The 2001 film “A Beautiful Mind” starring Russell Crowe gave the world insight into the life of John Nash, a brilliant Nobel Laureate who struggled with the schizophrenia. Paranoia about communists and loss of his rationale thought were some of the symptoms Mr. John Nash described throughout his battle with the disease. Schizophrenia affects as much as 0.7% of the population and is thought to currently be affecting 21 million people worldwide. It is characterized by a variety of signs that are grouped into positive and negative symptoms. Positive symptoms are those that individuals without schizophrenia would not normally experience including delusions and hallucinations. Negative symptoms are a lack of a normal emotional response in people with suspected schizophrenia. These could include loss of motivation, flat expressions, inability to experience pleasure, and lack of a desire to form relationships. There is no laboratory test to diagnose schizophrenia, instead the use of the patients own experiences and clinical observations are used to make a diagnosis. Schizophrenia is thought to be caused by a combination of genetic factors and environmental factors. The disease is heritable. There is no cure for schizophrenia and current treatments are focused on controlling the hallucinations and delusions.
Previous research has identified changes in the levels of specific fatty acids in the cell membranes of people with schizophrenia. These fatty acids are ones you have likely heard of, omega-3 and omega-6 fatty acids. They have been the attention of much research for their proposed health benefits. These fatty acids are found in foods such as fish, flax, eggs, and nuts. While their proposed health benefits have not yet been substantiated, new research suggests that supplementation of omega-3 fatty acids to people who are at risk for schizophrenia may be able to prevent them from developing schizophrenia/psychosis in the first place.
In the study, published in Nature, people between the ages of 13 and 25 who were at high risk for schizophrenia were recruited. They split them into two groups, one who received the omega-3 fatty acid supplementation and one who received a placebo. The fatty acids used for treatment were eicosapentaenoic acid and docosahexaenoic acid. Both groups took their respective treatment for 12 weeks and were then followed up 7 years later to look for signs of schizophrenia. The results of this study are actually quite striking. In the people who were given 12 weeks of fatty acid supplementation, only 10% of the participants went on to develop schizophrenia. Compare this to the fact the 40% of the placebo group went on to develop schizophrenia. That means, out of the 40 people in the placebo group, 16 developed schizophrenia 8 years later, while 12 short weeks of fatty acid pills resulted in only 4 people in the test group getting schizophrenia. In addition, the people in the treatment group had a significant reduction in their schizophrenia symptom scores with the greatest decrease being seen in the positive symptoms (the hallucinations and delusions). It is important to note that the 40% rate of schizophrenia in this placebo group is similar to the transition rate of 35% from high risk to schizophrenia reported in other sources.
There is reason for cautious optimism with these results. The treatment is cost effective, free of major side effects, and may give hints to one of the causes of schizophrenia. This was a small study with only 80 participants. It remains to be seen if the results hold up in a larger group of at risk individuals. Additionally, it is unknown whether this type of treatment will help individuals who already have schizophrenia. We also still don’t know exactly how these omega-3 fatty acids are working to prevent the disease. Still, an intervention for people at risk for developing schizophrenia is needed. A study in 2013 identified that as time went on, the rate of people transitioning from an at risk state to full blown psychosis/schizophrenia increased. In the study, 18% of people developed psychosis by 6 months and 36% by 3 years. This type of intervention could be a game changer. Not only would it hopefully prevent many people from developing schizophrenia, but it would also come with minimal to no side effects compared to currently available treatments. That’s what you call a win-win.
Header photo credit: “Cloth embroidered by a schizophrenia sufferer” by cometstarmoon