The use of antipsychotic medication for
the prevention of psychotic disorders is
controversial. Long-chain omega-3 (omega-3)
polyunsaturated fatty acids (PUFAs) may
be beneficial in a range of psychiatric
conditions, including schizophrenia. Given
that omega-3 PUFAs are generally beneficial
to health and without clinically relevant
adverse effects, their preventive use in
psychosis merits investigation.
To determine whether omega-3 PUFAs
reduce the rate of progression to first-episode
psychotic disorder in adolescents and young
adults aged 13 to 25 years with subthreshold
Seventy-six of 81 participants
(93.8%) completed the intervention. By study's
end (12 months), 2 of 41 individuals (4.9%)
in the omega-3 group and 11 of 40 (27.5%)
in the placebo group had transitioned to
psychotic disorder (P = .007). The difference
between the groups in the cumulative risk
of progression to full-threshold psychosis
was 22.6% (95% confidence interval, 4.8-40.4).
Omega-3 Polyunsaturated fatty acids also
significantly reduced positive symptoms
(P = .01), negative symptoms (P = .02),
and general symptoms (P = .01) and improved
functioning (P = .002) compared with placebo.
The incidence of adverse effects did not
differ between the treatment groups.
Long-chain omega-3 PUFAs reduce the risk
of progression to psychotic disorder and
may offer a safe and efficacious strategy
for indicated prevention in young people
with subthreshold psychotic states.