G. Paul Amminger Discusses an Impressive Step Forward for Patients With Schizophrenia

Fast Breaking Papers Commentary, February 2011

G. Paul Amminger

Article: Long-Chain omega-3 Fatty Acids for Indicated Prevention of Psychotic Disorders A Randomized, Placebo-Controlled Trial


Authors: Amminger, GP;Schafer, MR;Papageorgiou, K;Klier, CM;Cotton, SM;Harrigan, SM;Mackinnon, A;McGorry, PD;Berger, GE
Journal: ARCH GEN PSYCHIAT
Volume: 67, Issue: 2, Page: 146-154, Year: FEB 2010
* Orygen Youth Hlth Res Ctr, 35 Poplar Rd,Locked Bag 10, Melbourne, Vic 3052, Australia.
* Med Univ Vienna, Dept Child & Adolescent Psychiat, Vienna, Austria.
(Addresses have been truncated)

G. Paul Amminger talks with ScienceWatch.com and answers a few questions about this month's Fast Breaking Paper paper in the field of Psychiatry/Psychology.


SW: Why do you think your paper is highly cited?

We show that treatment with a natural substance, without any clinically relevant side effects, may prevent, or at least delay, the onset of schizophrenia. More specifically, four people meeting at-risk criteria need to be treated with omega-3 polyunsaturated fatty acids (PUFA) for 12 weeks to prevent one conversion to psychosis during a period of one year.

This is comparable in magnitude with the number needed to treat reported in clinical trials of antipsychotic medications but treatment with fish oil has a much higher acceptance by young people than treatment with antipsychotics. The most striking finding of the study is that the group differences were sustained after cessation of the intervention. Trials of antipsychotics have not found this.

These results are very impressive and really represent a step forward potentially for patients and their families.

SW: Does it describe a new discovery, methodology, or synthesis of knowledge?

This is a first-of-its-kind study. Since the 1990s, researchers have wondered if schizophrenia could be stopped in its earliest stages, before it fully overpowers a person's grip on reality. Studies have tried antipsychotics in select young people, but troubling side effects pose ethical questions and results have been mixed.

SW: Would you summarize the significance of your paper in layman's terms?

Schizophrenia is a severe mental illness that strikes adolescents and young adults. About 2.4 million Americans have the disorder, which is treated with antipsychotic medication.
Fish oil pills may be able to save some young people with early signs of mental illness from descending into schizophrenia.

SW: How did you become involved in this research, and how would you describe the particular challenges, setbacks, and successes that you've encountered along the way?

Compared to adult psychiatry, research on treatments for psychiatric disorders in children and adolescents is sparse. As a clinician who predominantly works with adolescents, I think much more evidence-based interventions are needed for this age group. This is an important motivation for me to conduct randomized-controlled trials. Treatment agents should be effective but ideally also free of side effects to make them acceptable for young people.

Omega-3 fatty acids are generally health beneficial and potentially effective across a range of psychiatric conditions including psychotic and mood disorders. As a natural substance, omega-3 fatty acids are widely accepted and therefore ideal for early intervention.

A particular challenge of my work is to convince other researchers and clinicians that it may be worthwhile using omega-3 fatty acids as first-line intervention before conventional medications under particular circumstances. 

SW: Where do you see your research leading in the future?

We hope that our study stimulates further research to determine if omega-3 fatty acids can also be successfully used for other psychiatric disorders (i.e., depression in young people where the use of SSRIs may be associated with an increased risk of suicidality).

SW: Do you foresee any social or political implications for your research?

The finding that treatment with a natural substance may prevent or at least delay the onset of psychotic disorder gives hope that there may be alternatives to antipsychotics for the prodromal phase.

We hope that a large, multi-center replication study which is currently recruiting helps to establish omega-3 PUFA as the treatment of first choice in young people in the early stages of psychotic disorders. If successful, it will be an absolutely tremendous development.End

A/Professor G. Paul Amminger
Orygen Youth Health Research Centre
Centre for Youth Mental Health
The University of Melbourne, Australia
Parkville, Victoria, Australia

KEYWORDS: LONG-CHAIN OMEGA-3 FATTY ACIDS, PREVENTION, PSYCHOTIC DISORDERS, RANDOMIZED, PLACEBO-CONTROLLED, CLINICAL TRIAL, ETHYL-EICOSAPENTAENOIC ACID, 1ST-EPISODE PSYCHOSIS, SCHIZOPHRENIA, SYMPTOMS, IMPAIRMENT, DEPRESSION, RISK, ABNORMALITIES, INTERVENTIONS, PSYCHIATRY.

 
 

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