Metabolic syndrome and other chronic health conditions such as heart disease, diabetes, and obesity, all involve lipid production changes. Lipids directly affect the neurotransmitter network in the brain, and also affect inflammation. Recently, lipid production has been investigated with respect to psychosis. Individuals with schizophrenia are at significantly increased risk for metabolic syndrome and chronic health problems influenced by lipid mechanisms and inflammation. Thus, a natural next step in clinical research would be to look at how lipid production and fatty acid levels are affected by antipsychotic medication.
To this end, Joseph McEvoy of the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center in North Carolina recently conducted a study involving 40 medication-free participants, half of whom had a first episode (FE) of psychosis, the remaining half of whom had chronic schizophrenia (RE). After several weeks of antipsychotic medication, the n3 and n6 fatty acid levels of these participants were compared to those of 29 control participants with no history of psychosis.
The fatty acids were used as lipid markers because these have been found to be altered in early psychosis. The medications used were analyzed to determine what effect, if any, they had on lipid production and fatty acid metabolism. McEvoy found that the FE participants had significant increases in n3 fatty acid after taking the medication for several weeks. Although there were some increases in n6 production, they were not as striking. The RE participants, however, had n6 and n3 levels that were similar to the controls.
These findings suggest that fatty acid development and lipid production may be most impaired at the initial onset of psychosis. Because of this, the neurocognitive process could become most altered and affected during the first episode. Or, perhaps the low n3 and lipid levels are present prior to the psychosis, suggesting a unique and novel indicator of potential risk. If this is the case, fatty acid supplements may provide a preventive or protective element for these individuals and those with FE psychosis.
“However,” added McEnvoy, “Our findings suggested that n3 supplementation may not be effective in subjects with RE schizophrenia.” Therefore, future work should address what supplements or approaches could be used to increase lipid development in individuals with chronic psychosis.
McEvoy, J., Baillie, R.A., Zhu, H., Buckley, P., Keshavan, M.S., et al. (2013). Lipidomics reveals early metabolic changes in subjects with schizophrenia: Effects of atypical antipsychotics. PLoS ONE 8(7): e68717. doi:10.1371/journal.pone.0068717
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