Therapeutic use of omega-3 fatty acids in bipolar disorder Expert Rev. Neurother. 11(7), 1029–1047 (2011) Vicent Balanzá-Martínez et al Introduction Bipolar disorder (BD) is a severe, chronic affective disorder, associated with significant disability, morbidity and premature mortality. Omega-3 polyunsaturated fatty acids (PUFAs) play several important roles in brain development and functioning. Evidence from animal models of dietary omega-3 (n-3) PUFA deficiency suggest that these fatty acids are relevant to promote brain development and to regulate behavioral and neurochemical aspects related to mood disorders, such as stress responses, depression and aggression, as well as dopaminergic content and function. Preclinical and clinical evidence suggests roles for PUFAs in BD. n-3 PUFAs seem to be an effective adjunctive treatment for unipolar and bipolar depression, but further large-scale, well-controlled trials are needed to examine its clinical utility in BD. The use of n-3 as a mood stabilizer among BD patients is discussed here. This article summarizes the molecular pathways related to the role of n-3 as a neuroprotective and neurogenic agent, with a specific focus on BDNF. It is proposed that the n-3–BDNF association is involved in the pathophysiology of BD and represents a promising target for developing a novel class of rationally devised therapies. Conclusion Epidemiological, biochemical, experimental and intervention evidence is still limited, but support the hypotheses that low PUFA status is involved in the pathogenesis of BD and that n-3 supplementation is useful for BD, especially to treat depressive symptoms. Longer-term, well-controlled RCTs are justified to confirm this efficacy and establish the minimum dose and length of supplementation required to significantly improve intermediate and clinical outcomes in BD. It is proposed that the n-3–BDNF connection is involved in the pathophysiology of BD and represents a promising target for developing a novel class of rationally devised therapies. Bipolar disorder is a severe disorder, which is frequently associated with chronic conditions, such as CVD and MetS (Metabolic Syndrome). Benefits of n-3 fatty acids have been shown for these disorders . n-3 PUFAs are safe and well-tolerated nutrients  and only mild, transient adverse events, such as nausea, are likely to occur [116,183]. Moreover, they represent an appealing option for patients, their relatives and clinicians because they are relatively cheap and perceived as a ‘natural remedy’. Altogether, it is predicted that supplementation with n-3 PUFAs will benefit the physical health of BD patients. To our knowledge, this hypothesis has not been tested to date.
Omega-3 fatty acids decreased irritability of patients with bipolar disorder in an add-on, open label study Kemal Sagduyu et al Published: 09 February 2005 Nutrition Journal 2005, 4:6 doi:10.1186/1475-2891-4-6 Abstract This is a report on a 37-patient continuation study of the open ended, Omega-3 Fatty Acid (O-3FA) add-on study. Subjects consisted of the original 19 patients, along with 18 new patients recruited and followed in the same fashion as the first nineteen. Subjects carried a DSM-IV-TR diagnosis of Bipolar Disorder and were visiting a Mood Disorder Clinic regularly through the length of the study. At each visit, patients` clinical status was monitored using the Clinical Monitoring Form. Subjects reported on the frequency and severity of irritability experienced during the preceding ten days; frequency was measured by way of percentage of days in which subjects experienced irritability, while severity of that irritability was rated on a Likert scale of 1 – 4 (if present). The irritability component of Young Mania Rating Scale (YMRS) was also recorded quarterly on 13 of the 39 patients consistently. Patients had persistent irritability despite their ongoing pharmacologic and psychotherapy. Omega-3 Fatty Acid intake helped with the irritability component of patients suffering from bipolar disorder with a significant presenting sign of irritability. Low dose (1 to 2 grams per day), add-on O-3FA may also help with the irritability component of different clinical conditions, such as schizophrenia, borderline personality disorder and other psychiatric conditions with a commonpresenting sign of irritability.