Omega-3 benefits may be sustained in early psychosis

By Eleanor McDermid, Senior medwireNews Reporter

The positive effects of omega-3 supplementation seen in patients at high risk of psychosis in a previous randomised, controlled trial may be sustained, the investigators reported at the International Early Psychosis Conference in Tokyo, Japan.

When followed up a median of 6.7 years after the original intervention, just four (9.8%) of 41 patients in the omega-3 group had transitioned to psychosis, compared with 16 (40.0%) of 40 patients given placebo.

However, lead researcher G Paul Amminger (University of Melbourne, Victoria, Australia) cautioned that “it will not be possible to make recommendations on the efficacy of omega-3 preventing transition to psychosis until the results have been confirmed in two replication trials.”

The original trial included 81 patients, aged 13 to 25 years, who had subthreshold positive psychotic symptoms, transient psychosis or genetic risk for psychosis plus a decrease in functioning.

The participants were randomly assigned to receive 1.2 g/day long-chain omega-3 polyunsaturated fatty acids or placebo for 12 weeks. At the 12-month follow-up, two (4.9%) patients in the omega-3 group and 11 (27.5%) in the placebo group had transitioned to psychosis. So during the extended follow-up, another two patients in the omega-3 group and five in the placebo group transitioned.

In addition, patients in the omega-3 group had a significantly slower progression to transition than those in the placebo group, and significantly better scores on the Global Assessment of Functioning scale.

However, independent commentators urged caution, noting that the evidence for benefits with omega-3 in psychosis is generally weak, despite the plausible theory, and echoing Amminger’s comment that the results must be replicated in additional patient groups.

In a press statement, Peter Jones (University of Cambridge, UK) said that, despite these concerns, “the fact that the early and rather dramatic effect in the small, initial trial was maintained is certainly of interest. Let’s hope this will be one occasion when the effect of a pilot trial doesn’t melt away when the larger, independent trial comes out.”

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