Red cell and plasma fatty acid changes accompanying symptom remission in a patient with schizophrenia treated with eicosapentaenoic acid.
Richardson, A.J., Easton, T., Puri, B.K. (2000) European Neuropsychopharmacology 10(3) 189-93.
Abstract:
The administration of the omega-3 fatty acid eicosapentaenoic acid (EPA) to a drug-naive patient with schizophrenia, untreated with conventional antipsychotic medication, led to a dramatic and sustained clinical improvement in both positive and negative symptoms. This was accompanied by a correction in erythrocyte membranes of abnormalities in both n-3 and n-6 highly unsaturated fatty acids (HUFAs). Therefore EPA is able to reverse the phospholipid abnormalities previously described in schizophrenia.
This reversal is associated with, and is likely to be the cause of, the clinical improvement. In particular, EPA appears to have reversed the depletion of not only n-3 HUFAs, but also of membrane arachidonic acid, possibly via inhibition of HUFA-specific phospholipase A(2), an enzyme which removes HUFAs from the S(N)2 position of membrane phospholipids, or by activation of a fatty acid coenzyme A ligase. Correction by EPA of abnormalities in both enzyme systems is not ruled out.
FAB RESEARCH COMMENT:
In a young man diagnosed with schizophrenia who was not taking medications, dietary supplementation with the omega-3 fatty acid EPA for 6 months led to a dramatic and sustained improvement in his clinical symptoms, as reported elsewhere. (Puri and Richardson 1998)Here, we report in detail the corresponding changes in the patient's blood fatty acid profile over this 6 month treatment period.
Initially, this patient had very low blood levels of the long-chain omega-3 EPA and DHA, but both of these increased following EPA supplementation at 2g/day.
More surprising was that supplementation with omega-3 EPA only also led to increases in blood concentrations of AA (a key omega-6 fatty acid), which were also very low initially.
This suggests that EPA may be able to modify the action of enzymes that remove or add AA omega-6 (and other fatty acids) to cell membranes - although more research is needed to investigate this.
Meanwhile - these results are consistent with existing evidence of fatty acid abnormalities in schizophrenia (involving low blood levels of both omega-3 and omega-6 fatty acids), and indicate that an increased dietary intake of omega-3 EPA may help both to normalise blood fatty acids and reduce schizophrenia symptoms.
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