Omega-3 Fatty Acid Monotherapy for Pediatric Bipolar Disorder: A Prospective Open-Label Trial

This 8-week study was conducted on 20 children with an average age of 8.7 years (ranging from 6-17 years) who had been diagnosed with a clinically significant manic episode by clinical evaluation and who had YMRS (Young Mania Rating Scale) scores greater than 15. Approximately 2/3 of the subjects met the diagnostic criteria for bipolar I disorder with most of the remaining (25%) fulfilling the criterion for bipolar II disorder. The patients (mixed genders) were obtained from referrals to a pediatric psychopharmacology program at the Massachusetts General Hospital. Treatment with mood stabilizers, anticonvulsants, antidepressants, and neuroleptic pharmacotherapies were not permitted during this study.

The patients received omega-3 fatty acid supplementation beginning with a dose of 3 capsules per day providing a total intake of DHA/EPA combined of 1290 mg/day (165 mg of DHA + 1125 mg of EPA). Following initial dosage with 3 capsules per day, those patients showing no improvement or some worsening in their clinical symptomology based on mania severity scoring were given increased supplementation (increases of up to 3 capsules at a time) to the permitted upper weekly intake of 10 capsules/day (maximum of 4300 mg of DHA/EPA combined per day). Overall, the subjects exhibited a statistically significant improvement in their YMRS scores with an average reduction of 34% (from an average entry YMRS score of 28.9 to an eventual score of 19.1). The adverse effects (some gastrointestinal problems, headache, cold/flu/allergy/infection, plus some others) were considered to be few and mild by the investigators. Since only 35% of the subjects showed a more pronounced response by the use of accepted criterion (> 50% decrease on the YMRS), the researchers conclude that the omega-3 fatty acid treatment as offered was associated with a very modest improvement in manic symptoms in children with BPD (pediatric bipolar disorder).