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Integrative Therapies for Bipolar Disorder - Omega 3 Fatty Acids (Fish Oils)

Scott Olson, ND

Omega-3 essential fatty acids (oils), which include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found primarily in fish (such as mackerel, lake trout, herring, sardines, albacore tuna, and salmon) and some plants. While they are necessary for the proper functioning of our bodies, the levels necessary for health benefits are more than can readily be achieved through diet alone. These oils are used as supplemental treatments for an array of conditions including heart disease, diabetes, and arthritis. These oils also play a role in brain development and function.

Epidemiological (population) studies suggest that people who consume a large amount of seafood high in EPA/DHA have low rates of bipolar disorder. However, controlled clinical research with people who are taking EPA/DHA as a supplement to treat bipolar disorder are almost non-existent. A few very small trials in women with bipolar disorder who stopped taking conventional medications while trying to get pregnant have yielded some interesting and encouraging results, but the studies are so small and the population so specific (women wanting to conceive) that it is difficult to make any general conclusions and recommendations about these oils and the treatment of bipolar disorder.

Because EPA and DHA play many essential roles in the body and brain, CAM practitioners (and the American Heart Association) suggest that most people should supplement their diets with these oils. Overall, the evidence suggests that EPA/DHA is also a good supplement for people with bipolar disorder. However, additional studies are needed to fully understand what role these oils play in treating this disease.

Safety and Dosing

Normal dosing for the omega-3 fatty acids is between 1-4 grams a day. Most fish-oil supplements contain about 18% EPA/DHA, so to get a gram of EPA/DHA, one has to take approximately five 1-gram supplements.

Fish oils have been shown to both lower cardiovascular (heart) disease risk and raise cholesterol in some people. Likewise, EPA and DHA lowers blood sugar in diabetics while raising it in other people. If you are taking medications for diabetes, your dosing may have to change. If you are considering taking more than 1 gram of EPA/DHA a day, and are on medications for diabetes or cardiovascular disease, you should consult with your health professional.

Side Effects of Omega-3 Oils

  • Stomach upset
  • Nosebleeds
  • Loose stools

Most side effects from taking fish oils are mild. Fish oils may act as an anticoagulant (blood thinner), so consult with your health provider if you are taking any other blood-thinning medications.