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Reduced mania and depression in juvenile bipolar disorder associated with long-chain ω-3 polyunsaturated fatty acid supplementation


Long-chain ω-3 polyunsaturated fatty acid (LCn-3PUFA) supplementation may improve symptoms of depression in children and bipolar disorder (BD) in adults. No studies have examined the effectiveness of LCn-3PUFA supplementation in the treatment of mania and depression in juvenile BD (JBD) when given as an adjunct to standard pharmacological treatment. Eighteen children and adolescents with JBD received supplements containing 360 mg per day eicosapentaenoic acid (EPA) and 1560 mg per day docosahexaenoic acid (DHA) for 6 weeks in an open-label study. Intake and fasting red blood cell (RBC) LCn-3PUFA, mania, depression and global function were assessed before and after supplementation. RBC EPA and DHA were significantly higher following supplementation. Clinician ratings of mania and depression were significantly lower and global functioning significantly higher after supplementation. Parent ratings of internalizing and externalizing behaviours were also significantly lower following supplementation. A larger randomized controlled trial appears warranted in this participant population.

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We thank Robert Blake and Melinda Phang for assistance in conducting LCn-3PUFA analyses. We also thank Sonney Morrison and Hunter Area Pathology Service staff for assistance with blood collection. We especially thank Robert Brown, Andrew Millgate and James Neal for constructive advice in the preparation of this paper. We thank Nu-Mega Ingredients Pty Ltd for in-kind donation of ω-3 capsules.

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Correspondence to E H Clayton.

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Contributors: EHC assisted with design of the study and data collection, was responsible for data analysis and interpretation and drafted the paper; TLH, SJH and CJK collected data and assisted with interpretation and revision of the paper; MLG assisted with interpretation and revision of the paper and PLH assisted with data analysis and interpretation and revision of the paper. All authors contributed to the intellectual content and approved the final version of the paper.

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Clayton, E., Hanstock, T., Hirneth, S. et al. Reduced mania and depression in juvenile bipolar disorder associated with long-chain ω-3 polyunsaturated fatty acid supplementation. Eur J Clin Nutr 63, 1037–1040 (2009).

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  • ω-3
  • EPA
  • DHA
  • children and adolescents
  • psychiatry
  • juvenile bipolar disorder

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