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Open Access Research article

Role of Omega-3 fatty acids in preventing metabolic disturbances in patients on olanzapine plus either sodium valproate or lithium: a randomized double-blind placebo-controlled trial

Toktam Faghihi1, Adel Jahed2, Javad Mahmoudi-Gharaei34, Vandad Sharifi4, Shahin Akhondzadeh34 and Padideh Ghaeli14*

Author Affiliations

1 Faculty of Pharmacy, Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Endocrinology, Booali University Hospital, Islamic Azad University, Tehran Medical Branch, Tehran, Iran

3 Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran

4 Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran

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DARU Journal of Pharmaceutical Sciences 2012, 20:43  doi:10.1186/2008-2231-20-43

Published: 4 October 2012

Abstract

Background

Metabolic and cardiovascular side effects have been noted with the use of second generation antipsychotics (SGAs) and mood stabilizers. Since Omega-3 fatty acids have been known to prevent some cardiovascular risks, this preliminary study was designed to evaluate the cardiovascular benefits of omega-3 when added to the combinations of olanzapine with mood stabilizers.

Methods

This study was a randomized, double-blind, placebo-controlled, within-subject trial in adult psychiatric patients who were receiving olanzapine combined with lithium (Li) or valproate sodium (VPA). Omega-3 as fish oil with less than 1 g/day of EPA/DHA or its placebo was added to patients’ olanzapine and mood stabilizer regimens for 6 weeks. Metabolic parameters including anthropometric variables, lipid profile, metabolic syndrome indices, C-reactive protein, fibrinogen and lipoprotein (a) [(Lp) (a)] were assessed for participants.

Results

Forty one participants completed this study; 20 patients received omega-3 and 21 patients received placebo, added to their regimen of SGA and mood stabilizer. Omega-3 addition did not modulate anthropometric, metabolic syndrome and lipid parameter changes in 6 weeks. However, fibrinogen levels significantly decreased, Lp (a) did not increase and non-high-density lipoprotein cholesterol (non-HDL-C) did not go beyond its target level after omega-3 supplementation. Additionally, a significant inter-group effect was noted for Lp(a).

Conclusions

This study suggests that use of short-term omega-3 supplementation added to a combined regimen of olanzapine and mood stabilizer may have a small modulating effect on some cardiovascular risk factors. Trials in longer periods of time and with larger number of patients are needed to further evaluate the effects of omega-3 supplements on preventing cardiovascular risk factors.

This trial is registered at irct.ir and its Identifier is as following: IRCT138712231764N1

Keywords:
Metabolic Disturbance; Hyperlipidemia; Omega-3; Olanzapine; Valproate; Lithium