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for depression or bipolar disorder, but five do, and all eight acknowledge that there is

promising evidence for its use in the treatment of depression and bipolar disorder.

5. MOOD STABILIZATION IN BIPOLAR DISORDER:

 Bipolar disorder (manic-depressive illness) is a common neuropsychiatric illness with a

high morbidity and mortality. Despite the use of mood-stabilizing drugs, including

lithium and valproate, there are high rates of recurrence. All of the currently available

mood-stabilizing drugs appear to affect neuronal signal transduction (or second

messenger) mechanisms. Biochemical studies have shown that dietary treatment with

omega-3 essential fatty acids leads to the incorporation of these compounds into the

membranes crucial for cell signaling. This mechanism may be similar to some of the

actions of lithium and valproate.

 Fugh-Berman and Cott relied on Stoll’s pioneering bipolar study to indicate the

potential of omega-3s as psychotropic agents for mood stabilization: A double-blind

study by Stoll, A. et al. (1999)^5 demonstrated that dietary supplementation with omega-

3 essential fatty acids resulted in marked mood-stabilizing activity for persons with

bipolar disorder. Significant group differences in favor of fish oil were seen on the

Hamilton Depression Scale, the Global Assessment Scale and the Clinical Global

Impression Scale. The authors concluded that omega-3 essential fatty acids were well

tolerated and improved the short-term course of the illness.

 In Brown et al. II, Mischoulon and Freeman surveyed the conflicting studies, plus the

meta-analysis by Sarris et al. (2012), concluding that people with rapid cycles may

benefit less from omega-3 supplementation and that most of the benefit is probably in

the depressive rather than in the manic phase of the illness.^6

6. DEPRESSION

 It has been theorized that omega-3 essential fatty acids may reduce the development of

depression, since depressive patients show significant depletion of omega-3s. There

appears to be an inverse relationship between the prevalence of major depression and