In their innovative preliminary trial, Stoll et al1 concluded that ω3 fatty acids were well tolerated and improved the short-term course of illness in patients with bipolar disorder. Although only 120 days in the blind phase, this study was reasonably well-designed. The primary outcome measure was the length of time to complete the blind phase of the study without any treatment-emergent mood episodes, but the results as shown in Table 21 also showed that all of the "noncompleted" cases (3 of 14 cases) in the ω3 group developed a manic episode (mania, hypomania, and worsening of mixed state), whereas the depressive symptoms of all of the noncompleted cases (10 of 16 cases), except 1 in the placebo group, worsened! The aforementioned observation might suggest the hypothesis that ω3 fatty acids could prevent depression but not mania among the bipolar patients. To test this hypothesis, future research should design a way to compare the ω3 fatty acid treatment effectiveness between depressive and manic phases of patients with bipolar disorder.
Su K, Shen WW, Huang S. Are ω3 Fatty Acids Beneficial in Depression but Not Mania?. Arch Gen Psychiatry. 2000;57(7):716. doi: