By David McEvoy
Schizophrenia is a chronic, severe, and disabling brain disease. Approximately one percent of the population develops schizophrenia during their lifetime – more than two million Americans suffer from the illness in any given year. Although schizophrenia affects men and women with equal frequency, the disorder often appears earlier in men, usually in the late teens or early twenties; women are generally affected in the twenties to early thirties. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. These symptoms may leave them fearful and withdrawn. Their speech and behaviour can be disorganised and strange to the extent that they may be incomprehensible or frightening to others.
How is Schizophrenia Diagnosed?
There is currently no physical or lab test that can conclusively diagnose schizophrenia – a psychiatrist usually makes the diagnosis based on clinical symptoms. Physical testing can rule out many other conditions (seizure disorders, metabolic disorders, thyroid dysfunction, brain tumour, the effects of street drug use, and so on) that sometimes have similar symptoms.
What causes Schizophrenia?
Although the exact cause of schizophrenia remains unknown, experts agree that schizophrenia develops as a result of interplay between biological predisposition (for example, inheriting certain genes) and environmental factors. These lines of research are beginning to converge: brain development disruption is likely the result of genetic and/or environmental stressors early in development (during pregnancy or early childhood), leading to subtle alterations in the brain. Environmental factors later in development can either damage the brain further and further increase the risk of schizophrenia, or lessen the expression of genetic or neurodevelopment defects, thus decreasing the risk of schizophrenia.
Treatment for schizophrenia
The American Psychiatric Association publication ‘Guidelines for the Treatment of Patients with Schizophrenia’ states: “Antipsychotic medications are indicated for nearly all acute psychotic episodes in patients with schizophrenia.”
There is also a significant overlap in terms of the medications for schizophrenia and bipolar disorder (Manic Depression). There are two main classifications of medications (from a layman’s perspective); the traditional antipsychotic medications (Haldol, etc.), and the newer, ‘atypical’ antipsychotic medications that have come out in the past decade (Clozapine, Geodon, Seroquel, Risperdal, Zyprexa, Abilify, etc.). It is recommended that sufferers or their carers speak to online support groups to get in touch with others, and to hear about their personal successes and problems with the different medications. It is also a good idea to read as much as possible regarding the medications available, and talk with a psychiatrist, to identify the medications that may be appropriate. It should be kept in mind that whilst both the older and newer medications can greatly help a person with schizophrenia, they all have significant side effects that vary according to the individual. No medication available, unfortunately, constitutes an actual cure for schizophrenia.
A natural treatment for schizophrenia?
While the conclusions drawn range from the positive to the negative, research does suggest that people with schizophrenia may benefit by a reduction in symptoms when they take fish oil capsules that are high in the EPA (a type of Omega-3 fatty acid) form of oil. It is important to be careful about the type of fish oil you are using, as not all fish oils are effective. Researchers at the University of Sheffield tell us: “What people really need to be looking at is the amount of EPA in the fish oil they are buying. Our data from previous studies suggests that DHA is of little use in the treatment of schizophrenia, but EPA is the substance that yields the best results. Dosage wise it is suggested that about 2,000 mg/day to 4,000 mg/day (2 to 4 grams/day) should help.”
A research review article from 2005 in the journal Drugs states: “The evidence to date supports the adjunctive use [i.e. in addition to antipsychotic medications] of omega-3 fatty acids in the management of treatment unresponsive depression and schizophrenia. As these conditions are associated with increased risk of coronary heart disease and diabetes mellitus, omega-3 fatty acids should also benefit the physical state of these patients.” (Drugs, 2005; 65(8):1051-9).
Fish fats, and the oils extracted from them, contain two biologically-active omega 3 fatty acids, DHA, EPA. There are good theoretical reasons why both might be important in the brain. However, with regard to schizophrenia, evidence is accumulating that it is the EPA which is really helpful, whereas DHA may not be beneficial in this context.
The strongest evidence comes from a study at Sheffield University by Dr Malcolm Peet and his colleagues. They did a study in patients with chronic, partially treatment-resistant schizophrenia. These patients continued on their existing medications. They were then randomised on a double-blind basis to receive either a placebo, or high EPA fish oil from sardines or anchovies, or high DHA fish oil from tuna. In other words, all the treatments were coded so that neither the patients nor the doctors knew which patient was receiving which treatment until the trial had been completed and the code broken. When the code was broken, the results were very clear. The placebo patients, as is usual in such experiments, showed a small improvement. The DHA patients also showed a small improvement, but in fact a lesser one than was evident in the placebo group, raising the possibility that DHA may not be helpful. In contrast, the patients on EPA showed a significant improvement which was comparable to that seen with the newer antipsychotic drugs, yet without the side effects.
Other studies have also shown that the same EPA rich oil as was used in the Sheffield study is very helpful in improving symptoms even in those who have a shorter history of schizophrenia. It therefore seems that the best fish oils to use are those which are high in EPA.
These findings have been fully embraced by the Schizophrenia Association of Great Britain, which recommends EPA fish oil along with other nutritional supplements on a daily basis to help treat this condition.
The current evidence points towards this natural essential fatty acid being beneficial for schizophrenia especially when run alongside current antipsychotic medication.
Any good doctor or nutritionist will tell you that the best way to get any nutrient is to eat a very balanced diet. In the case of Omega 3 oil this would be in the form of fish. Sadly due to the pollution levels found in our oceans today eating large portions of fish every day is not advisable.
Therefore anyone with schizophrenia who wants to supplement their diet with omega 3 oil must purchase fish oil capsules that are high in EPA. Make sure at point of purchase that the capsules are free of toxins and contaminates and that they also have a high EPA to DHA ratio, as these types of capsules were found to be more effective by some leading doctors in the UK.
Copyright 2005 David McEvoy
The author Dave McEvoy has CFS and bipolar disorder with a history of schizophrenia in his family. Dave also runs a high quality supplement site www.mind1st.co.uk
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