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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 sac on July 12, 2004, at 16:12:05
I have bipolar II and do not like the side effects I get from the moods stabilizers that I've been on. Mostly, I suffer from depression and I was wondering how fish oils compare to the traditional mood stabilizers. Have there been any studies comparing it with, say, Depakote? I'm looking for something that will improve my persistant dysthymia (already on Prozac 20mgs and can't go higher b/c of hypomanic switch). I'm tired of feeling hostile and irritable on Depakote and also if Dep is a mood stablilizer, why do I feel so "moody" on it?
Posted by Larry Hoover on July 14, 2004, at 10:16:48
In reply to How does fish oil compare to traditional meds??, posted by sac on July 12, 2004, at 16:12:05
> I have bipolar II and do not like the side effects I get from the moods stabilizers that I've been on. Mostly, I suffer from depression and I was wondering how fish oils compare to the traditional mood stabilizers. Have there been any studies comparing it with, say, Depakote?
Not that I'm aware of. I believe there is a study like that being conducted by the National Institutes of Health (NIH)(I don't recall if the comparator is valproic acid or not), but it isn't completed yet.
> I'm looking for something that will improve my persistant dysthymia (already on Prozac 20mgs and can't go higher b/c of hypomanic switch). I'm tired of feeling hostile and irritable on Depakote and also if Dep is a mood stablilizer, why do I feel so "moody" on it?
The original work by Dr. Stoll was fish oil as an augmentative in bipolar disorder. It wasn't a substitute, it was an add-on to whatever the subjects were already taking. If I recall correctly, at least one of the subjects was able to stop using their mood stabilizer while using the fish oil.
It's not possible to predict with any certainty what effect fish oil will have on *you*, but it tends to be mood-stabilizing, and calming. I can almost guarantee you that you are deficient in the fatty acids found in fish oil. It does sometimes cause mood problems, though. We humans are weird critters.
You don't need fancy shmancy fish oil, IMHO. The stuff at Sam's Club or Costco, or Walmart is just fine. Always take it with a meal, and the bigger and fattier the meal, the better. You might want to start out with 3 grams per day, dividing the dose between meals, if necessary. Work up gradually to whatever level is tolerable. Stoll's subjects were taking the equivalent of over thirty caps a day, but he was trying to prove the concept in as short a time as possible with as few subjects as possible (funding issues). Make sure you up your vitamin E intake along with the fish oil, no less than 400 IU/day.
Good luck,
Lar
Posted by sac on July 14, 2004, at 21:10:11
In reply to Re: How does fish oil compare to traditional meds?? » sac, posted by Larry Hoover on July 14, 2004, at 10:16:48
Thank you for your very informative response. Yes, I have the book by Dr. Stoll regarding the Omega-3's. I have begun taking 6 grams per day this past week and I plan to up this to 9 grams total. I am sure, as you suggest, that I am probably very deficient in omega-3's. I do feel a calming response to them which is a good thing. I plan for the time being to add this to my existing regime of 20mgs. Prozac, and low dose Depakote (250mgs.ER) and see what happens. Thanks again. -Stacey
Posted by sb417 on July 14, 2004, at 21:33:02
In reply to Re: How does fish oil compare to traditional meds?? » Larry Hoover, posted by sac on July 14, 2004, at 21:10:11
When you speak of taking 6 grams or 9 grams, are you referring to grams of EPA or DHA, or are you referring to the number of grams of EPA plus DHA?
Posted by Larry Hoover on July 15, 2004, at 9:06:57
In reply to Re: How does fish oil compare to traditional meds?? » Larry Hoover, posted by sac on July 14, 2004, at 21:10:11
> Thank you for your very informative response. Yes, I have the book by Dr. Stoll regarding the Omega-3's. I have begun taking 6 grams per day this past week and I plan to up this to 9 grams total. I am sure, as you suggest, that I am probably very deficient in omega-3's. I do feel a calming response to them which is a good thing. I plan for the time being to add this to my existing regime of 20mgs. Prozac, and low dose Depakote (250mgs.ER) and see what happens. Thanks again. -Stacey
Great news! I'm glad it's helping. It's really good for your heart, blood pressure, cholesterol....all kinds of stuff, too.
You're welcome.
Lar
Posted by sac on July 16, 2004, at 23:00:40
In reply to Re: How does fish oil compare to traditional meds?? » sac, posted by sb417 on July 14, 2004, at 21:33:02
Actually, it's still a little confusing to me but one brand I take (Omega Rx) label says 1065 mg fish oil per capsule, 630 omega 3, 400mg EPA and 200 DHA. I take 3 of those per days. The other brand I have (Omega Brite) has per 3 capsules 1,125 mg EPA and 165 mg DHA and I am also taking 3 of these per day.
> When you speak of taking 6 grams or 9 grams, are you referring to grams of EPA or DHA, or are you referring to the number of grams of EPA plus DHA?
>
Posted by SLS on July 17, 2004, at 7:14:26
In reply to Re: How does fish oil compare to traditional meds?? » sac, posted by Larry Hoover on July 14, 2004, at 10:16:48
> You don't need fancy shmancy fish oil, IMHO.
My doctor thought that farm-raised wasn't quite as good as open-sea. Any opinion?
- Scott
Posted by sb417 on July 17, 2004, at 12:04:05
In reply to Re: How does fish oil compare to traditional meds?? » sb417, posted by sac on July 16, 2004, at 23:00:40
Hi sac,
Yes, it is confusing. I've tried two different brands. One of them lists the mg and percentages the way your first brand does. The other one, Twinlab's Mega Twin EPA Fish oil, just lists the amounts of EPA and DHA. I do feel that the Twinlab brand is better. I can actually feel a slight difference in my mood when I take it.
Posted by h on July 19, 2004, at 11:58:18
In reply to Re: How does fish oil compare to traditional meds?? » sac, posted by sb417 on July 17, 2004, at 12:04:05
How much fish oil do you need to take anyway? 100 mg? 500? Please advise
i am taking 10 mg of lexapro daily. But I'm interested in fish oil as well. Anybody taking both?
Posted by sac on July 19, 2004, at 13:50:48
In reply to Re: How much fish oil do you need to get effect?, posted by h on July 19, 2004, at 11:58:18
Generally, the studies done so far on fish oils and mood are in the 6 to 9 gram/day range. My Pdoc suggests at least 5 grams per day of omega-3 fatty acids to help with depression/mood stabilization. I currently take 6 - 8 1,000 mg fish oil capsules daily. It's only been two weeks into my fish oil regime but I do think they are vital especially for people with mood problems. I don't notice much if I take just 1,000 mg/day but when I take about 6 of these I notice a calming effect.
> How much fish oil do you need to take anyway? 100 mg? 500? Please advise
>
> i am taking 10 mg of lexapro daily. But I'm interested in fish oil as well. Anybody taking both?
Posted by Larry Hoover on July 20, 2004, at 8:49:43
In reply to Re: How does fish oil compare to traditional meds??, posted by SLS on July 17, 2004, at 7:14:26
> > You don't need fancy shmancy fish oil, IMHO.
>
> My doctor thought that farm-raised wasn't quite as good as open-sea. Any opinion?
>
>
> - ScottThe USDA food-component database lists farm-raised Atlantic salmon as being superior to wild-caught, with respect to omega-3 concentrations. It all depends on the aquaculture method, though. There have been experiments which involved that whole feather-meal, bonemeal, ground up animal bits sort of thing, but fish meal (ground up trash fish, with trash being a word that wouldn't make those fishes' mothers very happy) was always superior. In Europe, and probably in lesser amounts than it once was, soy-based rations were popular. I think they've moved away from that, though.
As it stands now, as far as I can tell, there is no advantage to either farm-raised or wild-caught fish oils.
Lar
Posted by robot on August 10, 2004, at 23:44:01
In reply to Re: How much fish oil do you need to get effect?, posted by h on July 19, 2004, at 11:58:18
Ive been taking lexapro and just a few weeks ago started taking Cod Liver Oil, bottled by Carlson (says its Norwegian w/ lemon to help with taste--ans it does taste fine). I have definitely noticed a positive effect, but its pretty subtle at the doses ive been taking (maybe 1 to 2g of both DHA and EPA). Plus its hard to tell--because Im so up and down all the time, plus Ive just added another AD to the lex (wellbutrin), which is making me sleep less, which makes it even harder to determine what is doing what.
Since its not good to try to get all of it from Liver oils, Id like to add another oil, like flaxseed. I like to take the oil straight, not the capsules. And I would guess its cheaper this way. I would like to get around 5 g or so but its so darn expensive. Its worth it, though, to find a supplement that actually does something. It seems to me that the first thing any doc should do is make sure a patient is getting their omegas.
good luck> How much fish oil do you need to take anyway? 100 mg? 500? Please advise
>
> i am taking 10 mg of lexapro daily. But I'm interested in fish oil as well. Anybody taking both?
Posted by robot on August 10, 2004, at 23:46:32
In reply to Re: How does fish oil compare to traditional meds?? » SLS, posted by Larry Hoover on July 20, 2004, at 8:49:43
Here's a question: Do the effects of fish oil build up? I mean, are the positive effects generally going to just go away the week I stop taking it? Or am I causing my brain the change and function better on a more permanent basis than that?
I apologize if this has already been discussed.
Posted by robot on August 10, 2004, at 23:52:43
In reply to Re: How does fish oil compare to traditional meds?? » Larry Hoover, posted by sac on July 14, 2004, at 21:10:11
Stacy-- please let us know how it works for you.
> Thank you for your very informative response. Yes, I have the book by Dr. Stoll regarding the Omega-3's. I have begun taking 6 grams per day this past week and I plan to up this to 9 grams total. I am sure, as you suggest, that I am probably very deficient in omega-3's. I do feel a calming response to them which is a good thing. I plan for the time being to add this to my existing regime of 20mgs. Prozac, and low dose Depakote (250mgs.ER) and see what happens. Thanks again. -Stacey
Posted by robot on August 11, 2004, at 21:14:40
In reply to Re: How much fish oil do you need to get effect?, posted by h on July 19, 2004, at 11:58:18
I found this product--if you buy a few at once, it would cost about $16 per 16oz bottle, a dollar per ounce (that includes shipping). Ill probably try it. It looks like it has just about all the EFAs.
http://store.yahoo.com/americasvitaminstore/efa-vegetarian.html
Posted by Larry Hoover on August 14, 2004, at 13:50:00
In reply to Re: How much fish oil do you need to get effect?, posted by robot on August 10, 2004, at 23:44:01
> Ive been taking lexapro and just a few weeks ago started taking Cod Liver Oil, bottled by Carlson (says its Norwegian w/ lemon to help with taste--ans it does taste fine). I have definitely noticed a positive effect, but its pretty subtle at the doses ive been taking (maybe 1 to 2g of both DHA and EPA). Plus its hard to tell--because Im so up and down all the time, plus Ive just added another AD to the lex (wellbutrin), which is making me sleep less, which makes it even harder to determine what is doing what.
> Since its not good to try to get all of it from Liver oils, Id like to add another oil, like flaxseed.
The problem with fish *liver* oils is that they contain too much vitamins A and D to be taking them in sufficient quantities to get the EPA and DHA you need. That said, it takes a fair bit of effort to overdose, and getting your body's stores of these two vitamins up is not a bad thing, all by itself.
Instead of flax oil, why not just switch to fish oil? Salmon oils are readily available, and you don't have to be concerned about your body's ability to convert them to EPA and DHA, as both are pre-formed.
> I like to take the oil straight, not the capsules. And I would guess its cheaper this way. I would like to get around 5 g or so but its so darn expensive. Its worth it, though, to find a supplement that actually does something.
Even if you don't notice obvious benefits, I can assure you that you are improving many different aspects of health.
> It seems to me that the first thing any doc should do is make sure a patient is getting their omegas.
> good luckAbsolutely. The very first thing.
Lar
Posted by Larry Hoover on August 14, 2004, at 13:52:37
In reply to Re: How does fish oil compare to traditional meds?? » Larry Hoover, posted by robot on August 10, 2004, at 23:46:32
> Here's a question: Do the effects of fish oil build up? I mean, are the positive effects generally going to just go away the week I stop taking it? Or am I causing my brain the change and function better on a more permanent basis than that?
Yes, there is a cumulative effect. It has been estimated that it takes eight months of high-dose supplementation to restore brain membrane fatty acid concentrations to ideal omega-3 levels (based on animal turnover studies). If you stop taking omega-3 supplements, and your diet is otherwise deficient, your brain function will gradually decline, but very slowly.
> I apologize if this has already been discussed.
Please don't worry about asking questions, discussed before, or not discussed before.
Lar
Posted by Larry Hoover on August 14, 2004, at 13:55:03
In reply to Re: Fish Oil products, posted by robot on August 11, 2004, at 21:14:40
> I found this product--if you buy a few at once, it would cost about $16 per 16oz bottle, a dollar per ounce (that includes shipping). Ill probably try it. It looks like it has just about all the EFAs.
>
> http://store.yahoo.com/americasvitaminstore/efa-vegetarian.htmlI still recommend fish oil, over flax oil. Just my opinion, though.
Lar
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