omega-3 dietary supplements in schizophrenia

Conditions: Schizophrenia; Schizophreniform Disorder; Schizoaffective Disorder; Bipolar Disorder; Psychosis NOS

Summary: this 16-week placebo-control study looks to investigate whether patients with schizophrenia for two years or less may benefit from omega-3 supplements.

this study looks to investigate whether patients with schizophrenia for 2 years or less may benefit from omega-3 supplements. the main hypothesis to be tested in this study is that white matter integrity assessed with diffusion tensor imaging (dti) and erythrocyte membrane omega-3 concentration may provide the means for identifying patients most likely to derive clinical benefit from omega-3 supplementation. to test this hypothesis the investigators will enroll 58 patients with recent-onset schizophrenia into a 16-week long randomized double blind placebo-controlled study of risperidone versus risperidone plus omega-3 supplementation. study assessments after consent will include a baseline mri and an mri at the final visit, blood-work, clinical interviews to assess symptoms, and medical assessments for side effects. dti exams and peripheral omega-3 concentration will be obtained prior to the initiation of treatment and the primary outcome measure will be the total brief psychiatric rating scale score. specific aims are: * to examine the efficacy of omega-3 fatty acids as an adjuvant agent in the treatment of patients with recent-onset schizophrenia. the investigators hypothesize that patients treated with omega-3 fatty acids will demonstrate greater brief psychiatric rating scale (bprs) reductions compared to the placebo group. * to identify whether pre-treatment fractional anisotropy (fa) assessed by dti predicts which patients will derive clinical benefit from omega-3 fatty acids. the investigators hypothesize that patients with lower fractional anisotropy will derive greater clinical benefit from omega-3 fatty acid supplementation. * to identify whether pre-treatment peripheral omega-3 fatty acid concentrations predict which patients will derive clinical benefit from omega-3 fatty acids. the investigators hypothesize that patients with lower peripheral omega-3 fatty acid concentrations will derive greater clinical benefit from omega-3 fatty acid supplementation.

Eligibility criteria:
inclusion criteria: * current dsm-iv-defined diagnosis of schizophrenia, schizophreniform, schizoaffective disorder, psychosis nos or bipolar i as assessed using the structured clinical interview for axis i dsm-iv disorders; * does not dsm-iv criteria for a current substance-induced psychotic disorder, a psychotic disorder due to a general medical condition, delusional disorder, brief psychotic disorder, shared psychotic disorder, or a mood disorder with psychotic features; * current positive symptoms rated more than 4 (moderate) on one of these bprs items: conceptual disorganization, grandiosity, hallucinatory behavior, and unusual thought content; * is in a early phase of illness as defined by having taken antipsychotic medications for a cumulative lifetime period of 2 years or less; * age 15 to 40; * competent and willing to sign informed consent; and * for women, negative pregnancy test and agreement to use a medically accepted birth control method. exclusion criteria: * serious neurological or endocrine disorder or any medical condition or treatment known to affect the brain; * any medical condition which requires treatment with a medication with psychotropic effects; * significant risk of suicidal or homicidal behavior; * cognitive or language limitations, or any other factor that would preclude subjects providing informed consent; * medical contraindications to treatment with risperidone (e.g. neuroleptic malignant syndrome with prior risperidone exposure), omega-3 supplements (e.g. bleeding disorder, seafood allergies) or placebo capsules (e.g. allergies to capsule components); * contraindications to mri imaging (e.g. presence of a pacemaker); * lack of response to a prior adequate trial of risperidone; * taking omega-3 supplements within the past 8 weeks, and * requires treatment with an antidepressant or mood stabilizing medication.

Keywords: adolescence adult antipsychotic agents female human male risperidone omega-3 schizophrenia schizophreniform schizoaffective schizophrenia -- *drug therapy