Omega-3,a natural medication for many psychiatic and physical diseases
I read in the May 99 issue of Archives of General Psychiatry that a small group of unstable bipolar patients showed a good response to omega-3 fatty acids.One of my bipolar patients had intractable OCD.She worried about Aids all the time although her risks were negligible and her tests were negative.She was on lithium,olanzepine 10mg daily and fluoxetine 80mg daily.I added omega-3 fish oil and within a few days her OCD was well under control.Three other changes of note occurred too.She was a 30 per day smoker and yet within 2 weeks she stopped smoking.She became relaxed and her sleeping pattern became very good.Three years later she had no significant OCD (except when she stopped taking the fish oil,as she did twice), have a relationship without any AIDS worries but continued to take her omega-3 at about 5g daily.
These facts fascinated me so I have been reading all I can find about omega-3 since as well as trying it on people for whom nothing else worked.I have seen several cases respond well to fish oil only but this is quite unusual. In fact I find that OCD is one of the most difficult and intractable conditions I treat and the overall success rate I expect is only about 15%. The most I hope for is that if the nutrients work (and I normally have to use many different nutrients) I can reduce the SSRI dose so that they are not drowsy. Here are some of the best cases I have seen where a good response occurred to nutrients;: In one case a 25-year woman spent much of her time washing her hands in a ritual fashion,could not wash her hair and could not change her baby`s nappy (diaper).She had agoraphobia too so she could not leave home without her partner.After 3 days on omega-3 her hand washing dropped to a normal level,she could change the diaper and could wash her hair.Her agoraphobia disappeared and she noticed she was more relaxed and was sleeping well.A month later her hands,which had been in a terrible state, were back to normal and she could not believe she was well for the first time since she was sexually assaulted at 13.A few months later she got a job for the first time in her life.She ran out of the fish oil twice and relapsed in about two days so.This woman had been attending psychiatric clinics for years to little effect and she continues on clomipramine 225mg daily.Her omega-3 dose was 4 fish oil capsules,each containing 180mg EPA and 120mg of DHA.This is not a drug but a dietary supplement and costs less than a euro or dollar daily.She is smoking less now too.Five months later she remained well,and was taking 7 omega-3 daily.In another case a woman got relief from her ritual washing on 3g omega-3 daily.In the fourth case an 18-year old man prone to worrying about stupid things such as could his 72-year old grandmother get pregnant and who drove his parents demented as well as having several rituals is much better on omega-3.He was unable to take any SSRI drug.In the fifth case a 10-year old boy who was on paroxetine for his rituals of touching things is now able to cope on omega-3 only and his mother is really pleased with his progress.He takes 1g daily.In one case where a woman`s obsesssions are still present to a significant extent she feels much better overall and is increasing her omega-3 dose to 3g from 2g daily.Having noted the fact that the agoraphobic OCD lady who had been sexually abused felt clean since going on omega-3 I have now had another case where a very troubled woman (following sexual abuse in her youth) is much more at ease with herself and got through her fourth pregnancy without any post-natal depression which she had in the other pregnancies.It is likely that the omega-3 played a big part.
In conventional psychiatry the treatment for OCD is high doses of SSRIs such as Prozac 60mg daily -note in 2012 this dose ois being reduced due to possible risks to heart. Natural treatments that may help some patients and are used as an addition to SSRIs include the following: methionine 500mg three to six daily,calcium 1,000mg daily, vitamin B6 200mg daily (or P5P 50mg daily) . Inositol is used in doses of about 1-18g daily depending on the source you read-generally use close to 1g but I have read good reports of up to 18g too.,3-10g fish oil. Betaine 100-500mg daily and zinc 50mg daily may help too. Avoid supplements of folic acid,copper and also avoid too much chocolate.If you get a bad reaction to any of these items stop it immediately as sometimes they have a negative effect on some individuals depending on the body`s biochemistry.You do not have to take all on this list-every person is different.I routinely do a series of tests to detemine what the biochemistry is like before I recommed nutrients for most psychiatric conditions and would always others to do the same.
In many cases the smoking level drops significantly after only a few days on high doses of omega-3 (especially if on 10g or so) and some have stopped smoking with no great difficulty.A few people in their 40s and 50s gradually stopped smoking without any real plans to do so-it just seemed to happen spontaneouly.A 31-year old man who is prone to depression went on 3g omega-3 daily and gave up smoking within a week.A month later he was in good form and had no craving for nicotine.The sleeping pattern improves,anxiety and depression frequently respond and several have come off benzodiazepines or at least reduced their consumption by 30%.One man who was taking enormous doses of benzodiazepines for 20years got off them over several months.One woman who used take a benzodiazepine to sleep told me she needed only 4 in the following month and her panic attacks disappeared since she went on 2g of omega-3.Eight months later she has taken no further benzodiazepines but has taken 30 zopiclone 7.5mg in total and has no panic attacks.One alcoholic drinks 3 cans of beer daily instead of nine since he went on the omega-3 and he has cut his tobacco input by more than half.One woman put her 70-year old alcoholic mother on 3g omega-3 daily and has noticed that her mother`s drinking pattern is now quite acceptable.One 40-year-old teacher who drank a bottle of wine a day now drinks 2 or 3 glasses instead and this situation has been stable for over two years.A 47-year old technician who was on fluoxetine 20mg for depression was not doing great.I added omega-3 and he stopped the fluoxetine a month later.He is in very good form,smokes only a few cigarettes daily instead of 20 and takes 2 glasses of wine instead of a bottle daily.Omega-3 helps in about 30% of cases of intractable depression,usually in association with antidepressants.A 22 year-old woman who was on methadone reduced her consumption by 20% in a week so easily that she only noticed the extra amount she had left at the end of the week.A 39-year man on methadone reduced his consumption by 15% without difficulty.A 23-year old man who who a bad craving despite being on 80mg methadone daily had no craving since he started on 3g omega-3 daily.His sister was amazed to see him spend Euros (dollars) 13 weekly on fish oil where recently he spent everything on heroin.Two years later he is off all drugs and has a full-time job.Trying it in heroin addicts may be worthwhile then.A man who tried for years but could not come off eight 30mg codeine tablets daily managed to do so with a high dose of omega-3.He took 15g daily compared to the dose of 9.6g used in the bipolar trial.Incidentally his smoking level dropped by 30% too but it has gone back to his normal figure now that he is off the omega-3.He was surprised that he could have his breakfast without having a cigarette first thing in the morning while on the fish oil.Incidentally a useful website on other treatments for smoking is www.findhelp.com. These are some of the best results achieved. Some achieved little or no benefit.
From looking at the literature I have seen people with schizophrenia benefitting from it too and I understand that schizophrenia is less devastating in parts of the world where a lot of fish or wild game is consumed.I recommend 2g daily of EPA in many schizophrenics but what I prefer nowadays is to do some tests on these patients as described towards the end of this page. Depending on the results I prescribe a whole series of nutrients,always including fish oil. Some prefer to use the multivitamin regime in "Orthomolecular Treatment for Schizophrenia" by Abram Hoffer MD.This book is available for four dollars plus postage from www.amazon.com .He suggests trying to pick up food allergy causes as about half of the chronics experience allergy to one or more foods.He suggests using niacin 3-6g daily,B6 up to a gram daily ,vit C 3g daily,50mg zinc,200-600 microgram of selenium,manganese 30mg, and omega-3 fish oil which according to recent work by Peet and Horrobin should be around 2g daily of EPA. My own experience with schizophrenia is that Hoffer`s regime is only relevant to those with the paranoid type but that type is about 45% of the total.Pyroluric schizophrenics would benefit from primrose oil instead of omega-3. In 2001 I tried fish oil on a reluctant 35-year old schizophrenic who had never worked and in a few weeks he got 2 jobs (60 hours weekly)which he held for 8 months before stopping his medication and his omega-3 followed by another episode in hospital.I have never seen such a response in any patient with this condition since but it put me on the path of learning all about nutritional or biochemical psychiatry which has resulted in me treating dozens of schizophrenic patients every year. I am getting hopeful that the majority of schizophrenics who have been suffering for less than ten years can make a moderate to good recovery if they have a parent to guide them and if they take the nutrients regularly.They have to continue on their antispychotics too.
Research in Sheffield University in UK shows a 25% improvement in Schizophrenics who take fish oil who and I believe that everybody with that condition should try omega-3 for several months at least if they cannot go through the series of tests which I do on my patients.During the Second World War in Norway the incidence of schizophrenia declined which suggests some connection with the diet and especially the return to eating a more natural diet.Bit by bit omega-3 replaces excess omega-6 fatty acids in our brain if we take omega-3 fish oil so that it functions in a much more natural state.
In my own work I see patients with schizophrenia,bipolar and depression who often come to me from a long distance away from my practice in Dublin.I take blood,urine and sometimes hair samples and send them to a specialised nutritional laboratory in London and another lab in Chicago,as well as using local labs in Dublin.The results determine the best nutrients for their condition which I recommend that they take in addition to and not as a replacement for their regular medication.
Seeing that so much psychiatric conditions come on in the late teens I wonder if putting everybody who does not eat much fish on a small amount (1-2g daily)of fish oil might be protective against mental illness and perhaps reduce the number of young suicides.Maybe that is why it was popular in the past to give children cod liver oil which contains a significant amount of omega-3.Recent research in Scotland suggests that taking omega-3,particularly DHA, in pregnacy may improve the child`s intelligence.It appears to reduce pre-eclampsia and eclampsia and reduces post-natal depression.It is fascinating that post-natal depression is often post-natal elation and the first manifestation of bipolar disorder.It looks as if the baby takes some of the mother`s omega-3 and leaves her vulnerable to abnormal transmission through the cell membrane in the brain which appears to be the fundamental flaw in BP.Omega-3 is found in breast milk too.The minimum dose in pregnancy would be 300mg of DHA daily.Particularly in pregnancy I favour the Eskimo-3 brand because it has a very low level of contaminants and has natural anti-oxidants from the fish put back into it plus Vit.E. The minimum dose of Eskimo-3 in pregnancy would be 3ml daily of the liquid form which would give 450mg of EPA too.The maximum dose should not exceed the FDA figure of 3g daily. Mumomega is good too. Children should benefit from fish oil too by taking up to 500mg-1g daily-I have seen some do much better in school with better concentration while on fish oil.For children up to 12 years I recommend Eskimo Kids brand. I like MorDHA Mini Omega-3 IQ for children of 6 months to a year and Morepa Mini-Junior for 5-10 year olds.
Not everybody responds to omega-3 but many do and I have been little short of amazed at how useful it has been and how quickly it starts to work-usually in a few days but it may take a lot longer in some people.I do not take patients off their regular medication and they simply add whatever level of omega-3 gives them relief.There is great individual variation in the amount required.I suggest that 1g of EPA is a reasonable starting dose for depression (and they should probably try that dose for a month before increasing it).Schizophrenics should probably try 2g daily of EPA plus the nutrients mentioned above.Other conditions may require higher doses and starting on 3g total omega-3 daily is reasonable but the dose varies for everybody.Most people manage on less that 5g daily.The dose can be adjusted every few days.It is available in supermarkets such as Tesco or Walmart. Another one I recommend is Omacor which is sold as a highly concentrated 1,000mg capsule containing 840 mg of fish oil-46% EPA and 38% DHA,both in the ethyl ester form.It is available as a prescribed drug in many countries and its website is www.omacor.com. I also like Eskimo-3 which is expensive.The liquid form is very concentrated with 1500mg omega-3 in 5ml but a capsule form is available too with 500mg in 3 capsules.Note that it is the weight of EPA and DHA that is relevant biologically and not the weight of the capsules themselves.Thus a one gram capsule may contain perhaps 180mg EPA and 120mg DHA.The FDA has determined that 3g daily is safe and that dose will cover most users but doses of up to 10g daily have been used safely in other situations,especially in bipolar disorder.A very small number need over 10g and it is worth noting that Eskimos (Inuit) consume 18g daily on average from their fish diet.An interesting point about bipolar (manic depression) is that it affects 6.5% of Germans but only 1 in 500 in Iceland. I was at a psychiateric conference in Madrid in March 2007 where I spoke to several doctors from Iceland and they were unaware of this figure. If anybody knows the current figure there please email me at email@example.com The rate of schizophrenia is similar in Iceland and Germany , suggesting that omega-3 seems a very natural part of the treatment for bipolar. For those like myself who do extensive biochemical tests for mental illness I note that schizophrenia has more severe biochemical abnormailities. Because there appears to be a large element of oxidative stress (free radical overproduction) in mental illness it is widely recommended that a supplement of Vit. C (1g-2g)and E(400-800 i.u) and perhaps a multivitamin should be taken too as antioxidants.Because it appears to inhibit clotting to a minimal extent(and so reduce embolic strokes overall) it may be safer for those on drugs used to thin the blood to avoid taking omega-3 and it is unsuitable for haemophiliacs.Some people notice the taste after the stomach acid gets to work on it but this is not really a problem with Eskimo-3 capsules. In 2012 I recommend Morepa as one of my top choices in fish oil.
Omega-3 is basically the oil content of fatty fish such as mackerel and salmon and is found mainly in 2 forms-EPA and DHA of which EPA appears to be the more important biologically in adults and DHA in children and pregnant women.Recently DHA has been found to be low in bipolar patients and in those with Alzheimer`s Disease.Perhaps because of our ancestral origin in the sea,where the fatty acids in plankton provided the food, about 8% of our brain by weight (which is itself 60% fat) is made up of omega-3 and we cannot synthesise it ourselves.A deficiency in our level of this chemical could be the cause of a lot of our psychiatric problems.As a family doctor I deal with a large number of these patients and it has reached the stage where I now recommend a trial of omega-3 in almost every case as part of their treatment.
I met a psychiatrist from London at a conference in May 2002 and he told me he prescribes it every day because "it really works".Other psychiatrists have never heard of it.
IN AUGUST 2003 I BOUGHT 3 CDS ON "NUTRITIONAL TREATMENT OF PSYCHOTIC DISORDERS" BY WILLIAM WALSH PH.D OF THE PFEIFFER RESEARCH CENTER NEAR CHICAGO.HIS VIEWS ARE MOST INTERESTING AND ARE WORTH LOOKING INTO.OMEGA-3 IS JUST ONE OF MANY NATURAL MEDICATIONS THEY RECOMMEND AT PFEIFFER FOR A WHOLE RANGE OF PSYCHIATRIC CONDITIONS,USUALLY IN ASSOCIATION WITH REGULAR MEDICATION.They are at www.hriptc.org and you can read their founder`s views on many topics on the Alternative Mental Health page on this website.
I have concentrated above on psychiatric problems but omega-3 is very useful too in physical illness.It reduces heart attacks and strokes,improves the skin,is good for joints,reduces cholesterol (the Eskimo-3 version appears the best for cholesterol reduction and is the only version I would favour in diabetics),reduces blood pressure and even makes people look younger.Tom Saldeen`s book is worth reading on the physical benefits. IN AUGUST 2003 I ADDED MORE DATA ON THE PHYSICAL AND MENTAL BENEFITS OF OMEGA-3 ON THE "WHERE IS OMEGA-3 USEFUL" PAGE.
The Omega-3 Connection by Andrew L. Stoll. Probably the best book for psychiatric use.Omega-3 Oils by Donald O.Rudin and Clara Felix.Rudin was one of the first people to really understand the value of omega-3. However his emphasis on flaxsed oil as opposed to fish oil would not be popular nowadays. Both of these books are available from amazon.com.
In Feb 2010 an article in Archives of General Psychiatry suggested that omega-3 may help to prevent the onset of psychosis. The time scale involved in the article seems to be to be quite short and we really need a long-term report on thousands of cases to give this theory a more secure foundation. You can read the summary at
The American government sponsored free web site at www.pubmed.com will give you summaries of thousands of articles on omega-3 or fish oil or almost any medical subject you wish to know about.Just put the subject you want in the box provided. Some of the information is quite esoteric and will mostly suit health professionals or scientists.
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