Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial.
Level 2 - randomized trial
Individual randomized double-blind placebo-controlled trial
PubMed 20124114 · doi:10.1001/archgenpsychiatry.2009.192
What was done
A randomized, double-blind, placebo-controlled trial evaluated whether long-chain omega-3 polyunsaturated fatty acids (PUFAs) prevent transition to psychotic disorder in individuals aged 13 to 25 years at ultra-high risk. Conducted between 2004 and 2007 at a hospital psychosis detection unit in Vienna, Austria, 81 participants were assigned to 1.2 g/day of omega-3 PUFA or placebo for 12 weeks, followed by a 40-week monitoring period (12 months total). The primary outcome was transition to psychotic disorder; secondary outcomes included symptom changes, functioning, and adverse effects.
What was found
Seventy-six of 81 participants (93.8%) completed the 12-week intervention. At 12 months, 2 of 41 participants (4.9%) in the omega-3 group and 11 of 40 (27.5%) in the placebo group transitioned to psychotic disorder (P = .007), representing a 22.6% difference in cumulative risk of progression (95% CI, 4.8-40.4). Omega-3 PUFAs significantly reduced positive symptoms (P = .01), negative symptoms (P = .02), and general symptoms (P = .01), and improved functioning (P = .002) compared to placebo. Adverse effect rates did not differ between groups.
Why it matters
This trial indicates that a short course of omega-3 PUFAs may safely prevent or delay onset of full-threshold psychotic disorders in ultra-high-risk youth without the side effects of antipsychotic medication.
Limits
The study was conducted at a single site with a small sample size (n = 81), and outcomes were monitored only up to 12 months, leaving longer-term persistence of the preventive benefit uncertain.
Cited by
- supports Supplementation with at least 1 gram of omega-3 containing EPA per day for 8 to 12 weeks showed modest benefit for early-phase psychosis and schizophrenia, but did not have the same effect for chronic schizophrenia.