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Comments and Controversies


Omega-3s for BPD

Vol. 11, No. 11 / November 2012

As a psychiatrist who incorporates diet and dietary supplements in my practice, I appreciated the excellent review of omega-3 fatty acids for psychiatric illness (Current Psychiatry, September 2012, p. 40-45; bit.ly/1ApTrXC). It’s far better to support normal biochemistry and avoid side effects whenever possible.

However, regarding treatment of borderline personality disorder (BPD), the author stated that omega-3 fatty acids are ineffective. I have found them clinically useful for BPD. In the 2003 study the author cited, Zanarini et al1 concluded “E-EPA [ethyl-eicosapentaenoic acid] is a nutriceutical agent that is both well tolerated and may be efficacious for the treatment of moderately disturbed women with borderline personality disorder. Ninety percent of those taking this compound were able to complete the entire 8-week trial and reported no clinically relevant side effects. Those treated with this compound also experienced a significantly greater reduction in their overall aggression as well as their depressive symptoms than those treated with placebo.” These results suggest that omega-3 fatty acids may be an effective monotherapy for women with moderately severe BPD.

Hyla Cass, MD
Private Practice
Pacific Palisades, CA

The author responds

Dr. Cass is correct. Zanarini et al did suggest that omega-3 fatty acids are beneficial in reducing aggression and depressive symptoms in women with moderate borderline personality disorder who were not prescribed other psychotropics. However, the study was small (N = 30), and further research is needed to support these findings.

Mary Morreale, MD
Assistant Professor
Department of Psychiatry
Wayne State University
Detroit, MI

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