Omega-3 Fatty Acid Treatment for Bipolar Disorder

Omega-3 essential fatty acids, naturally occurring substances found in food, have long been known to play a role in brain development. Now, research shows that these long chains of fatty acids may be of use in treating Bipolar Disorder. A study by Harvard researcher Andrew Stoll, MD, for instance, looked at a group of thirty bipolar adults who were given a four-month trial on either omega-3 fatty acids or a placebo (in this case, olive oil). The study found that the omega-3 group had a longer period of remission of symptoms than the placebo group. Stoll did not recommend omega-3 fatty acids as a first line of treatment. Patients who were already on mood stabilizers continued on them along with the large doses of omega-3 fatty acids that were added to their treatment regimens.¹

How omega-3 fatty acids can improve mood is still a matter of debate, but some scientists theorize that it has an effect on brain function in ways that are similar to lithium and Depakote. It's been suggested that there may be an association between the increased prevalence of depression and the lower consumption of omega-3 fatty acids in the modern diet. Omega-3 fatty acids are found in fatty fish such as mackerel, halibut, herring, salmon, and tuna and also in plant sources such as canola oil, flaxseed oil, ground flaxseed, leafy greens, soybean oil, tofu, and walnuts.

In my practice, I prescribed omega-3 fatty acids as treatment for two siblings (of two different bipolar child patients) who seemed mildly depressed. In both cases, the ingestion of omega-3 fatty acids appeared to normalize their moods. However, one to two years later, one of the children developed clear manic episodes and needed to be treated with a mood stabilizer. The other child became more depressed within a few years after starting omega-3 fatty acid treatment but showed no evidence of bipolarity and did well on an antidepressant.

I also decided to try omega-3 fatty acid supplements with two girls who had Bipolar Disorder and ADHD and had experienced a variety of side effects while on different mood stabilizers and stimulants. To my surprise, both girls appeared much improved with this treatment alone. Recently, I ran into the parents of one of the girls; the family had moved to Pennsylvania, and I had not seen their daughter (who was now eighteen and about to go off to college) in four years. They told me that her new psychiatrist had continued her on the omega-3 fatty acids and that her mood has been relatively stable over the years. She had experienced some intermittent mild mood swings, but they were treated with psychosocial interventions and had resolved without adding medication.

Potential side effects of omega-3 fatty acids treatment include loose stool, increased irritability, elevated mood, a fishy after taste, and nose bleeds. One boy I treated, with no known history of allergies, developed a rash all over his body shortly after starting on omega-3. Why this happened is unknown, but the rash definitely ended his treatment with fish oil.

One more caution should be added: As omega-3 fatty acids can potentially interfere with the ability of blood to clot, they should not betaken by people with clotting disorders or by those on anticoagulants (blood thinners), nor should they be taken before surgery. In addition, given the ability of omega-3 fatty acids to act as a medication, I'd recommend checking with your doctor before beginning a therapeutictrial on your own. Dietary supplements are probably a good way to get higher doses of omega-3 fatty acids, as excessive fish consumption can cause a potentially dangerous elevation of mercury levels in the body. It's recommended that vitamin C and E supplements also be taken with the fish oil treatment.

1. A. L. Stoll, W. E. Severus, M. P. Freeman, et al., Omega 3 fatty acids in Bipolar Disorder, Archives of General Psychiatry 56 (1999): 407.

Excerpted from: