Wednesday, November 23, 2016

Study Suggests Omega-3s May Not Improve Outcomes in People at High Risk of Psychosis

For years, researchers have been encouraged by evidence from a small, single-center trial that suggested omega-3 polyunsaturated fatty acids (PUFAs) might reduce the risk of onset and improve outcomes in patients at ultrahigh risk (UHR) for psychosis. The results of a multicenter study published today in JAMA Psychiatry now suggest omega-3s may be no better than placebo at preventing psychosis, reducing symptoms, or improving function in UHR patients.

“Although ω-3 PUFAs were well tolerated, they did not demonstrate an advantage over placebo in the prevention of psychosis at 6- or 12-month follow-up evaluations,” Patrick McGorry, M.D., Ph.D., of the University of Melbourne and colleagues wrote. “Secondary outcome measures of psychiatric symptoms and functioning tended to favor the placebo group.”

For the study, McGorry and colleagues recruited individuals from 10 specialized early psychosis programs in Australia, Asia, and Europe who met UHR criteria. They randomly assigned 304 people (aged 13 to 40) to take capsules containing 1.4 grams of omega-3 PUFA or placebo daily in combination with up to 20 sessions of cognitive-behavioral case management (CBCM) for six months. After the six-month intervention phase, the patients stopped taking the capsules but could continue to access CBCM as needed. Patients were allowed to take antidepressants for depression throughout the trial.

When the authors compared the rates of transition to psychosis status at six and 12 months, they found no significant difference between the groups; transition rates were 5.1% and 11.2% in the control group compared with 6.7% and 11.5% in the PUFA group. 

In a related editorial, John Kane, M.D., and Christoph Correll, M.D., of Hofstra Northwell School of Medicine in New York offer several factors to consider when interpreting the findings, including the “possibility … that this study did not show inefficacy of ω-3 PUFAs, but rather efficacy of the control condition (CBCM), which was given to both groups.”

“McGorry et al are to be congratulated on the conduct of this important replication study. … One hopes that two additional multisite studies of ω-3 PUFAs will further clarify its role in the prevention of psychosis,” they concluded.

For related information, see the Psychiatric News article “Multimodal Approach May Improve Ability to Predict Transition to Psychosis.”

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