Shared Biological Pathways between Antipsychotics and Omega-3 Fatty Acids

Meta-analyses on the effect of omega-3 used as a supplement at different stages of schizophrenia suggest that the supplement is efficacious at reducing symptoms in the earlier stages of schizophrenia but results are mixed for chronic schizophrenia patients [179,180]. Indeed, some studies on chronic schizophrenia patients find that omega-3 supplementation improves symptomatology and prevents some of the antipsychotic side effects [50,181,182], while others find no efficacy of omega-3 supplementation in the stable or acute phases of the disorder [183,184]. In FEP, a clinical trial found that the efficacy of the supplementation was dependent on the dose and the length of the supplementation, with higher doses and longer periods of supplementation being associated with better clinical outcomes [185,186]. In UHR patients, omega-3 supplementation has been shown to reduce the risk of psychotic transition (27.5% vs. 4.9%; p = 0.007) [187] with a long-lasting effect (seven years follow-up) [188], although a more recent multi-center study shows a lack of effect of omega-3 supplementation [189]. However, this multi-center cohort presented lower rates of psychotic transition, which may have been attributed to several biases related to compliance with the treatment … Indeed, almost 60% of participants had not taken the omega-3 supplement as required, and a secondary analysis that compared compliant versus non-compliant participants showed that the cumulative psychotic conversion rate within one year was significantly higher in the non-compliant group compared to the compliant group (14.8% vs. 4.7%)

This review is a contribution to our understanding of the role played by omega-3 fatty acids in different biological pathways that are involved in schizophrenia. Exploring the biological pathways omega-3 is involved in improves our knowledge about the mechanisms underlying the pathophysiology of schizophrenia. We show that omega-3 supplementation is involved in mechanisms and has biological actions similar to antipsychotics. However, omega-3 does not present the cumbersome side effects that antipsychotics do. Further, omega-3 appears to be efficient as soon as the first symptoms of schizophrenia emerge, in UHR patients, a phase in which antipsychotics are the least effective. Thus, omega-3 supplementation has been proposed as an alternative to antipsychotics in this very early stage. In FEP patients, omega-3 appears to improve recovery and could be prescribed as add-on to their current medication. The low cost associated with omega-3 supplementation makes it a realistic and relatively easy treatment to implement. While omega-3 supplementation appears to be a promising therapeutic strategy, it is possible that only a subgroup of the individuals would benefit from this treatment. Further research is needed to determine the biological factors justifying this supplementation, paving the way to a more personalised medicine.


I personally swear by the stuff. It has helped me in so many ways.

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I’ve been taking fish oil and a multi vitamin for years.

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That’s cool.

I currently don’t get any omega 3 as I’m a vegan.

Considering to buy algal omega 3 capsules at some point.

■■■■■■■ expensive, for me.

So I will just take what I personally believe is my personal bare minimum requirement of omega 3.

I will check in with my gut instinct and research to tell me.

Anyways I think that’s a safe thing to do as potentially too much omega 3 is probably risky as it is a blood thinner.

So too much blood thinning may be bad.

I don’t know… Just pondering.

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Some vegan foods that contain ALA (which can be converted by the body to omega 3 - although not as efficiently as one might like) are walnuts, flax, and chia seeds.

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Can Omega 3 help with my cognitive symptoms? And, does it increase weight?

It shouldn’t impact weight at normal doses. It would only be a couple of grams of fat at most.

It might help cognitive symptoms:

This study was on people with schizophrenia and metabolic syndrome

This one did not test supplementation, but found people with lower levels of omega 3 were more cognitively impaired.

Our results indicate that reduced blood omega-3 fatty acids are associated with cognitive impairment, which then impacts social functioning outcomes in schizophrenia.

The studies suggest that it is most important in young people, people with more recent onset, and that a higher dosage and longer term of supplementation had better results (so it is not fast-acting). Even in older people and people who have been ill a long time though, omega 3 are an essential fatty acid which means that you need to be getting them in your diet, at the very least, in order to be as healthy as you can.

The effective dosages tested in clinical trials were all at least 1,200 mg of omega 3, with a mix of DHA and EPA but heavier on the DHA. That’s not a huge dose but it is larger than many supplements.


You have any idea the dosage I should take?

When my doctor prescribed me omega 3, I wasn’t well, and my positives worsened because of omega 3. Part of the reason was that, it was a very, very high dose, like 1500 mgs or something a day.

Also, can you suggest what metabolic syndrome is, which is mentioned in the above cited research?

You should probably ask your doctor - the dosage you mention is in the range of what was tested, which was probably why he prescribed that amount.

Maybe you could start smaller and work up. Most of the dosages that are that large are a couple of pills, so you could ask him/her about taking a partial dose.

Thank You. I will ask him.

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Metabolic syndrome is a collection of problems such as high fasting blood sugar, high triglycerides, low good cholesterol, higher blood pressure and a larger waistline.

It seems to be something that is related to both schizophrenia itself as well as some medications, but people without schizophrenia get it too.

It is interesting that you say this.

I had gained weight in the last 10 years, used to feel excessive hunger on various medications. Currently, I am losing weight fast, as I am on Abilify/Ziprasidone combination and there is no excessive hunger. Does this mean that my cognitive deficits may reverse? I feel my memory is improving, and so is my processing speed, attention span, etc…

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Does omega 3 raises bad cholesterol if taken to much?

I found this, about metabolic syndrome:

[Metabolic syndrome] negatively impacts cognitive performance and brain structure. Potential explanatory models include impaired vascular reactivity, neuroinflammation, oxidative stress, and abnormal brain lipid metabolism.

So if you had metabolic syndrome and it is now improving or gone, it seems like that would positively benefit cognition.

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Thanks. This is good to know. I will exercise harder now.

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It seems like it would be more likely to cause a small reduction in cholesterol.

Omega-3 fats have a notable effect on triglyceride levels:

  • One study showed that ingesting 900 mg of omega-3 fatty acids each day resulted in a 4% decrease in triglyceride levels after about six months.
  • The most effective dose of omega-3s used in most studies was between 2 and 4 grams. This resulted in a drop in triglycerides between 25% and 45%.
  • The effectiveness of omega-3 fatty acids on triglycerides appears to be dose-dependent. This means that the more omega-3 fatty acids ingested, the lower your triglyceride levels will fall.
  • Omega-3 fatty acids seem to affect recently ingested triglycerides and work best when following a healthy diet.
  • Individuals with extremely high triglyceride levels (greater than 500 mg/dL) appear to get the most benefit from omega-3 fatty acid supplementation.