Fish oil showing promise in kids' brain disorders
By Julie Deardorff
Tribune health and fitness writer
June 12, 2007
European cardiologists routinely give heart attack survivors fish oil, one of the richest sources of omega-3 fatty acids.
But researchers suspect that omega-3's benefits extend beyond the heart. Now psychiatrists are wondering: Could omega-3 also help children suffering from attention deficit or bipolar disorder?
In an unusual twist in psychopharmacology, fish oil, which hasn't been studied as extensively as patentable drugs, is showing promise as an alternative or complement to pharmaceuticals.
It comes at a good time. The incidence of attention deficit and childhood bipolar disorder and spending for antipsychotic drugs is soaring in the U.S., but there is no gold standard of treatment.
Often, children are prescribed adult "mood-stabilizing" medications that have not been tested for safety in younger populations, even though there is growing evidence that bipolar disorder is manifested differently in children than in adults.
Commonly used drugs such as lithium have been shown to be only minimally effective in treating pediatric mania, while side effects (weight gain, acne and thirst) often discourage children from taking the medication.
Further complicating the drug-treatment approach is that bipolar and attention-deficit disorder share many of the same characteristics, including hyperactivity, distractibility, irritability and temper tantrums. But bipolar children will respond to mood stabilizers, while stimulants, which help patients with attention-deficit disorder, could push a bipolar child into increased symptoms of mania, according to the National Alliance for the Mentally Ill of Greater Chicago.
A feasible alternative, says researcher Janet Wozniak of Harvard's Massachusetts General Hospital, is an omega-3 product with unnaturally high levels an omega-3 fatty acid called EPA, or eicosapentaenoic acid.
In a small, eight-week trial, Wozniak's team tested a supplement called OmegaBrite in 20 children with pediatric bipolar disease.
Fish oil naturally has about 30 percent EPA and another fatty acid called DHA, or docosahexaenoic acid. The other 70 percent is other naturally occurring fatty acids.
OmegaBrite contains 90 percent omega-3 fatty acids; 70 percent EPA -- the highest EPA concentrate available in North America -- 10 percent DHA and 10 percent other omega-3 fatty acids.
In the study, 10 of the 20 children experienced a 30 percent reduction in symptoms with no side effects, which showed, "manic symptoms can be rapidly reduced in youths with bipolar disorder with a safe and well-tolerated nutritional supplement," Wozniak said.
Still, though Wozniak was enthusiastic, the authors concluded the improvement was "very modest," according to the study, published in European Neuropsychopharmacology.
And though epidemiologic research supports the notion that omega-3 has a protective effect against mood disorders, several issues still need to be resolved, including the most effective dose and the relationship between EPA and DHA.
At the Pfeiffer Treatment Center in Warrenville, where doctors treat everything from autism and bipolar to learning disorders and anxiety, about 90 percent of the patients take an omega-3 supplement. But the type of omega fatty acid they are given depends on the person's individual body chemistry and nutrient imbalance.
"DHA seems to be more important for pervasive development disorders, such as autism or Asperberger's," said Pfeiffer's Dr. Judith Bowman, who advocates fish-oil products from Nordic Naturals and Carlson.
"EPA seems more important for inflammation. We test 150 to 180 different parameters and select the omega that appears to be best for [a person's] chemistry."
Even people suffering from the same disorder might get supplements with different levels of EPA and DHA, said Albert Mensah, another doctor at Pfeiffer. "But certainly the concept is there. There's a great benefit with fish oil with all patients."
West Chicago's Irene O'Neill, 51, who was diagnosed with bipolar disorder when she was 20, has had great success with lithium -- including a 20-year career with Lucent technologies (now Alcatel-Lucent) -- but she still worries about the drug's side effects.
"I would be much happier if I were able to do equally well on only fish oil," said O'Neill, now a mental-health professional at the DuPage County Health Department and president of The Awakenings Project, a coalition of artists who live with mental illness. "But I can't afford to put my mental health in jeopardy by trying as yet unproven remedies, although the fish oil shows promise."
Especially as a complementary treatment. While the American Heart Association recommends fish oil and fish (salmon, sardines, herring, tuna or mackerel) to reduce heart attack risk and to help survivors, omega 3 also is suggested for people at risk for obesity and diabetes.
That means the health benefits of omega-3 -- also found in canola, ground flaxseed, walnuts and dark green leafy vegetables -- may be especially important in patients with psychiatric disorders, due to the high prevalence of smoking and obesity among them and the metabolic side effects of some psychotropic medications, researchers have found.
----------
Copyright (c) 2007, Chicago Tribune
