Laterality changes accompanying symptom remission in schizophrenia following treatment with eicosapentaenoic acid

Introduction: A patient with severe intractable symptoms of schizophrenia w as treated for 6 months with a fatty acid supplement, primarily as a test o f the hypothesis that membrane phospholipid metabolism is abnormal in schiz ophrenia. His symptomatology was predominantly positive, consistent with an 'Active' syndrome thought to reflect a relative imbalance of left over rig ht hemispheric activation. Longitudinal studies have previously shown chang es in functional lateralisation with symptom remission in schizophrenia, he nce this was examined at intervals over the 6-month period. Method: The sub ject was a 30-year-old male with DSM-IV schizophrenia. For 2 years prior to this study his clinical profile had not changed and he had remained free o f neuroleptic medication. Treatment with 30 ml/day of emulsion rich in eico sapentaenoic acid was started, and clinical ratings were made at monthly in tervals for 6 months. Motor laterality had been assessed using Annett's han dedness scale and pegboard task 1 year pre-baseline, and this was reheated at 0, 3 and 6 months from the start of treatment. Results: As measured by t he Schedules for the Assessment of Positive Symptoms and Negative Symptoms, a marked reduction in his symptoms was first apparent at 2-month follow-up ; further improvement followed, so that at the 6-month point few symptoms r emained. Corresponding to his clinical improvement, the patient's performan ce on the pegboard task at 3-month follow-up had shifted from a strong righ t-hand advantage to near symmetry, owing to a marked improvement in his lef t-hand scores. On retest at 6 months this change in asymmetry was also main tained. Conclusions: These findings suggest that treatment with certain fat ty acids may have significant benefits in the management of schizophrenia. They are also consistent with existing evidence that an Active syndrome of schizophrenia reflects a left over right hemispheric imbalance which is fun ctional in nature, and can therefore change with symptom remission. (C) 199 9 Elsevier Science B.V. All rights reserved.