Omega EPA is a pharmaceutical-grade fish oil concentrate containing high levels of eicosapentaenoic acid (EPA), an omega-3 fatty acid, but negligible levels of docosahexaenoic acid (DHA), another omega-3 commonly found in fish oil supplements. Studies show that EPA, and not DHA, supports healthy mood and thought patterns.
| NPN
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Product Code
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Size
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Weight Per Capsule
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| 80002850
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AOR04117
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90 Softgels
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400 mg
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| 80002850
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AOR04046
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180 Softgels
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400 mg
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| Supplement Facts
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| Serving Size: 1 Softgel
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Amount Per Serving
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| Fish Oil
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325mg
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| (Eicosapentaenoic acid (EPA) Ethyl Ester 80%/325mg]
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| Non-medicinal ingredients: mixed tocopherols, rosemary oil. Capsule: gelatin, water and glycerin
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AOR guarantees that no ingredients not listed on the label have been added to the product. Contains no wheat, gluten, corn, nuts, dairy, soy, eggs, or shellfish.
Suggested Use
Take two to three softgels, twice daily with food, or as directed by a health care practitioner. Do not use if you are pregnant or breastfeeding.
Main Applications
As reported by literature:
• Supports mood balance and healthy thought patterns.
Source
Anchovy
Pregnancy / Nursing
No studies. Best avoided.
Cautions
None known
Pharmaceutical-Grade EPA, not DHA, for Healthy Mood and Thought Patterns
The common thinking on the different functions of the different omega-3s is: EPA for the heart, DHA for the brain.
There's a reasonable-sounding argument behind this notion, based on the fact that DHA (docosahexaenoic acid, or 22:6w3) is a major component of the brain, while there's only a tiny amount of EPA (eicosapentaenoic acid, or 20:5w3) in the nervous system. So when research started to show that countries and individuals who consumed more fish seemed more resistant to depression, schizophrenia, seasonal affective disorder (SAD), and bipolar disorder, almost everyone leapt to the conclusion that the seaborne secret just had to be DHA.
Not that it made any practical difference, of course: after all, nearly all EPA and DHA supplements come in the form of concentrated fish oil softgels with a significant amount of both fatty acids. So, the assumption was, you could get both benefits in one pill by just taking a common fish oil supplement.
Nice-sounding theory. But, as a series of randomized, placebo-controlled, clinical trials have shown, dead wrong.
Running our expectations through the spin cycle, resent research has revealed that DHA is, at best, useless when it comes to supporting the health of your thought patterns and outlook on the world. Worse: DHA may even be counterproductive. Surprisingly, EPA turns out to be the real slayer of the "Noonday Demons."
DHA: Brain Fat? Or Fat Chance?
• In one trial, researchers tested the effects of pure DHA on victims of clinical depression. For six weeks, people suffering with major depression took a supplement containing either pure DHA (two grams (2000 milligrams) a day or an inactive stand-in oil for six weeks. At the end of the trial, DHA had exerted no detectable effect whatsoever.
• In an even more pointed failure, researchers ran a trial to see if DHA supplements could prevent the depression and deficits in information processing associated with postpartum depression. This seemed like an especially good opportunity for DHA to strut its stuff, because women's levels of DHA usually decline late in their pregnancies, and they remain depressed for months after the birth of their child. Instead, the results were a complete flop. Women taking DHA supplements were no less depressed, and no better able to process information, than were women taking an inert fatty acid softgel, even though their DHA levels were much higher.
• A third trial sought to lay plain the differing effects of EPA and DHA on thought patterns and mental functioning - focusing this time on people suffering from schizophrenia. Forty-five people diagnosed with the disease were randomly assigned to begin using either two grams of high-EPA oil, the same amount of high-DHA oil, or a corn oil placebo, with no one knowing who was taking what.
The results in the DHA group were surprising. At best, they had gotten no better than people on the dummy pill. And overall, in fact, the subjects administered DHA appeared to fare worse than in the placebo group. Although the differences did not reach the statistical level of significance, there was actually a higher percentage of people taking DHA who were either treading water or showing further decay at the end of the trial than was seen with the placebo. On top of this, whereas the severity of so-called "positive" symptoms (delusions, psychoses, etc) had fallen by an average of 13.7% in patients taking the placebo, it was only reduced by 3.3% in DHA-treated subjects. In other words, it appears that patients get more relief from their "positive" symptoms if they take an inactive dummy pill than if they take DHA - suggesting that DHA may even interfere with the progress that they could otherwise make if they just continue with their conventional treatment.
It was a whole different picture in the pure EPA group. Every single one of the people who had taken the EPA-only supplement got better, with an even split between the number of people showing considerable improvements (more than 25%) on their symptom scores and the number showing more minor improvements.
• To make sure the results hadn't been some kind of wild fluke, the same group initiated a second trial to confirm the powers of EPA-only supplements. For three months, 30 relapsing schizophrenia sufferers who were not already taking drugs for their conditions took either straight EPA or placebo capsules as their sole encapsulated support - unless, during the course of the trial, their doctors deemed it clinically imperative to put them on antipsychotics, in which case the patients' safety came first and medication was permitted. But no one would know who was getting EPA, and who was taking the stand-in oil capsules. At the end of the trial, 100% of the people taking the dummy pill had been forced to go on an antipsychotic drug - versus only 57% of the EPA users.
The Power of EPA Confirmed
Since then, three more randomized, placebo-controlled trials have been performed using highly purified EPA supplements to help people with schizophrenia - and two such trials have been performed in victims of clinical depression. There have also been an additional two studies in schizophrenics, and an additional one in victims of depression, using either very high doses of omega-3 supplements containing mostly EPA (but still including some DHA), or such a supplement combined with antioxidants.
All but one of these eight trials showed that the EPA-containing supplements brought relief from these mental torments - and in that one trial, the problem seems to have been the use of excessively high doses.
• In one trial, for instance, 20 patients with major depressive disorder were randomly given either 2 grams of pure EPA or a matching stand-in for four weeks. Even in this short period, sixty percent of the people taking pure EPA experienced a remarkable 50% or greater reduction in their scores of depression, versus just ten percent of people taking the placebo. On average, the relief was clocked as a remarkable 12.4 point improvement on the Hamilton depression scale scores in EPA users - versus just a 1.6 point improvement among people stuck with the lookalike pills.
• Another double-blind trial compared the effects of EPA to the antidepressant drug fluoxetine in patients with major depressive disorder. EPA supplements were found to be as effective as the drug, with a response rate of 50% to fluoxetine, 56% to EPA and 81% to a combination of both.
Summarizing the evidence from these reports, the lead researcher in the trial which originally identified the opposing effects of EPA and DHA concluded that "In both schizophrenia and depression, the studies indicate that DHA is, if anything, rather worse than placebo in its effects on symptomology. Only EPA has given significant positive benefits."
Bipolar Disorder
Harvard Medical School performed a double-blind, placebo-controlled trial using high-dose fish oil supplements in 30 people trapped in bipolar disorder ("manic depression") in 1999, using the amount of long-chain omega-3s found in 32 standard fish oil capsules. At the end of the study, 86% of the people who had been taking the megadose EPA-containing oil were still free of relapse - versus only 38% of the people taking the placebo. Based on the research showing that DHA is at best an empty filler, and may even undermine the effects of EPA in schizophrenia and depression, the reason that the study required so much omega-3 may be that the high content of DHA in the supplement would have forced people to take still higher amounts of EPA to make it effective. Dr. Andrew Stoll, the lead investigator in the Harvard bipolar trial, says that his "clinical observation" is that "too much DHA relative to EPA may cause a worsening of mood. I therefore recommend using a supplement with as high an EPA content as possible".
Borderline Personality Disorder (BPD)
Having seen the convincing results experienced by EPA users with other disorders of the mind and personality, scientists initiated a pilot randomized, double-blind, placebo-controlled trial of EPA in 30 women plagued by BPD. The results were not earth-shattering - but they were significant. While symptoms improved in both groups, BPD sufferers taking the pure EPA supplements experienced greater reductions in both depression (about 15% more improved) and aggression (a 10% additional improvement) than did victims taking the placebo.
While the responses were not overwhelming, they were real - and it's worth remembering that BPD doesn't respond well to conventional drug therapies, either. Any relief from the nightmare of this disease represents an advance. Additionally, the dose in this pilot study may not have been optimal, and the authors called for "Studies assessing different doses of E-EPA for longer periods of time in larger samples".
What's the Story on these Morning Glories?
What is the key function of EPA in the brain that underlies its ability to support the health of the mind? The truth is, we don't know- at least, not with certainty. But we do have a good working hypothesis. Pioneering essential fatty acid researcher Ralph Holman put the core insight succinctly: "DHA is structure. EPA is function."
DHA is an essential structural component of nerve cells, needed in large amounts to build the brain during embryonic and childhood development. But once the brain and nervous system has matured, the developed brain's day-to-day DHA needs are minimal.
By contrast, although only a small amount of EPA is present in brain cell membranes at any given time, that small quantity is continuously being used up, necessitating ongoing replacement. EPA is quickly "turned over" as the brain ceaselessly releases EPA from its cell membranes for use in "signal transduction," conveying neurochemical messages within neurons just as neurotransmitters like serotonin and dopamine carry messages between them. EPA also fine-tunes and balances the signaling carried out by the brain's main omega-6 fat, arachidonic acid (AA). Because EPA is biochemically consumed in the process of carrying out its signal transduction role, the brain has a need for a large, steady supply of new EPA to keep functioning optimally.
The reason why DHA might actually worsen symptoms in people with mood and thought pattern disorders is less clear, but may simply be a matter of displacement. There's only so much "room" available for unsaturated fatty acids in the phospholipids of the brain's cellular membranes, and taking extra DHA (which is already plentiful in the brain) may squeeze out EPA by competing with it for the limited number of spots available to be filled when these phospholipids are being biosynthesized. Taking EPA supplements, by contrast, guarantees that the brain can meet its needs for a continuous, reliable supply of EPA, ensuring that adequate EPA is available when the brain needs it for signal transduction.
However it works, the evidence is clear. People looking to harness the power of omega-3 fatty acids for the health of their brains should look to supplements rich in EPA - and with as little DHA as possible.
The Wonky Well
Clinical depression, schizophrenia, bipolar disorder, and borderline personality disorder are serious illnesses which require qualified medical diagnosis and treatment. For people suffering with these disorders, the new research on EPA is very good news: with physician guidance, it suggests, high doses of this biologically essential orthomolecule in purified form may complement the conventional therapies already prescribed by their doctors.
Fortunately, of course, most of us do not suffer from such extreme psychic disturbances. But that doesn't mean that our minds are as clear, our feelings as stable, our responses to the world as reasonable, or our outlooks on life as bright as they could be - or should be, for our own health and happiness. We don't just want to be "non-insane," in other words: we want to be dynamically engaged with life, grasping the world in both hands and squeezing forth its sweet nectar. The good news, this research suggests, is that when not encumbered by DHA, pharmaceutical-grade EPA supplements can open your brain to the real possibilities around you, shattering the "mind forg'd manacles" that are holding you back from experiencing life's joys to their fullest.
April 2006: The Fish You Can Catch
The Fish You Can Catch: EPA, not DHA is the Omega-3 for Healthy Mood and Thought Patterns
Spring 2003: Best Selenium
Q and A: Phamaceutical-Grade Fish Oil and more
Sept 2001: ETA Omega-3
Fish and heavy-metal poisoning
ETA Omega-3
Comparison of therapeutic effects of omega-3 fatty acid eicosapentaenoic acid and fluoxetine, separately and in combination, in major depressive disorder.
Aust N Z J Psychiatry. 2008 Mar;42(3):192-8.
Jazayeri S, Tehrani-Doost M, Keshavarz SA, Hosseini M, Djazayery A, Amini H, Jalali M, Peet M.
OBJECTIVE: To compare therapeutic effects of eicosapentaenoic acid (EPA), fluoxetine and a combination of them in major depression.
METHOD: Sixty outpatients with a diagnosis of major depressive disorder based on DSM-IV criteria and a score >or=15 in the 17-item Hamilton Depression Rating Scale (HDRS) were randomly allocated to receive daily either 1000 mg EPA or 20 mg fluoxetine, or their combination for 8 weeks. Double dummy technique was used to double blind the study. Patients were assessed at 2 week intervals. Change in HDRS was the primary outcome measure.
RESULTS: Analysis of covariance for HDRS at week 8 across treatment groups was performed in 48 patients who completed at least 4 weeks of the study, with the last observation carried forward. Treatment, age of onset and baseline HDRS had a significant effect on HDRS at week 8. EPA + fluoxetine combination was significantly better than fluoxetine or EPA alone from the fourth week of treatment. Fluoxetine and EPA appear to be equally effective in controlling depressive symptoms. Response rates (>or=50% decrease in baseline HDRS) were 50%, 56% and 81% in the fluoxetine, EPA and combination groups, respectively.
CONCLUSIONS: In the present 8 week trial EPA and fluoxetine had equal therapeutic effects in major depressive disorder. EPA + fluoxetine combination was superior to either of them alone.
Eicosapentaenoic acid confers neuroprotection in the amyloid-beta challenged aged hippocampus.
Neurobiol Aging. 2007 Jun;28(6):845-55. Epub 2006 May 22.
Lynch AM, Loane DJ, Minogue AM, Clarke RM, Kilroy D, Nally RE, Roche OJ, O'Connell F, Lynch MA.
Among the changes that occur in the hippocampus with age, is a deficit in long-term potentiation (LTP). This impairment is associated with inflammatory changes, which are typified by increased concentration of the pro-inflammatory cytokine interleukin-1beta (IL-1beta). Activated microglia are the most likely cell source of IL-1beta, but data demonstrating an age-related increase in microglial activation is equivocal. Here we demonstrate that the age-related deficit in LTP is accompanied by increased expression of cell surface markers of activated microglia (major histocompatibility complex II and CD40) and increased IL-1beta production, and that these changes may be stimulated by interferon-gamma. Treatment of aged rats with eicosapentaenoic acid (EPA) attenuates these changes and we suggest that IL-4 mediates the action of EPA. We demonstrate that aged rats exhibit an exaggerated response to intracerebroventricular injection of beta-amyloid peptide 1-40 (Abeta). Thus Abeta inhibited LTP in aged, but not young, rats and induced a further increase in hippocampal IL-1beta concentration. Of particular significance is the demonstration that EPA protects the aged brain so that the increased vulnerability to Abeta is ameliorated in EPA-treated rats.
Omega-3 fatty acid supplementation in patients with recurrent self-harm: Single-centre double-blind randomised controlled trial.
Br J Psychiatry. 2007 Feb;190:118-122.
Hallahan B, Hibbeln JR, Davis JM, Garland MR.
BACKGROUND: Trials have demonstrated benefits of long-chain omega-3 essential fatty acid (n-3 EFA) supplementation in a variety of psychiatric disorders.
AIMS: To assess the efficacy of n-3 EFAs in improving psychological well-being in patients with recurrent self-harm.
METHOD: Patients (n=49) presenting after an act of repeated self-harm were randomised to receive 1.2 g eicosapentaenoic acid plus 0.9 g decosahexaenoic acid (n=22) or placebo (n=27) for 12 weeks in addition to standard psychiatric care. Six psychological domains were measured at baseline and end point.
RESULTS: At 12 weeks, the n-3 EFA group had significantly greater improvements in scores for depression, suicidality and daily stresses. Scores for impulsivity, aggression and hostility did not differ.
CONCLUSIONS: Supplementation achieved substantial reductions in surrogate markers of suicidal behaviour and improvements in well-being. Larger studies are warranted to determine if insufficient dietary intake of n-3 EFAs is a reversible risk factor for self-harm.
Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study.
Section of Neurobiology of Psychosis, PO66, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
Frangou S, Lewis M, McCrone P.
BACKGROUND: Epidemiological and clinical studies suggest that increased intake of eicosapentaenoic acid (EPA) alleviates unipolar depression.
AIMS: To examine the efficacy of EPA in treating depression in bipolar disorder.
METHOD: In a12-week, double-blind study individuals with bipolar depression were randomly assigned to adjunctive treatment with placebo (n=26) or with 1 g/day (n=24) or 2 g/day (n=25) of ethyl-EPA. Primary efficacy was assessed by the Hamilton Rating Scale for Depression (HRSD), with changes in the Young Mania Rating Scale and Clinical Global Impression Scale (CGI) as secondary outcome measures.
RESULTS: There was no apparent benefit of 2 g over 1 g ethyl-EPA daily. Significant improvement was noted with ethyl-EPA treatment compared with placebo in the HRSD (P=0.04) and the CGI (P=0.004) scores. Both doses were well tolerated.
CONCLUSIONS: Adjunctive ethyl-EPA is an effective and well-tolerated intervention in bipolar depression.
Two double-blind placebo-controlled pilot studies of eicosapentaenoic acid in the treatment of schizophrenia.
Schizophr Res. 2001 Apr 30; 49(3): 243-51.
Peet M, Brind J, Ramchand CN, Shah S, Vankar GK.
Evidence that the metabolism of phospholipids and polyunsaturated fatty acids (PUFA) is abnormal in schizophrenia provided the rationale for intervention studies using PUFA supplementation. An initial open label study indicating efficacy for n-3 PUFA in schizophrenia led to two small double-blind pilot studies. The first study was designed to distinguish between the possible effects of two different n-3 PUFA: eicosapentaenoic acid (EPA) and docohexaenoic acid (DHA). Forty-five schizophrenic patients on stable antipsychotic medication who were still symptomatic were treated with either EPA, DHA or placebo for 3 months. Improvement on EPA measured by the Positive and Negative Syndrome Scale (PANSS) was statistically superior to both DHA and placebo using changes in percentage scores on the total PANSS. EPA was significantly superior to DHA for positive symptoms using ANOVA for repeated measures. In the second placebo-controlled study, EPA was used as a sole treatment, though the use of antipsychotic drugs was still permitted if this was clinically imperative. By the end of the study, all 12 patients on placebo, but only eight out of 14 patients on EPA, were taking antipsychotic drugs. Despite this, patients taking EPA had significantly lower scores on the PANSS rating scale by the end of the study. It is concluded that EPA may represent a new treatment approach to schizophrenia, and this requires investigation by large-scale placebo-controlled trials.
Eicosapentaenoic acid in the treatment of schizophrenia and depression: rationale and preliminary double-blind clinical trial results.
Prostaglandins Leukot Essent Fatty Acids. 2003 Dec; 69(6): 477-85.
Peet M.
It has been hypothesised that polyunsaturated fatty acids (PUFA) play an important role in the aetiology of schizophrenia and depression. Evidence supporting this hypothesis for schizophrenia includes abnormal brain phospholipid turnover shown by 31P Magnetic Resonance Spectroscopy, increased levels of phospholipase A2, reduced niacin skin flush response, abnormal electroretinogram, and reduced cell membrane levels of n-3 and n-6 PUFA. In depression, there is strong epidemiological evidence that fish consumption reduces risk of becoming depressed and evidence that cell membrane levels of n-3 PUFA are reduced. Four out of five placebo-controlled double- blind trials of eicosapentaenoic acid (EPA) in the treatment of schizophrenia have given positive findings. In depression, two placebo-controlled trials have shown a strong therapeutic effect of ethyl-EPA added to existing medication. The mode of action of EPA is currently not known, but recent evidence suggests that arachidonic acid (AA) if of particular importance in schizophrenia and that clinical improvement in schizophrenic patients using EPA treatment correlates with changes in AA.
A dose-ranging study of the effects of ethyl-eicosapentaenoate in patients with ongoing depression despite apparently adequate treatment with standard drugs.
Arch Gen Psychiatry. 2002 Oct; 59(10): 913-9.
Peet M, Horrobin DF.
BACKGROUND: In depressed patients, low blood levels of eicosapentaenoic acid are seen. We tested the antidepressive effect of ethyl-eicosapentaenoate in these patients.
METHODS: We included 70 patients with persistant depression despite ongoing treatment with an adequate dose of a standard antidepressant. Patients were randomized on a double-blind basis to placebo or ethyl-eicosapentaenoate at dosages of 1, 2, or 4 g/d for 12 weeks in addition to unchanged background medication. Patients underwent assessment using the 17-item Hamilton Depression Rating Scale, the Montgomery-Asberg Depression Rating Scale, and the Beck Depression Inventory.
RESULTS: Forty-six (88%) of 52 patients receiving ethyl-eicosapentaenoate and 14 (78%) of 18 patients receiving placebo completed the 12-week study with no serious adverse events. The 1-g/d group showed a significantly better outcome than the placebo group on all 3 rating scales. In the intention-to-treat group, 5 (29%) of 17 patients receiving placebo and 9 (53%) of 17 patients receiving 1 g/d of ethyl-eicosapentaenoate achieved a 50% reduction on the Hamilton Depression Rating Scale score. In the per-protocol group, the corresponding figures were 3 (25%) of 12 patients for placebo and 9 (69%) of 13 patients for the 1-g/d group. The 2-g/d group showed little evidence of efficacy, whereas the 4-g/d group showed nonsignificant trends toward improvement. All of the individual items on all 3 rating scales improved with the 1-g/d dosage of ethyl-eicosapentaenoate vs placebo, with strong beneficial effects on items rating depression, anxiety, sleep, lassitude, libido, and suicidality.
CONCLUSION: Treatment with ethyl-eicosapentaenoate at a dosage of 1 g/d was effective in treating depression in patients who remained depressed despite adequate standard therapy.
Omega-3 Fatty acid treatment of women with borderline personality disorder: a double-blind, placebo-controlled pilot study.
Am J Psychiatry. 2003 Jan; 160(1): 167-9.
Zanarini MC, Frankenburg FR.
OBJECTIVE: The purpose of this study was to compare the efficacy of ethyl-eicosapentaenoic acid (E-EPA) and placebo in the treatment of female subjects with borderline personality disorder.
METHOD: The authors conducted an 8-week, placebo-controlled, double-blind study of E-EPA in 30 female subjects meeting Revised Diagnostic Interview for Borderlines and DSM-IV criteria for borderline personality disorder.
RESULTS: Twenty subjects were randomly assigned to 1 g of E-EPA; 10 subjects were given placebo. Ninety percent of those in both groups completed all 8 weeks of the trial. Analyses that used random-effects regression modeling and controlled for baseline severity showed E-EPA to be superior to placebo in diminishing aggression as well as the severity of depressive symptoms.
CONCLUSIONS: The results of this study suggest that E-EPA may be a safe and effective form of monotherapy for women with moderately severe borderline personality disorder.
Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial.
Arch Gen Psychiatry. 1999 May; 56(5): 407-12.
Stoll AL, Severus WE, Freeman MP, Rueter S, Zboyan HA, Diamond E, Cress KK, Marangell LB.
BACKGROUND: Omega3 fatty acids may inhibit neuronal signal transduction pathways in a manner similar to that of lithium carbonate and valproate, 2 effective treatments for bipolar disorder. The present study was performed to examine whether omega3 fatty acids also exhibit mood-stabilizing properties in bipolar disorder. METHODS: A 4-month, double-blind, placebo-controlled study, comparing omega3 fatty acids (9.6 g/d) vs placebo (olive oil), in addition to usual treatment, in 30 patients with bipolar disorder. RESULTS: A Kaplan-Meier survival analysis of the cohort found that the omega3 fatty acid patient group had a significantly longer period of remission than the placebo group (P = .002; Mantel-Cox). In addition, for nearly every other outcome measure, the omega3 fatty acid group performed better than the placebo group. CONCLUSION: Omega3 fatty acids were well tolerated and improved the short-term course of illness in this preliminary study of patients with bipolar disorder.