Are n-3 Fatty acids Benefical in Depression but Not Mania?
Kuan-Pin Su, MD; Winston W. Shen, MD Su KP; Huang SY; Shen WW
Abstract
In their innovative preliminary trial, Stoll et al1 concluded that 3 fatty acids were well tolerated and improved the short-term course of illness in patients with bipolar disorder. Although only 120 days in the blind phase, this study was reasonably well-designed. The primary outcome measure was the length of time to complete the blind phase of the study without any treatment-emergent mood episodes, but the results as shown in Table 21 also showed that all of the
"noncompleted" cases (3 of 14 cases) in the 3 group developed a manic episode (mania, hypomania, and worsening of mixed state), whereas the depressive symptoms of all of the noncompleted cases (10 of 16 cases), except 1 in the placebo group, worsened! The aforementioned observation might suggest the hypothesis that 3 fatty acids could prevent depression but not mania among the bipolar patients. To test this hypothesis, future research should design a way to compare the 3 fatty acid treatment effectiveness between depressive and manic phases of patients with bipolar disorder.
In addition, we suggest that the patients in the placebo group should also receive tertiary butylhydroquinone and tocopherols as they did in the 3 fatty acids group, to avoid the possible therapeutic effect from this compound as a confounding factor, and that the concern of having a "fishy" aftertaste in the 3 fatty acids group can be amended by blending an orange flavor into the gelatin capsules for the 3 fatty acids and placebo groups.
