, not EPA, was decreased in this region. Does this mean that DHA matters? Much of the recent focus in omega-three treatment studies has been on EPA, but I'm not convinced that we know enough yet to focus on one or the other.

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1 gram of EPA per day -- the dose in biggest best-targeted study above, Frangou 2006 -- may be the best standard dose to shoot for. At least one might say that is probably the minimum to shoot for. How many pills is 1 gram of EPA? Depends on how concentrated the pill is, how much EPA per pill. Cheaper, less concentrated; and vice versa. See my fish (oil) stories page for the fishy details on the cheapest way to go.

Three Risks

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Mercury and other heavy metals
Hypomania
Increased risk of easy bleeding if taking other medications known to do likewise.

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Another commonly eaten fish, albacore ("white") tuna has more mercury than canned light tuna. So, when choosing your two meals of fish and shellfish, you may eat up to 6 ounces (one average meal) of albacore tuna per week.

Youtube video on Consumer Reports and Fish Oil in Prescription Form

1.
Prescription Fish Oil
http://www.youtube.com/watch?v=5H04t08PkiU

2.
Here is a page that states what is in the prescription pills.

http://www.omegavia.com/prescription-fish-oil-pill1/

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Each Lovaza pill has about 850 to 900 mg of Omega-3 fatty acids.
The EPA content is 465 mg and DHA content is 375 mg per pill.

OmegaBrite is the version used in the Stoll studies.

It is mostly EPA.

Since then DHA has become more popular. But if you want the Stoll product (his wife was the CEO of that Company originally)
That is the one to get.

http://www.omegabrite.com/

I am not sure if now after many years, Stoll is involved with this company. But he and his wife were, and this is what was used in his studies, back then.

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Originally Posted by mrsD (Post 804479)

Hi, Mrs. D.
Thank you. I used to order that one but lost track of the name in a move and then a computer crash.
I will wait until the weather cools here in Florida. I only order supplements online during late fall and winter months. Otherwise, the stuff is cooked before it gets to me.

M

found it - from "All In The Mind" - August 20th 2011

Here is a transcript from a show/interview with three scientists, mediated by Natasha Mitchell. the discussion (link below) touches on many issues regarding inflammation, depression and the development of other pathologies.

It states that we still lack well-designed studies with sufficiently large sample populations is to prove or disprove any definitive role of Omega-3 fatty acids in depression and inflammation. It discusses an inconclusive study on gestating women given DHA on the basis that depletion could occur due to fetal development. It also indicates that EPA seems to be more effective in treating depression, but indicates a need to differentiate between sub-types of depression and to discover which of these respond to treatment with Omega-3's.

This last part was the most interesting to me. anyway here is the link and some excerpts:

An inflammatory story: Depression and immunity
ALL IN THE MIND - 20 August 2011

they start in with fatty acids about half way down.

you have to click on "SHOW TRANSCRIPT" to see the article text.

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Natasha Mitchell: Now there's been a lot of inconsistent results of various studies investigating the benefits of Omega 3 supplementation on depression. Why so much inconsistency, is it simply a case of study design or is it that we can't really say with any certainty that Omega 3 supplementation is useful here?

Bronwyn Hegarty: A couple of factors. One is that some of the studies just haven't been designed, particularly in terms of having enough numbers. [...] But [...] I think it might be over-simplification to homogenise depression as a single disorder of inflammation if you like, and I think...at the Black Dog Institute what we see is there are different types of depression which have different causes and so it may be that Omega 3s will only be helpful for a certain sub-type of depression if you like. And what we need to do is to have a more thorough research to determine what types of depression are helped by Omega 3s.

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Natasha Mitchell: And the story is here you've got two different main types of Omega 3 fatty acid supplementations, you've got DHA and EPA, and in fact EPA might be more implicated in improving outcomes for depression than DHA.

Bronwyn Hegarty: Exactly, which again gives a strong link to inflammation. I should say that women who are pregnant are at risk of becoming depleted in Omega 3s because their baby requires Omega 3s for development, particularly development of the brain. The previous studies gave mainly DHA as a treatment because DHA is the major Omega 3 within the brain and is used a lot by the developing foetal brain.

Natasha Mitchell: It's a hungry foetus.

Bronwyn Hegarty: Exactly, but a lot of studies have shown that EPA rich Omega 3 supplements tend to be more effective at the treatment of depression. So that may have been one of the limiting criteria of that previous study. And so in our study we are wanting to find out whether an Omega 3 supplement that's higher in EPA will be of greater benefit.

~ waves ~

Dear Waves,

This is useful information.
Today I took two capsules that I have had in the fridge for a few months. They have slightly more EPA than DHE.

M

Since EFAs are called ESSENTIAL fatty acids, the bottom line is that we cannot live without them.

Whether they will cure or control a condition already present, is very difficult to prove, because of the many variables people have when chosen for study subjects. Nutritional studies are always difficult to substantiate.

But since we cannot live without EFA's ...a certain amount daily should be in your food choices, and if not, you need to supplement them. There are global benefits besides psychiatric ones... strengthening the membranes lining your lungs, your retina, your stomach (they can help prevent and control GERD)
and improving immune functions to reduce overactivity and autoimmune reactions.... EFAs should be a considered part of your diet and or supplement routine IMO.

For what it is worth, the higher DHA types (we used Carlson's DHA) enabled my son to go off Ritalin and clonidine for his ADHD. So I started using EFAs in our home over a decade ago!
I have a thread about them on our Vitamin forum.
I used to get flamed constantly when I posted this information on BT... by the internet bullies who used to post there BTW.

http://neurotalk.psychcentral.com/showthread.php?t=6092

aren't fatty acids good for our ph balance, skin and heart? Your input is always appreciated mrs d!!!!!!!
bizi

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Originally Posted by bizi (Post 804734)

aren't fatty acids good for our ph balance, skin and heart? Your input is always appreciated mrs d!!!!!!!
bizi

Yes, Bizi,
I think they bring down inflammation too.

M

inflammation and EFAs

the inflammation thing is a little complex.

Fatty acids are used in the synthesis of prostaglandins - these are substances our body makes which are responsible for pro-inflammatory and anti-inflammatory response.

There are basically 3 types, one of which tends to have anti-inflammatory type actions while the other two have different types of primarily pro-inflammatory type actions.

prostaglandins are derived from fatty acids, some of which can be synthesized in the body. a deficit in dietary intake of essential fatty acids can cause the body to have an imbalance of what it needs to make the prostaglandins in "balanced" way. this can also happen if we get enough, but our intake is skewed.

It is a tricky business because there is not, in every case, a single metabolic pathway by which a fatty acide can be metabolized. The body will "choose" different metabolic pathways based on what it has available but also the proportions of what it has available, and accordingly, produce different quantities of the different types of prostaglandins. This process is affected by other nutrients necessary for metabolism of certain EFA's - eg, Magnesium, Zinc, Vit C and B complex... probably others. Deficiency in these, no matter if you are getting all the right EFA's, can produce an imbalance in prostaglandins.

An excessively high dietary intake of meat and dairy for example, will generally provide too many omega-6 ESSENTIAL fatty acids. These are not per se "bad for you." What is bad is a disproportionate intake of these.

FWIW, EPA, which is found in fish oil, is one of the building blocks for anti-inflammatory type prostaglandins. However what the article i posted tells us is, taking more of it might not help, unless you aren't getting enough of it. Now it is true that eating habits in our current society have been skewed towards high meat consumption (high Omega-6 source), so that most of us get have a much too high ratio of Omega-6:Omega-3s.. To make things worse, many of us lack required "assistive" nutrients for the processing of Omega-3's to produce our nice anti-inflammatory prostaglandins, because we do not eat our share of veggies!

i apologize to anyone fully knowledgeable about the precise biochemical processes involved for the gross oversimplification for the purposes of illustration.

i apologize to anyone in difficulty reading, if i have made this too complicated. Unfortunately it IS quite complicated.

~ waves ~