Overall, nine of the 14 patients who received omega-3 fatty acids had symptom-relief, while only three out of 16 patients who received the placebo showed relief, according to Stoll (McLean Hospital, 1999).
"Our study results indicate fish oil does possess elements to stabilize mood," he said.
More specifically, a Kaplan-Meier survival analysis of the cohort found that the omega-3 fatty acid patient group had "a significantly longer period of remission than the placebo group (p=0.002; Mantel-Cox). In addition, for nearly every other outcome measure, the omega-3 fatty acid group performed better than the placebo group."
While most patients in the study were on mood stabilizers, eight patients received no concomitant medications. Of those eight, the four patients who received omega-3 monotherapy remained in remission for a significantly longer time than did the four patients who received placebo monotherapy. However, Stoll cautioned against using omega-3 as first-line monotherapy.
"I wouldn't recommend it first for people. The patients in the study had failed other [medications]. The only way I would use omega-3s by themselves is in someone with an extremely mild form of the illness where treatment is almost optional. Otherwise, we use omega-3s as an adjunct," he said.
The most common adverse effect in both the omega-3 and olive oil groups was mild gastrointestinal distress, generally characterized by loose stools.
In an accompanying commentary to the published study, Stoll and co-author Marangell noted the high patient interest and acceptance of omega-3 fatty acids as mood stabilizers (Stoll and Marangell, 1999).
"This interest was based mainly on the recognition that omega-3 fatty acids are endogenous, 'natural' compounds with few side effects and little, if any, toxic effects," they said, adding that several patients have remained on open-label omega-3 monotherapy for longer than two years with continued efficacy.
Stoll told Psychiatric Times he uses omega-3 fatty acids as adjunctive medication in his clinical practice.
