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Ethyl-Eicosapentaenoic Acid in First-Episode Psychosis. A 1H-MRS Study.

Berger GE, Wood SJ, Wellard RM, Proffitt TM, McConchie M, Amminger GP, Jackson GD, Velakoulis D, Pantelis C, McGorry PD

[1] 1Department of Psychiatry, ORYGEN Research Centre, University of Melbourne, Parkville, Australia [2] 2Department of Research & Education, The Schloessli Clinic, Oetwil am See, Zuerich, Switzerland [3] 3Howard Florey Institute, The University of Melbourne, Parkville, Australia.

Ethyl-eicosapentaenoic acid (E-EPA) is an omega-3 fatty acid that has been used in a range of neuropsychiatric conditions with some benefits. However, its mechanism of action is unknown. Here, we investigate its effects on in vivo brain metabolism in first-episode psychosis (FEP). Proton magnetic resonance spectroscopy at 3 T was performed in the temporal lobes of 24 FEP patients before and after 12 weeks of treatment in the context of a larger double-blind, placebo-controlled E-EPA augmentation study. Treatment group effects for glutathione (F1,12=6.1, p=0.03), and a hemisphere-by-group interaction for glutamine/glutamate (F1,20=4.4, p=0.049) were found. Glutathione increased bilaterally and glutamate/glutamine increased in the left hemisphere following E-EPA administration. Improvement in negative symptoms correlated with metabolic brain changes, particularly glutathione (r=-0.57). These results suggest that E-EPA augmentation alters glutathione availability and modulates the glutamine/glutamate cycle in early psychosis, with some of the metabolic brain changes being correlated with negative symptom improvement. Larger confirmatory studies of these postulated metabolic brain effects of E-EPA are warranted.Neuropsychopharmacology advance online publication, 16 January 2008; doi:10.1038/sj.npp.1301628.

Published 17 January 2008 in Neuropsychopharmacology.
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