Shared Biological Pathways between Antipsychotics and Omega-3 Fatty Acids: A Key Feature for Schizophrenia Preventive Treatment?
Frajerman A, Scoriels L, Kebir O, Chaumette B (2024) Int J Mol Sci 22(13) 6881. doi: 10.3390/ijms22136881.
Web URL: Read this and related abstracts via Pubmed here. Free full text of this article is available online
Abstract:
Schizophrenia typically emerges during adolescence, with progression from an ultra-high risk state (UHR) to the first episode of psychosis (FEP) followed by a chronic phase.
The detailed pathophysiology of schizophrenia and the factors leading to progression across these stages remain relatively unknown. The current treatment relies on antipsychotics, which are effective for FEP and chronic schizophrenia but ineffective for UHR patients.
Antipsychotics modulate dopaminergic and glutamatergic neurotransmission, inflammation, oxidative stress, and membrane lipids pathways. Many of these biological pathways intercommunicate and play a role in schizophrenia pathophysiology.
In this context, research of preventive treatment in early stages has explored the antipsychotic effects of omega-3 supplementation in UHR and FEP patients. This review summarizes the action of omega-3 in various biological systems involved in schizophrenia.
Similar to antipsychotics, omega-3 supplementation reduces inflammation and oxidative stress, improves myelination, modifies the properties of cell membranes, and influences dopamine and glutamate pathways. Omega-3 supplementation also modulates one-carbon metabolism, the endocannabinoid system, and appears to present neuroprotective properties.
Omega-3 has little side effects compared to antipsychotics and may be safely prescribed for UHR patients and as an add-on for FEP patients. This could to lead to more efficacious individualised treatments, thus contributing to precision medicine in psychiatry.
FAB RESEARCH COMMENT:
As this review shows, the effects of the long-chain omega-3 fatty acids found in fish and seafood (EPA and DHA) on body and brain health involve many of the same mechanisms by which antipsychotic drugs are thought to operate in reducing symptoms of schizophrenia and other forms of psychosis.Some clinical trials have shown benefits from adjunctive treatment with omega-3 fatty acids in patients with established psychosis - especially at the onset of illness, or early in its course - but overall findings have been mixed.
Obviously, preventing the development of schizophrenia in the first place would be the ideal - and in young people at high risk of developing psychosis, some clinical trials show that dietary supplementation with omega-3 EPA/DHA may help to prevent the onset of clinical illness.
For such 'ultra-high-risk' patients, in whom antipsychotics have more risks than benefits, the use of omega-3 fatty acids offers a very promising option for preventing full psychotic illness from developing.
Omega-3 are not only safe and very well-accepted by most patients, but they also have well-established benefits for general health.
As this new review explains, the fact that many of their known mechanisms are the same as those thought to underlie the effects of antipsychotics provides a strong rationale for both their clinical use in patients at high risk for psychosis on the basis of existing evidence, as well as additional research in this area - particularly to establish optimal formulations and dosages.
For more information on this subject, see:
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