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Omega-3 Fatty Acids and Bipolar Disorder. By: Jessica Lepetich. Outline. Overview of Bipolar Disorder Current Treatments The Omega-3 FAs Connection Suggested Functions of Omega-3 FAs Studies Conclusions. Bipolar Disorder. Also known as manic-depressive illness

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outline
Outline
  • Overview of Bipolar Disorder
  • Current Treatments
  • The Omega-3 FAs Connection
  • Suggested Functions of Omega-3 FAs
  • Studies
  • Conclusions
bipolar disorder
Bipolar Disorder
  • Also known as manic-depressive illness
  • Brain disorder that causes unusual shifts in a person’s mood, energy and ability to function.

Image: www.theablecrew.org/ interactive/bip.gif

bipolar disorder1
Bipolar Disorder
  • Those who suffer may experience periods of mania.
    • Characterized by euphoric or irritable mood, increased energy, decreased need for sleep, rapid thinking and speech
  • As well as periods of depression
    • Characterized by loss energy, loss of usual interests and please, difficulty concentration and suicidal ideation
symptoms of mania
Increased energy, activity, and restlessness

Excessively "high," overly good, euphoric mood

Extreme irritability

Racing thoughts and talking very fast, jumping from one idea to another

Little sleep needed

Unrealistic beliefs in one's abilities and powers

Poor judgment

Spending sprees

A lasting period of behavior that is different from usual

Increased sexual drive

Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

Provocative, intrusive, or aggressive behavior

Denial that anything is wrong

Symptoms of Mania
symptoms of depression
Lasting sad, anxious, or empty mood

Feelings of hopelessness or pessimism

Feelings of guilt, worthlessness, or helplessness

Loss of interest or pleasure in activities once enjoyed, including sex

Decreased energy, a feeling of fatigue or of being "slowed down"

Restlessness or irritability

Difficulty concentrating, remembering, making decisions

Sleeping too much, or can't sleep

Change in appetite and/or unintended weight loss or gain

Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury

Thoughts of death or suicide, or suicide attempts

Symptoms of Depression
bipolar facts
Bipolar Facts
  • More than 2 millions adults (1% of population) suffer from bipolar disorder.
  • Ranked 6th in worldwide causes of disability
cause
Cause
  • A definite cause for any type of depression is difficult to determine but include genetics, changes in the brain, and environmental factors like stress and major life changes.
treatment options
Treatment Options
  • Medication
    • Mood Stabilizers:
      • Lithium, Valporate, Carbamazepine
  • Psychosocial Interventions
    • Psychotherapy
  • Other
    • Herbal Supplements, Omega-3 FA

Images: www.bipolaraware.co.uk/ Images/

lithium
Lithium
  • Most popular drug treatment for BPD
  • Affects the phosphatidylinositol system (PI), by decreasing the concentration of myo-insitol.
  • Therefore, the PI system cannot resynthesize as fast, so the chance of over-activation is reduced.
  • Side Effects: tremors, acne, weight gain, sedation, and cognitive dulling

Image:http://www.websters-online-dictionary.org/coreimages/digital+art/83514_9192_by_Morrhigan.jpg

pi system
PI System

Image: Stoll et al. (1999)

valproate
Valproate
  • Suggested to have an effect on the GABA neurotransmitter system.
  • Also suggested to directly inhbibit PKC.
  • Positive Aspects: Superior efficacy than lithium and less toxic
  • Side Effects: tremors, GI distress, hair thinning, hepatitis, and weight gain
slide13
PKC

http://www.ruf.rice.edu/~rur/issue1_files/Biology/Barron/Barron_3_small.jpg

omega 3 fatty acids
Omega-3 Fatty Acids
  • Long chain, polyunsaturated fatty acids (PUFAs) found in marine and plant sources.
  • EPA and DHA are marine derived.
  • Alpha-linolenic acid is found in plants, seeds, oils and nuts.

Image:http://www.healthcastle.com/images/salmon.jpg

why omega 3 and bipolar
In the CNS, phospholipids composed of omega-3 and omega-6 FAs play an essential role in neuronal signal transduction.

Correct balance of PUFA = normal neuronal functioning

Abnormal PUFA concentrations have been found in psychiatric disorders.

Many epidemiological studies have shown that countries with higher levels of omega-3 fatty acid consumption had lower rates of depression and bipolar disorder.

Why Omega-3 and Bipolar?
how do omega 3 fa s work
How do Omega-3 FA’s work?
  • Inhibition of neuronal signal transduction.
    • Specifically the PI System
  • Blockade of Ca2+, which reduces overactive neuronal signal transduction
  • PKC System

Image:http://www.suinaka.or.jp/diet/DHA.jpg

pi system1
PI System
  • Omega-3 FAs are going to cause a decrease in the concentration of myo-inositol.
  • Myo-insitol is needed to resynthesize the PI system, so a lower concentration would lead to a reduction in over-active signaling.

Image: Stoll et al. (1999)

pkc and ca2
PKC and Ca2+

Image:http://www.biocarta.com/pathfiles/h_pkcPathway.gif

  • PKC is normally activated by DAG and Ca2+.
  • Omega-3 FAs are shown to inhibit the catalytic domain of PKC.
  • Omega-3 FAs are also shown to create a Ca2+ channel blockage.
stoll et al
Stoll et al.
  • Combination of 30 men and women, 18-65 years of age.
  • Met DSM-IV definition for bipolar disorder.
  • ½ received placebo (olive oil ethyl esters), ½ received omega-3 FA supplement
  • Each subject took 7 pills a day for a total of 6.2 g of EPA and 3.4 g of DHA per day.
  • Found that omega-3 FAs lead to significant symptom reduction and a better outcome when compared to the group receiving the placebo pill.
sagduyu et al
Sagduyu et al.
  • 37 total subjects
  • All met DSM-IV criteria for bipolar disorder.
  • Average starting dose of omega-3 FAs 1824.32 mg
  • Average final dose was 2878.38 mg
  • Found that omega-3 FAs added to current bipolar treatment significantly helped reduce irritability.
chiu et al
Chiu et al.
  • 20 healthy volunteers and 20 patients with bipolar disorder, between the ages of 18 and 65 years.
  • All bipolar patients met the criteria specified in the DSM-IV.
  • Analyzed blood samples in order to look at omega-3 FA levels.
  • Found that there was a decreased concentration of DHA in the blood samples from the bipolar patients.
conclusions
Conclusions
  • Much research stills needs to be conducted before a solid relationship can be determined.
  • The exact system(s) that omega-3 FA’s affect need to be determined.
    • PI,PKC, Ca2+, or all a combination?
  • More double-blinded placebo studies are need, to see if omega-3 FAs as medication is a plausible idea
  • Bipolar disorder itself needs to clear up many of its own unanswered questions