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Omega-3 Fatty Acids Fact Sheet

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Medication Name (brand): 
Omega-3 Fatty Acids
Medication Name (clinical): 
Omega-3 Fatty Acids
Indications: 

Not regulated by the FDA, considered a nutritional supplement.

Mechanism: 

Mechanism of psychiatric effect is unknown. But anything that makes up cell membranes has got to be crucial in some way.

Dosing: 
  • Supplied in 500 mg capsules by most manufacturers.

  • Effective dose is unclear, but most studies have used doses from 1 gram to 6 grams QD. Dosing it BID or TID is recommended to minimize side effects.
  • To get omega-3 from the diet, regularly eat salmon, sardines or canned tuna, or sprinkle flax seed meal on foods.

Evidence of Efficacy: 
  • Bipolar disorder: One 1999 study showed that adjunctive high dose omega-3 prolonged remission in bipolar patients; but two 2003 studies could not replicate this effect.

  • Major Depression: Three placebo-controlled studies showed efficacy for adjunctive omega-3; one study found that omega-3 monotherapy did not separate from placebo.
  • Schizophrenia: Evidence mixed, but one monotherapy trial showed efficacy.
  • Cardiovascular disease: There is compelling evidence that omega-3s help to prevent death from cardiovascular disease; the American Heart Association officially recommends their use in the range of 1-4 grams QD.

What Is It?: 

There are three different omega-3’s: EPA and DHA (both derived from fish) and ALA (derived from flax seed and other vegetable matter). They are essential fatty acids which form the lipid bilayers of cell membranes.

Side Effects: 
  • Most common are gastrointestinal disturbances, especially diarrhea, and a fishy aftertaste.

  • Anecdotal reports of switch to mania.
  • Mercury content is not an issue with fish oil capsules, as the distillation process separates omega-3s from any potential contaminants.
  • No dangerous side effects; Inuit people have been reported to ingest up to 16 grams a day (via fish) with no dangerous side effects.

Drug-drug Interactions: 

None reported. Safe to combine with MAOIs.

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