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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Maureen on December 7, 1998, at 7:24:03
There was a recent article in the Boston Globe that reported on a study conducted by the chief of Psychopharm. at Brigham and Womens hospital . A population of people with Bipolar illness rec'd Fish oil supplements and the was a Placebo grp. The study was stopped midway as the Fish oil group waws so clearly benefiting. I believe the date of the article was Sept. 4.
Posted by Michelle on December 29, 1998, at 9:49:36
In reply to Re: Omega 3's and major Mental illness, posted by Maureen on December 7, 1998, at 7:24:03
I have read a number of articles and abstracts on research correlating omega 3 FA deficiencies and mood disorders. Here's a few references:
Biol Psychiatry 1998 Mar 1;43(5):315-319
Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients.
Peet M, Murphy B, Shay J, Horrobin D
University Department of Psychiatry, Sheffield, United Kingdom.J Affect Disord 1998 Mar;48(2-3):149-155
Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients.
Edwards R, Peet M, Shay J, Horrobin D
University Department of Psychiatry, University of Sheffield, UK.J Affect Disord 1996 Apr 26;38(1):35-46
Fatty acid composition in major depression: decreased omega 3 fractions in cholesteryl esters and increased C20: 4 omega 6/C20:5 omega 3 ratio in cholesteryl esters and phospholipids.
Maes M, Smith R, Christophe A, Cosyns P, Desnyder R, Meltzer H
Clinical Research Center, University Department of Psychiatry, Antwerp, Belgium.Lipids 1996 Mar;31 Suppl:S157-61
Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression.
Adams PB, Lawson S, Sanigorski A, Sinclair AJ
Central Region Mental Health Service, Rockhampton Base Hospital, Queensland, Australia.Am J Clin Nutr 1995 Jul;62(1):1-9
Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy.
Hibbeln JR, Salem N Jr
Laboratory of Membrane Biophysics and Biochemistry, DICBR, National Institute of Alcohol Abuse and Alcoholism, Rockville, MD 20852, USA.Can ancient diet improve modern psyche?
By John Fauber of the Journal Sentinel staff
September 21, 1998Researchers: Fat in the diet may affect mental ability
September 4, 1998
Web posted at: 6:36 p.m. EDT (2236 GMT)
From CNN Medical Correspondent Dan Rutz
Posted by dj on August 31, 1999, at 10:47:59
In reply to Re: Omega 3's and major Mental illness, posted by Michelle on December 29, 1998, at 9:49:36
Anyone have any e-copies of this stuff they can post...or urls???? or other references???
> I have read a number of articles and abstracts on research correlating omega 3 FA deficiencies and mood disorders. Here's a few references:
> Biol Psychiatry 1998 Mar 1;43(5):315-319
> Depletion of omega-3 fatty acid levels in red blood cell membranes of depressive patients.
> Peet M, Murphy B, Shay J, Horrobin D
> University Department of Psychiatry, Sheffield, United Kingdom.
> J Affect Disord 1998 Mar;48(2-3):149-155
> Omega-3 polyunsaturated fatty acid levels in the diet and in red blood cell membranes of depressed patients.
> Edwards R, Peet M, Shay J, Horrobin D
> University Department of Psychiatry, University of Sheffield, UK.
> J Affect Disord 1996 Apr 26;38(1):35-46
> Fatty acid composition in major depression: decreased omega 3 fractions in cholesteryl esters and increased C20: 4 omega 6/C20:5 omega 3 ratio in cholesteryl esters and phospholipids.
> Maes M, Smith R, Christophe A, Cosyns P, Desnyder R, Meltzer H
> Clinical Research Center, University Department of Psychiatry, Antwerp, Belgium.
> Lipids 1996 Mar;31 Suppl:S157-61
> Arachidonic acid to eicosapentaenoic acid ratio in blood correlates positively with clinical symptoms of depression.
> Adams PB, Lawson S, Sanigorski A, Sinclair AJ
> Central Region Mental Health Service, Rockhampton Base Hospital, Queensland, Australia.
> Am J Clin Nutr 1995 Jul;62(1):1-9
> Dietary polyunsaturated fatty acids and depression: when cholesterol does not satisfy.
> Hibbeln JR, Salem N Jr
> Laboratory of Membrane Biophysics and Biochemistry, DICBR, National Institute of Alcohol Abuse and Alcoholism, Rockville, MD 20852, USA.
> Can ancient diet improve modern psyche?
> By John Fauber of the Journal Sentinel staff
> September 21, 1998
> Researchers: Fat in the diet may affect mental ability
> September 4, 1998
> Web posted at: 6:36 p.m. EDT (2236 GMT)
> From CNN Medical Correspondent Dan Rutz
Posted by yardena on August 31, 1999, at 14:46:55
In reply to Re: Omega 3's and major Mental illness, posted by ziva stahl on August 31, 1999, at 7:07:54
I saw a link from Dr. Ivan's depression central to an article about omega 3 oils. I believe the site is an AMA site.
Posted by JohnL on September 1, 1999, at 16:57:07
In reply to Re: Omega 3's and major Mental illness, posted by yardena on August 31, 1999, at 14:46:55
This topic is very interesting. Would like to know more about that research study. Stopping a research study in midstream sounds fishy to me. No pun intended. :) I take fish oil every day. I find even the flavored stuff to be repulsive, but I swallow it anyway. I'm not sure what an effective amount is though. I take one or two tablespoons a day and can't say it has any effect one way or the other. Does anyone know how much to take?
Posted by Elizabeth on September 6, 1999, at 0:42:11
In reply to Re: Omega 3's - How Much?, posted by JohnL on September 1, 1999, at 16:57:07
Andy Stoll and colleagues did a small pilot study on this. They published their results in the May issue of the Archives of General Psychiatry (http://www.ama-assn.org/sci-pubs/journals/archive/psyc/vol_56/no_5/yoa8185.htm).
The doses required are prohibitively high, unfortunately. Hopefully more concentrated preparations will be available in the future.
Posted by Louise on September 6, 1999, at 14:41:36
In reply to Omega 3's - , posted by Louise on September 6, 1999, at 14:39:59
> > Andy Stoll and colleagues did a small pilot study on this. They published their results in the May issue of the Archives of General Psychiatry (http://www.ama-assn.org/sci-pubs/journals/archive/psyc/vol_56/no_5/yoa8185.htm).
> >
> > The doses required are prohibitively high, unfortunately. Hopefully more concentrated preparations will be available in the future.> Andy Stoll and colleagues did a small pilot study on this. They published their results in the May issue of the Archives of General Psychiatry (http://www.ama-assn.org/sci-pubs/journals/archive/psyc/vol_56/no_5/yoa8185.htm).
>
> The doses required are prohibitively high, unfortunately. Hopefully more concentrated preparations will be available in the future.Seven capsules 2td does seem pretty high! But then again, if fish breath stops you from getting high then maybe we can just buy stronger toothpaste!
Does anyone know how the GLA amounts in capsules labelled 'pure fish oil'dose 1000mg each relate to the capsules used in the previously mentioned study. ("Subjects received 7 capsules twice daily, for a total daily 3 fatty acid dosage of 6.2 g of eicosapentanoic acid and 3.4 g of docosahexanoic acid").
Can someone please make sense of these doses?
BTW, a post hoc test on the research data showed that ALL those on no other meds had not relapsed for a significantly longer time (bearing in mind that when talking stats this may only be 5% longer which isn't much when you're talking about bipolar mood swings) when taking these doses of Omega 3. This sounds like good news though.
It would be good to see a comparative groups study examining various serum levels of Omega 3 as the ideal dose seems elusive.
Louise
Posted by Elizabeth on September 6, 1999, at 23:39:43
In reply to Take 2 - Omega 3's comments & ????????, posted by Louise on September 6, 1999, at 14:41:36
On a bottle of fish oil extract that you find in your local health food store, there will be a listing of the amount (in grams) of each of the essential fatty acids is in "one serving" (note that this may be defined to be two pills, for example). The relevant fatty acids are eicosapentanoic acid (EPA) and docosahexanoic acid(DHA). You want to take enough pills to get effective doses of these -- I *believe* that EPA is the one that's really important, but I'm not positive.
Posted by Louise on September 7, 1999, at 3:55:56
In reply to Re: Take 2 - Omega 3's comments & ????????, posted by Elizabeth on September 6, 1999, at 23:39:43
> On a bottle of fish oil extract that you find in your local health food store, there will be a listing of the amount (in grams) of each of the essential fatty acids is in "one serving" (note that this may be defined to be two pills, for example). The relevant fatty acids are eicosapentanoic acid (EPA) and docosahexanoic acid(DHA). You want to take enough pills to get effective doses of these -- I *believe* that EPA is the one that's really important, but I'm not positive.
Hi Elizabeth
I bought the ones without the breakdown info in the plain packaging because they were much cheaper, so I'll just have to stop being lazy and check out the other brands for the info!
Why do you believe that EPA is more important?
Louise
Posted by Sandy on September 8, 1999, at 0:54:51
In reply to Omega 3's - how much?, posted by Louise on September 7, 1999, at 3:55:56
The following information is from Dr. Jerry Cott, Chief, Adult Psychopharmacology Research Program, NIMH in Bethesda, MD.
HOW MUCH: A "minimum" dose which might be considered reasonably effective is 1 gm/day of EPA plus DHA. The FDA recognizes up to 3 grams/day as being generally safe. Dr. Stoll thinks 5 grams is good.When doctors talk about Omega-3 in grams, they are referring to EPA & DHA content of fish oil. The outside of the bottle may say 1000mgs fish oil. Then, you check the back and it may say, 2 pills = 1000mgs. If it says 1000mgs of fish oil capsule contains 350 mg EPA & DHA, that means you'd have to take 3000mgs fish oil in order to get 1.05 grams of Omega-3.
Dr. Cott recommends taking supplements of antioxidants to prevent oxidation of all the extra omega-3 oil going into the body. Based on his studies of oxidative stress in mental disorders, Dr. Mahadik in Georgia is recommending 1200 IU natural vitamin E and 2000 mg vitamin C daily for adults. Take only "Natural E" with "d-alpha-tocopherol." The synthetic version begins with "dl." If Vitamin C cannot be tolerated, other antioxidants such as grape seed extract, alpha lipoic acid, or pycnogenol may be a substitute.
Posted by Louise on September 8, 1999, at 4:12:59
In reply to Re: Omega 3's - how much?, posted by Sandy on September 8, 1999, at 0:54:51
> The following information is from Dr. Jerry Cott, Chief, Adult Psychopharmacology Research Program, NIMH in Bethesda, MD.
>
> HOW MUCH: A "minimum" dose which might be considered reasonably effective is 1 gm/day of EPA plus DHA. The FDA recognizes up to 3 grams/day as being generally safe. Dr. Stoll thinks 5 grams is good.
>
> When doctors talk about Omega-3 in grams, they are referring to EPA & DHA content of fish oil. The outside of the bottle may say 1000mgs fish oil. Then, you check the back and it may say, 2 pills = 1000mgs. If it says 1000mgs of fish oil capsule contains 350 mg EPA & DHA, that means you'd have to take 3000mgs fish oil in order to get 1.05 grams of Omega-3.
>
> Dr. Cott recommends taking supplements of antioxidants to prevent oxidation of all the extra omega-3 oil going into the body. Based on his studies of oxidative stress in mental disorders, Dr. Mahadik in Georgia is recommending 1200 IU natural vitamin E and 2000 mg vitamin C daily for adults. Take only "Natural E" with "d-alpha-tocopherol." The synthetic version begins with "dl." If Vitamin C cannot be tolerated, other antioxidants such as grape seed extract, alpha lipoic acid, or pycnogenol may be a substitute.
Hi SandyThanks for the extremely useful info. It's so hard to know where to get hold of the stuff!
Louise
Posted by dj on September 10, 1999, at 16:26:46
In reply to Re: Omega 3's - how much?, posted by Sandy on September 8, 1999, at 0:54:51
http://www.pslgroup.com/dg/fdb3e.htm
Researchers Look To Omega-3 Fatty Acid For Manic Depression Treatment
----------------------------------------------------------------------
CHICAGO, IL - May 13, 1999 -- In a preliminary study, manic-depressive patients given omega-3 fatty acid had significantly longer remissions and performed better on four symptom-severity scales than the placebo group, according to an article in this month’s issue of the Archives of General Psychiatry.The researchers studied 30 patients with manic depressive illness in a four-month, double-blind, placebo-controlled study to compare the efficacy of omega-3 fatty acids (obtained from plant or marine sources, such as fish oil) versus placebo (olive oil) for treatment of manic depressive-illness.
According to lead author Andrew Stoll, M.D., and colleagues, manic-depressive illness is a common neuropsychiatic illness with a high morbidity and mortality.
"If further studies confirm their efficacy in bipolar disorder, omega-3 fatty acids may represent a new class of membrane-active psychotropic compounds and may herald the advent of a new class of rationally designed, mood-stabilising drugs," the researchers conclude.
Posted by Noa on December 21, 1999, at 16:56:29
In reply to Re: Omega 3's & Manic Depressin study.., posted by Stuart Wolfe M.D. on December 21, 1999, at 16:29:58
Can you recommend info on how much omega 3 supplement to take, whether to take along with a hefty cocktail of ADs lithium and ritalin?
Posted by joe ann on May 26, 2000, at 20:12:22
In reply to Re: Omega 3's & Manic Depressin study.., posted by Noa on December 21, 1999, at 16:56:29
my daughter was diagnosed recently with bipolar disorder. obviously, the psychiatrists suggested depakote, etc. we tried for a very short time, her reaction to non-therapeutic levels was so strong (slept for four days) that i decided to try other methods. The doctor suggested i research fish oils. well, i've been doing that and it has raised more questions as i go. my daughter already takes ritalin for "add" and misc. other meds for many physical problems.
what is a therapeutic dose? are there any problems reported regarding liver damage? does anyone have a good suggestion on where i should look for a reasonably reputable seller of fish oils?
Posted by Abby on May 27, 2000, at 11:25:48
In reply to Re: Omega 3's Manic Depressin study.., posted by joe ann on May 26, 2000, at 20:12:22
> my daughter was diagnosed recently with bipolar disorder. obviously, the psychiatrists suggested depakote, etc. we tried for a very short time, her reaction to non-therapeutic levels was so strong (slept for four days) that i decided to try other methods. The doctor suggested i research fish oils. well, i've been doing that and it has raised more questions as i go. my daughter already takes ritalin for "add" and misc. other meds for many physical problems.
>
> what is a therapeutic dose? are there any problems reported regarding liver damage? does anyone have a good suggestion on where i should look for a reasonably reputable seller of fish oils?There was a recent thread about a brand called omegabrite. Go to their web page www.omegabrite.com for more information. I phoned the company which said that all of the fish oils were screened for toxic elements.
Still, I caution you against using just omega supplements. All of the research suggests that omega-3 supplementation should be used as an adjunct.
My first question is: are you sure that she really has add and not just bipolar disorder? The two disorders can occur together, but often manic-depression in young people is simply misdiagnosed as ADD.
You say that she tried depakote. What about the other anti-convulsants--tegretol (probably not the first one to try), lamictal or neurontin?
Lithium is still a good drug for many people. Also consider the atypical neuroleptics Zyprexa (perhaps a bit sedating) and Risperdal.Abby
Posted by Cam W. on May 27, 2000, at 21:48:08
In reply to Your daughter and Omega 3s, not monotherapy, posted by Abby on May 27, 2000, at 11:25:48
Joe - The omega-3 fatty acids available in all preparations of fish oil are in such dilute concentrations that you have to take handfuls of capsules daily and you start to give off a "fishy" smell. Until (and if) they can concentrate the active ingredients, and conclusively prove that they work as a mood stabilizer, taking fish oil is going to be a hassle. - Cam
Posted by Orin on May 29, 2000, at 20:56:49
In reply to Re: Omega 3s - One current problem, posted by Cam W. on May 27, 2000, at 21:48:08
>Cam is right. A couple of years ago, I did a self-directed trial trying the different omega3 concentrates. Didn't see any mood effect, and I had this persistent bad fishy taste. Especially with the "salmon oil" concentrates. I have no idea how the researchers who've published about this got the doses up high enough to work. I did have a significant side effect, nosebleeds, that caused me to stop my trial.
Posted by SLS on May 31, 2000, at 15:38:02
In reply to Your daughter and Omega 3s, not monotherapy, posted by Abby on May 27, 2000, at 11:25:48
Hi Jo Ann.
Abby has offered some good suggestions for substitutes for Depakote.
As Abby indicated, ADD and bipolar disorder look pretty similar in children, and are often misdiagnosed. It is important to first make sure that she is indeed bipolar.
Someone recently posted the URL for a webpage that helps to distinguish between the two. I'll see if I can find it.
How old is she?
Does she ever experience manic states? If so, what are her behaviors during these times?
Does she suffer from depression?
Of the newer anticonvulsants that are now being used as mood stabilizers, Lamictal is the most effective. It is also the most mild in terms of side effects, and exerts the strongest antidepressant effect. I don't know how often this drug is used in children, though.
- Scott
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