Two double-blind placebo-controlled pilot studies of eicosapentaenoic acidin the treatment of schizophrenia

Evidence that the metabolism of phospholipids and polyunsaturated fatty aci ds (PUFA) is abnormal in schizophrenia provided the rationale for intervent ion studies using PUFA supplementation An initial open label study indicati ng efficacy for n-3 PUFA in schizophrenia led to two small double-blind pil ot studies. The first study was designed to distinguish between the possibl e effects of two different n-3 PUFA: eicosapentaenoic acid (EPA) and docohe xaenoic acid (DHA). Forty-five schizophrenic patients on stable antipsychot ic medication who were still symptomatic were treated with either EPA, DHA or placebo for 3 months. Improvement on EPA measured by the Positive and Ne gative Syndrome Scale (PANSS) was statistically superior to both DHA and pl acebo using changes in percentage scores on the total PANSS. EPA was signif icantly superior to DHA for positive symptoms using ANOVA for repeated meas ures. In the second placebo-controlled study, EPA was used as a sole treatm ent, though the use of antipsychotic drugs was still permitted if this was clinically imperative. By the end of the study, all 12 patients on placebo, but only eight out of 14 patients on EPA, were taking antipsychotic drugs. Despite this, patients taking EPA had significantly lower scores on the PA NSS rating scale by the end of the study. It is concluded that EPA may repr esent a new treatment approach to schizophrenia, and this requires investig ation by large-scale placebo-controlled trials. (C) 2001 Elsevier Science B .V. All rights reserved.