"You don't usually use new medicines based on one small study, but the fact that these [omega-3s] are so nontoxic and appear to be beneficial drives the equation toward using them," he said. "In fact, there are more data on fatty acids than on Neurontin [gabapentin], which is being widely used."
To help answer his patients' questions, Stoll has developed a user's guide. For example, he advises patients to find dietary supplement brands with high concentrations of omega-3 fatty acids to minimize the number of capsules to be taken daily.
Asked about the importance of the preliminary study, Stoll said there were three areas of impact: dietary, clinical and theoretical.
The study, Stoll said, pointed out how deficient Americans and people in other developed countries are in omega-3 fatty acids. "We evolved eating these omega-3s, and we are not getting them anymore. They are crucial for brain function," he said.
Clinically, the study results provided early evidence of the efficacy of omega-3 fatty acids for adjunctive treatment of BD, Stoll added. If other studies confirm the efficacy, it means that omega-3 fatty acids can be considered to be "a nice mood stabilizer that has antidepressant properties and is nontoxic."
On the theoretical front, Stoll said he and fellow investigators were searching for an agent with a specific mechanism-sort of a designer mood stabilizer. "This mechanism may apply to other compounds, and we may find a whole new class of mood stabilizers that have this membrane activity," he said, adding that this mechanism was more definitively described in the published article (Stoll et al., 1999).
"Biochemical studies of human white blood cells show that high-dose therapy with omega-3 fatty acids leads to the incorporation of these polyunsaturated compounds into the membrane phospholipids crucial for cell signaling," said Stoll and colleagues (1999). "Increased concentrations of omega-3 fatty acids in membrane phospholipids appear to suppress
phosphatidylinositol-associated signal transduction pathways [Medini et al.,1990; Sperling et al., 1993].