Posted 31 October 2007 - 12:58 AM
OK, since (in my view) we are in fairly unchartered waters, and you guys are so convinced that a DHA/EPA blend is superior to pure EPA, DISPROVE this argument:
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 (2
000 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.
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 amount 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.
References
Peet M, Brind J, Ramchand CN, Shah S, Vankar GK. 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, Horrobin DF. 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. 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.
Stoll AL, Locke CA, Marangell LB, Severus WE. Omega-3 fatty acids and
bipolar disorder: a review. Prostaglandins Leukot Essent Fatty Acids.
1999 May-Jun;60(5-6):329-37.
Zanarini MC, Frankenburg FR. 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.
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