A randomized, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia
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Elsevier
Abstract
Background: While antipsychotics are effective in the maintenance treatment of schizophrenia they have
safety and tolerability risks. We investigated whether a combination of omega-3 polyunsaturated fatty acids
(ω−3 PUFAs) and a metabolic antioxidant, alpha-lipoic acid (α-LA), is effective in preventing relapse after
antipsychotic discontinuation in subjects who were successfully treated for 2–3 years after a first-episode of
schizophrenia, schizo-affective or schizophreniform disorder.
Methods: In this randomized, double-blind, placebo controlled study antipsychotic treatment was tapered and
discontinued and participants received either ω−3 PUFAs (eicosapentaenoic acid 2 g/day and docosahexaenoic
acid 1 g/day) + α-LA 300 mg/day or placebo. Subjects were followed up for two years, or until relapse.
Results: Recruitmentwas terminated prematurely due to the high relapse rates in both treatment groups as
well as the severity of some of the relapse episodes. Of the 33 participants, 19/21(90%) randomized to
ω−3 PUFAs+α-LA relapsed and one (5%) completed two years without relapse (p = 0.6); and 9/12 (75%)
randomized to placebo relapsed and none completed two years without relapse. Mean times to relapse were
39.8 ± 25.4 and 38.3 ± 26.6 weeks for the ω−3 PUFAs + α-LA and placebo groups, respectively (p = 0.9).
There were no significant differences between the groups in relapse symptom severity.
Conclusions: We found no evidence that ω−3 PUFAs + α-LA could be a suitable alternative to maintenance
antipsychotic treatment in relapse prevention, in this small study. Antipsychotic discontinuation after a single
episode of schizophrenia carries a very high risk of relapse, and treatment guidelines endorsing this practice
should be revised
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Emsley, R. et al. 2014. A randomized, controlled trial of omega-3 fatty acids plus an antioxidant for relapse prevention after antipsychotic discontinuation in first-episode schizophrenia. Schizophrenia research, 158(1-3):230-235. [https://doi.org/10.1016/j.schres.2014.06.004]