Summary

Dr. Stoll and his team are at the leading edge of some of the most promising current research relating to treatment of bipolar disorder or manic-depressive illness. His preliminary research indicates that Omega-3 fatty acids, particularly those found in certain fish oil preparations, exhibit tremendous mood stabilization effects. While the current data is preliminary, the research will be repeated in the near future in order to confirm the initial results.

The results of Dr. Stoll's work to date in this area are contained in an article in the May 1999 Archives of General Psychiatry.

Our thanks to Dr. Stoll for letting us share the following information from his findings.

Background

Omega-3 fatty acids are a group of essential fatty acid nutrients derived from marine or plant sources. Based on preliminary research, Dr. Stoll's team hypothesized that Omega-3s had many of the same characteristics as effective mood stabilizers. In a double-blind study of 30 patients who were recently ill with bipolar disorder, Dr. Stoll found omega-3 fatty acids from concentrated fish oil to be an effective antidepressant and mood stabilizer.

Some Facts About Treatment With Omega-3 Fatty Acids

• Fish oil is currently the recommended source of omega-3. Flaxseed oil and perilla oil contain a different type of omega-3. Several cases of hypomania have occurred in people taking flaxseed oil, but the causes remain unclear.
• Omega-3s are usually added to whatever treatment you are already receiving, there is not yet enough experience to recommend using them alone in most cases. There are no known interactions with psychotropic drugs.
• Always discuss the use of any new medications, over-the-counter or otherwise, with your prescriber. Drug interaction risks and other dangers can be associated with any biological treatment.
• A starting dose of 5 grams of omega-3 per day is currently recommended. Calculate dosage based on the concentration of omega-3 fatty acids listed on the label of the fish oil supplement. This can be confusing due to the variety of different preparations. Focus on the omega-3 concentration in each capsule.
• The 2 main omega-3 fatty acids in fish oil are EPA and DHA. A high ratio of EPA to DHA is desirable in a fish oil capsule. Other desirable characteristics include small capsule size and high omega-3 concentration, which minimizes the number of capsules required per day.
• Dosage can be split between morning and night or taken all at night.
• Due to the volume of fish required to achieve the recommended daily dosage, it is not recommended that you use eating fish alone as a means of getting your Omega-3s.
• You may experience some fishy taste but treatment with fish oil does not make you smell like fish! Taking the supplements with orange juice can reduce the fishy taste.
• Do not pursue this treatment if you are taking any type of blood thinners, even high doses of aspirin, or any medications or substances that have the same blood thinning effect.
• Do not use cod liver or other fish liver oils to achieve high omega-3 doses, since it could result in vitamin A toxicity.
• The omega-3 fatty acids are not a panacea, but in many cases they do appear to be as effective as conventional medications.

Some Additional Facts About Omega-3 Fatty Acids

• Cold-water, oily fish are the main source of marine-derived omega-3 fatty acids.
• Farm-raised fish that are fed grain alone may contain little or no Omega-3s. Omega-3s come from algae that, in the marine food chain, are then eaten by krill who are in turn eaten by larger fish.
• Omega-3s have numerous health benefits in other areas, including heart, cholesterol, rheumatoid arthritis, & Crohn's Disease, to name a few.

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