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Omega-3, Obsessive Compulsive Disorder (OCD)
DR. EDMOND O`FLAHERTY
I read in the May 99 issue of Archives of General Psychiatry that a small group of unstable bipolar patients showed a good response to omega-3 fatty acids. One of my bipolar patients had intractable Obsessive Compulsive Disorder.She worried about Aids all the time although her risks were negligible and her tests were negative. She was on lithium, olanzepine 10mg daily and fluoxetine 80mg daily. I added omega-3 fish oil and within a few days her Obsessive Compulsive Disorder was well under control. Three other changes of note occurred too. She was a 30 per day smoker and yet within 2 weeks she stopped smoking. She became relaxed and her sleeping pattern became very good. Three years later she has no significant Obsessive Compulsive Disorder (except when she stops taking the fish oil, as she did twice), can have a relationship without any AIDS worries but continues to take her omega-3 at about 5g daily.
These facts fascinated me so I have been reading all I can find about omega-3 since as well as trying it on people for whom nothing else worked. Five cases (out of 8) of OCD have responded to a significant extent. In one case a 25-year woman spent much of her time washing her hands in a ritual fashion, could not wash her hair and could not change her baby’s nappy (diaper).She had agoraphobia too so she could not leave home without her partner. After 3 days on omega-3 her hand washing dropped to a normal level, she could change the diaper and could wash her hair. Her agoraphobia disappeared and she noticed she was more relaxed and was sleeping well. A month later her hands, which had been in a terrible state, were back to normal and she could not believe she was well for the first time since she was sexually assaulted at 13.A few months later she got a job for the first time in her life. She ran out of the fish oil twice and relapsed in about two days so now she makes sure to keep a supply in stock. This woman had been attending psychiatric clinics for years to little effect and she continues on clomipramine 225mg daily. Her omega-3 dose was 4 fish oil capsules, each containing 180mg EPA and 120mg of DHA.This is not a drug but a dietary supplement and costs less than a euro or dollar daily. She is smoking less now too. Five months later she remained well, and was taking 7 omega-3 daily. In the third case a woman got relief from her ritual washing on 3g omega-3 daily. In the fourth case an 18-year old man prone to worrying about stupid things such as could his 72-year old grandmother get pregnant and who drove his parents demented as well as having several rituals is much better on omega-3.He was unable to take any SSRI drug. In the fifth case a 10-year old boy who was on paroxetine for his rituals of touching things is now able to cope on omega-3 only and his mother is really pleased with his progress. He takes 1g daily. In one case where a woman’s obsessions are still present to a significant extent she feels much better overall and is increasing her omega-3 dose to 3g from 2g daily. In the seventh case I have seen no objective improvement in a 12-year old boy who is also on paroxetine 20mg.He is on 3g omega-3 for a month now and is going to try it for another few weeks as his condition is very troublesome to himself and his family. Having noted the fact that the agoraphobic OCD lady who had been sexually abused felt clean since going on omega-3 I have now had another case where a very troubled woman (following sexual abuse in her youth) is much more at ease with herself and got through her fourth pregnancy without any post-natal depression which she had in the other pregnancies. It is likely that the omega-3 played a big part.
In conventional psychiatry the treatment for OCD is high doses of SSRIs such as Prozac 60-80mg daily. Other natural treatments that may help and are used as an addition to SSRIs include the following: methionine 500mg twice daily, calcium 1,000mg daily, vitamin B6 200mg daily (or P5P 50mg daily). Inositol is used in doses of about 1-16g daily depending on the source you read-generally use close to 1g but I have read good reports of up to 16g too. Betaine 100-500mg daily and zinc 50mg daily may help too. Avoid supplements of folic acid, copper and also avoid too much chocolate. If you get a bad reaction to any of these items stop it immediately as sometimes they have a negative effect on some individuals depending on the body’s biochemistry. You do not have to take all on this list-every person is different.
In many cases the smoking level drops significantly after only a few days on high doses of omega-3 (especially if on 10g or so) and some have stopped smoking with no great difficulty. A few people in their 40s and 50s gradually stopped smoking without any real plans to do so-it just seemed to happen spontaneously 31-year old man who is prone to depression went on 3g omega-3 daily and gave up smoking within a week. A month later he was in good form and had no craving for nicotine. The sleeping pattern improves, anxiety and depression frequently respond and several have come off benzodiazepines or at least reduced their consumption by 30%.One man who was taking enormous doses of benzodiazepines for 20years got off them over several months. One woman who used take a benzodiazepine to sleep told me she needed only 4 in the following month and her panic attacks disappeared since she went on 2g of omega-3.Eight months later she has taken no further benzodiazepines but has taken 30 zopiclone 7.5mg in total and has no panic attacks. One alcoholic drinks 3 cans of beer daily instead of nine since he went on the omega-3 and he has cut his tobacco input by more than half. One woman put her 70-year old alcoholic mother on 3g omega-3 daily and has noticed that her mother’s drinking pattern is now quite acceptable. One 40-year-old teacher who drank a bottle of wine a day now drinks 2 or 3 glasses instead and this situation has been stable for over two years. A 47-year old technician who was on fluoxetine 20mg for depression was not doing great. I added omega-3 and he stopped the fluoxetine a month later. He is in very good form, smokes only a few cigarettes daily instead of 20 and takes 2 glasses of wine instead of a bottle daily.Omega-3 helps in about 30% of cases of intractable depression, usually in association with antidepressants. A 22 year-old woman who was on methadone reduced her consumption by 20% in a week so easily that she only noticed the extra amount she had left at the end of the week. A 39-year man on methadone reduced his consumption by 15% without difficulty. A 23-year old man who a bad craving despite being on 80mg methadone daily has no craving since he started on 3g omega-3 daily. His sister was amazed to see him spend Euros (dollars) 13 weekly on fish oil where recently he spent everything on heroin. Two years later he is off all drugs and has a full-time job. Trying it in heroin addicts may be worthwhile then. A man who tried for years but could not come off eight 30mg codeine tablets daily managed to do so with a high dose of omega-3.He took 15g daily compared to the dose of 9.6g used in the bipolar trial. Incidentally his smoking level dropped by 30% too but it has gone back to his normal figure now that he is off the omega-3.He was surprised that he could have his breakfast without having a cigarette first thing in the morning while on the fish oil. These are some of the better results achieved. However some achieved little or no benefit.
Research in Sheffield University in UK shows a 25% improvement in Schizophrenics who take fish oil who and I believe that everybody with that condition should try omega-3 for several months at least if they cannot go through the series of tests which I do on my patients. During the Second World War in Norway the incidence of schizophrenia declined which suggests some connection with the diet and especially the return to eating a more natural diet. Bit by bit omega-3 replaces excess omega-6 fatty acids in our brain if we take omega-3 fish oil so that it functions in a much more natural state.
This paragraph was added to this site in Oct. 2004. In my own practice now
I see patients with schizophrenia, bipolar and depression who often come to
me from a long distance away from my practice in Dublin. I take blood, urine
and sometimes hair samples and send them to a specialised nutritional laboratory
in London. The results determine the best nutrients for their condition which
I recommend that they take in addition to and not as a replacement for their
regular medication. It can make a great difference to their lives, gets many
of them back to work, keeps many out of hospital and it is by far the most useful
and satisfying work I do as a physician. Many of the patients I see have attended
top psychiatrists for years and it is very satisfying to see what I can achieve
for so many, but alas not all of them.
An interesting point about bipolar (manic depression) is that it affects 6.5% of Germans but only 1 in 500 in Iceland. The rate of schizophrenia is similar in both countries, suggesting that omega-3 seems a very natural part of the treatment for bipolar. It is widely recommended that a supplement of Vit. C (1g)and E(400-800 i.u) and perhaps a multivitamin should be taken too as antioxidants. Because it appears to inhibit clotting to a minimal extent(and so reduce embolic strokes overall) it may be safer for those on drugs used to thin the blood to avoid taking omega-3 and it is unsuitable for haemophiliacs.
Omega-3 is basically the oil content of fatty fish such as mackerel and salmon and is found mainly in 2 forms-EPA and DHA of which EPA appears to be the more important biologically in adults. A deficiency in our level of this chemical could be the cause of a lot of our psychiatric problems. As a family doctor I deal with a large number of these patients and it has reached the stage where I now recommend a trial of omega-3 in almost every case as part of their treatment.
I met a psychiatrist from London at a conference in May 2002 and he told me
he prescribes it every day because "it really works”. Other psychiatrists
have never heard of it. IN AUGUST 2003 I BOUGHT 3 CDS ON "NUTRITIONAL TREATMENT
OF PSYCHOTIC DISORDERS" BY WILLIAM WALSH PH.D OF THE PFEIFFER RESEARCH
CENTER NEAR CHICAGO.HIS VIEWS ARE MOST INTERESTING AND ARE WORTH LOOKING INTO.OMEGA-3
IS JUST ONE OF MANY NATURAL MEDICATIONS THEY RECOMMEND AT PFEIFFER FOR A WHOLE
RANGE OF PSYCHIATRIC CONDITIONS,USUALLY IN ASSOCIATION WITH REGULAR MEDICATION.
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