Omega 3 Fish Oil Schizophrenia

Schizophrenia treatment Omega 3 Fish Oil EPA

Schizophrenia its self is not caused by poor nutrition, however people with schizophrenia are in need of sound nutrition just like everybody else. People who have poor nutrition can actually make things worse and also make it difficult for themselves to respond to treatment. It has been recognised that people with schizophrenia fail to eat a proper nutritious diet.
Essential nutrients and fatty acids are required to allow the body’s biochemical machinery to function efficiently and correctly. If the body becomes deficient of these nutrients it cannot function properly. Essential nutrients and fatty acids are relatively more important for the brain than any other tissue. This is because the brain uses up so much energy and metabolises so quickly. Although the brain is only around 2% of the body weight, it uses up about 20% of the bodies energy. So on average, its biochemical activity per unit weight is ten times higher than that of other organs. Like anyone else, people with schizophrenia may develop specific deficiencies of particular essential nutrients.

Schizophrenia treatment Omega 3 Fish Oil EPA

Ideally we should get all our essential fatty acids, minerals and vitamins from food; in practise this is often simply not possible. It is therefore sensible to take each day a good quality universal supplement which provides all the known essential fatty acids, minerals and vitamins. There are several of these available and assistants in chemist’s shops or health food shops will usually be able to point you in the right direction. Many people with schizophrenia have poor gastrointestinal absorption, especially if they are sensitive to gluten. In this case an extra multivitamin or multi mineral supplement each day, which provides twice the usual amount, may be appropriate. It is particularly important to take enough B12, folic acid and B6. These all help control the levels of homocysteine which may be harmful to nerve cells and which is so often elevated in people with schizophrenia.

Schizophrenia treatment Omega 3 Fish Oil EPA

Oxygen is essential to life, but under some circumstances it may be too active, damaging cells by oxidizing their components. There is increasing evidence from many different directions that, in schizophrenia, nerve and other cells are oxidized more readily than usual. This suggests an increased need for antioxidant intakes which are higher than those provided by ordinary multivitamin or multimineral tablets. It is important to use two antioxidants, one which will work in the watery parts of the body and one which will work in the cell membranes. Much more work needs to be done to work out exactly the levels of antioxidants required. However, a reasonable proposal in the light of current knowledge is that around 500mg/ day of vitamin c and 100 IU of vitamin E should be taken in addition to the multinutrients.

Vitamin c works best in the watery parts of the body and vitamin E in the cell membranes. Together they produce a co-ordinated effect.

Total fat. A major world health organisation (WHO) study has shown that all races and countries are about equally affected by schizophrenia with regard to the numbers of patients / 1000 population. However, the same study showed that the severity of the illness is considerably worse in some countries than others. Danish investigators have shown that this is best explained by the total amount of fat in the diet, especially saturated fats, the types found in meats, dairy products and hard margarines. The higher the intake of this types of fat, the higher the risk of a poor outcome of schizophrenia. It therefore makes sense to cut down on fat intake as much as possible. This is likely to have general health benefits.

Good fats. Not all fats are bad. While the WHO study showed that high levels of saturated fats were associated with a poor outcome of schizophrenia. It also showed that vegetable and fish fats were associated with a relatively good outcome. People with a low intake of saturated fats and a high intake of vegetable and fish fats did well

Fish fats, and the oils extracted from them, contain two biologically active omega 3 fatty acids, DHA, EPA. There are good theoretical reasons why both might be important in the brain. However, with regard to schizophrenia evidence is accumulating that it is the EPA which is really helpful whereas DHA may not be beneficial in this context. The strongest evidence comes from a study at Sheffield University by Dr Malcolm Peet and his colleagues. They did a study in patients with chronic, partially treatment resistant schizophrenia. These patients continued on their existing medications. They were then randomised on a double blind basis to receive either a placebo, or high EPA fish oil from sardines or anchovies, or high DHA fish oil from tuna. The words randomization and double-blind mean that all the treatments were coded so that neither the patients nor the doctors know which patient was receiving which treatment until the trial had been completed and the code broken. When the code was broken, the results were very clear. The placebo patients, as always happens showed a small improvement. The DHA patients also showed a small improvement but this was actually less than the placebo group, raising the possibility that DHA may not be helpful. In contrast the patients on EPA showed a significant improvement which was comparable to that seen with the newer antipsychotic drugs but without the side effects.

Other studies have also shown that the same EPA rich oil as was used in the Sheffield study is very helpful in improving symptoms even in those who have a shorter history of schizophrenia. It therefore seems that the best fish oils to use are those which are high in EPA.

References

1 Jablensky A . The 100 year epidemiology of schizophrenia. Schizophrenia research 1997; 28:111-125.
2 Christensen O, Christensen E. Fat consumption and schizophrenia . Acta psychiatrica Scandinavica 1988; 78: 587-591
3 Mellor JE, Peet M. Double blind placebo controlled trial of omega 3 fatty acids as an adjunct to the treatment schizophrenia Davos Switzerland, Feb 7-13 1998.

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