Supplementation with a combination of ω-3 fatty acids and antioxidants (vitamins E and C) improves the outcome of schizophrenia
Supplementation with a combination of ω-3 fatty acids and antioxidants (vitamins E and C) improves the outcome of schizophrenia
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DOI：
10.1016/s0920-9964(02)00284-0
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发表时间：
2003-08-01
影响因子：
4.5
通讯作者：
Mahadik, SP
中科院分区：
文献类型：
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作者：
Arvindakshan, M;Ghate, M;Mahadik, SP
细胞膜必需多不饱和脂肪酸(EPUFAs)，即花生四烯酸(AA)、二十碳五烯酸(EPA)、二十二碳五烯酸(DPA)和二十二碳六烯酸(DHA)水平降低，以及它们与精神病理学的关系，在接受长期药物治疗的精神分裂症患者和未接受药物治疗的精神分裂症患者中都得到了一致的报道。过去补充omega-6或omega-3或两种EPUFA的研究通常在慢性药物治疗的老年患者中报道了不同程度的疗效，并提示主要补充omega-3 EPUFA(EPA和GT；DHA)可能是更可取的。我们报告了对33例精神分裂症患者(N=33)早晚口服EPA/DHA(180：120 mg)和抗氧化剂(维生素E/C，400 IU：500 mg)的混合物，为期4个月。在治疗前、治疗后和治疗后4个月按既定程序检测红细胞膜脂肪酸水平、血浆过氧化脂质和临床指标，以确定患者体内治疗效果的稳定性。将血清脂肪酸和过氧化脂质水平与正常对照组(N=45)进行比较。治疗后RBC EPUFAs水平显著高于治疗前水平和正常对照组水平，而血浆过氧化产物水平没有明显增加。同时，由于简明精神病学评定量表(BPRS)和阳性与阴性症状量表(PANSS)、一般精神病理学-PANSS总分的下降以及Henrich的生活质量(QOL)量表的增加，精神病理学的得分显著下降。经过4个月的补充清洗，EPUFA水平恢复到治疗前水平。然而，临床上的改善明显保留。未来的研究需要在安慰剂对照试验中进行，也需要在更多的患者中单独补充脂肪酸的对照组进行，无论是慢性患者还是从未服用药物的患者，并在监测饮食摄入量的同时进行更长时间的治疗。这可能会证明EPUFA补充是一种非常有效的治疗方法，可以在较长一段时间内改善结果。(C)2002 Elsevier Science B.V.保留所有权利。
Reduced levels of membrane essential polyunsaturated fatty acids (EPUFAs), namely, arachidonic acid (AA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acids (DHAs), and their association with psychopathology have been consistently reported in both chronic-medicated schizophrenic patients as well as in never-medicated patients soon after the first episode of psychosis. Past supplementation studies with either omega-6 or omega-3 or both EPUFAs generally in chronic-medicated-older patients have reported varying degrees of therapeutic effects, and have suggested that supplementation with primarily omega-3 EPUFAs (EPA> DHA) may be preferable. We report the supplementation with a mixture of EPA/DHA (180:120 mg) and antioxidants (vitamin E/C, 400 IU:500 mg) orally morning and evening to schizophrenic patients (N= 33) for 4 months. The red blood cell (RBC) membrane fatty acid levels, plasma lipid peroxides and clinical measures were carried out by established procedures at pretreatment, posttreatment and after 4 months of postsupplementation period to determine the stability of treatment effects within patients. Levels of fatty acids and lipid peroxides were compared with their levels in normal controls (NC) (N=45). Posttreatment levels of RBC EPUFAs were significantly higher than pretreatment levels as well as levels in normal controls without any significant increase in plasma peroxides. Concomitantly, there was significant reduction in psychopathology based on reduction in individual total scores for brief psychiatric rating scale (BPRS) and positive and negative syndrome scale (PANSS), general psychopathology-PANSS and increase in Henrich's Quality of Life (QOL) Scale. The EPUFA levels returned to pretreatment levels after 4 months of supplementation washout. However, the clinical improvement was significantly retained. Future studies need be done in placebo-controlled trials and also with a comparison group supplemented with fatty acids alone in a larger number of patients, both chronic as well as never medicated, and for a longer duration of treatment while the dietary intake is monitored. This may establish the EPUFA supplementation a very effective treatment to improve the outcome for an extended period of time. (C) 2002 Elsevier Science B.V All rights reserved.