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Findings of decreased omega-3 fatty acid levels in the red blood cells138 and brains139 of a limited number of schizophrenic patients and the results of uncontrolled supplementation studies have created interest in the use of long-chain omega-3 fatty acid supplements as an adjunct to conventional antipsychotic therapy regimens for schizophrenia.

A pilot study in 45 schizophrenic patients found that the addition of 2 g/day of EPA to standard antipsychotic therapy was superior to the addition of a 2 g/day of DHA or a placebo in decreasing residual symptoms. When EPA supplementation was used as the sole treatment for schizophrenic patients experiencing a relapse, 8 out of 14 patients supplemented with 2 g/day of EPA required antipsychotic medication by the end of the 12-week study period compared to 12 out of 12 of those on the placebo.

Results of randomized controlled trials using ethyl-EPA as an adjunct to standard antipsychotic therapy in schizophrenic patients have been somewhat contradictory. In one trial, the addition of 3 g/day of ethyl-EPA to standard antipsychotic treatment for 12 weeks improved symptom scores and decreased dyskinesia scores, while in a larger trial, supplementation with the same dose of ethyl-EPA was not different than placebo in improving symptoms, mood, or cognition.

In a placebo-controlled trial comparing the addition of 1, 2, or 4 g/day of ethyl-EPA to different medication regimens, ethyl-EPA supplementation improved symptoms of schizophrenic patients on the antipsychotic medication clozapine, but not other medications. Although limited evidence suggests that EPA supplementation may be a useful adjunct to antipsychotic therapy in schizophrenic patients, larger long-term studies addressing clinically relevant outcomes are needed.

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