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Vitamin D & Schizophrenia (2021)

Vitamin D deficiency is more common in patients with schizophrenia. This is due to factors such as social isolation, lack of movement, smoking, spending less time outside, malnutrition, and disruption of vitamin D synthesis by antipsychotic drugs.

The study looked into the relationship between sunlight exposure and positive, negative, and cognitive symptoms. 52 patients were invited to take part and 40 completed the study.

Patients had their serum 25OHD levels measured in order to understand their current vitamin D level in the blood.

The following clinical assessment scales were used pre and post replacement of Vitamin D:

  • SANS – scale for the assessment of negative symptoms
  • SAPS – Scale for the Assessment of Positive Symptoms
  • WCST-CV- Wisconsin Card Sorting Test used to evaluate executive function

Vitamin D deficiency was found in 65.4% of the patients with vitamin D values below the normal limit.

Various levels of oral vitamin D was given once a week for eight weeks to the patients according to their initial levels. Vitamin D levels were measured again eight weeks after the initiation of the treatment. Additionally, patients whose serum vitamin D level could not reach > 30 ng/mL within the eight weeks were given additional doses until the optimal level was reached.

Results showed that the mean SANS score was statistically significantly lower after replacement of vitamin D and the total attention score was also significantly improved. The study therefore concluded that addressing vitamin D deficiency in schizophrenic patients (together with antipsychotic treatment) can improve the total attention span and positive and negative symptoms in schizophrenia.

The abstract can be accessed here.

Neriman A, Hakan Y, Ozge U. The psychotropic effect of vitamin D supplementation on schizophrenia symptoms. BMC psychiatry. 2021 Dec;21(1):1-0.

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Iron deficiency and schizophrenia (2018)

This paper investigated iron deficiency and schizophrenia. Previous research finding that iron deficiency may alter dopaminergic transmission, this study was conducted to identify whether low blood iron levels could be related to severity of schizophrenia symptoms. This study was conducted on 121 patients during their first episode of schizophrenia disorder. Symptoms were measured using the positive and negative syndrome scale (PANSS), and iron deficiency was defined as a serum ferritin less than 20ng/ml. The study found patients with iron deficiency were significantly more likely to have more prominent negative symptoms, and patients with more negative symptoms had significantly lower serum ferritin (iron) levels than their counterparts. This study highlights a possibility for further investigation as to whether iron supplementation could be used as an intervention.

The abstract can be accessed here

Kim SW, Stewart R, Park WY, Jhon M, Lee JY, Kim SY, Kim JM, Amminger P, Chung YC, Yoon JS. Latent iron deficiency as a marker of negative symptoms in patients with first-episode schizophrenia spectrum disorder. Nutrients. 2018 Nov;10(11):1707

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Omega 3 and schizophrenia (2016)

This study investigated omega 3 and schizophrenia. Specifically, the study explored the effect of omega-3 supplementation in symptom severity in schizophrenic patients over a long period of time, as previous studies have had mixed findings when interventions lasted 10-12 weeks.  A randomized placebo-controlled trial was conducted over 26 weeks to study whether omega-3 fatty acids would have an effect on symptom severity in first episode schizophrenic patients. 71 patients were assigned either a placebo of olive oil or 2.2g/day of omega-3 supplement. Severity of symptoms were measured using the positive and negative syndrome scale (PANNSS). A 50% improvement in symptom severity was recorded more frequently in the omega-3 group compared to the placebo group. Significant improvements were found in depressive symptoms, the level of functioning and clinical global impression when patients were supplemented. These findings suggest that a 6-month intervention of omega-3 supplementation may be able to decrease symptom severity in first episode schizophrenia patients.

The abstract can be viewed by clicking here

Pawełczyk T, Grancow-Grabka M, Kotlicka-Antczak M, Trafalska E, Pawełczyk A. A randomized controlled study of the efficacy of six-month supplementation with concentrated fish oil rich in omega-3 polyunsaturated fatty acids in first episode schizophrenia. J Psychiatr Res. 2016 Feb;73:34-44.

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Antipsychotics, Omega 3 and Schizophrenia (2021)

This study explored antipsychotics, omega 3 and schizophrenia. The review compiled previous studies surrounding treatment of schizophrenia using omega-3 and looked at what pathways in the brain are impacted by an omega-3 supplementation. After compiling information on omega-3 and anti-psychotic drugs it was found that the drugs used to treat schizophrenia and omega-3 supplementation impact on dopamine and glutamate transmission, oxidative stress, inflammation, myelination, and neurotransmission pathways in a similar way. Through evaluation of multiple clinical studies on omega-3 supplementation it was concluded that omega-3 has been linked to improved symptoms in those experiencing a schizophrenic episode. This research suggests that omega-3 supplementation may be an important consideration in schizophrenia. 

To view the abstract, click here

Shared Biological Pathways between Antipsychotics and Omega-3 Fatty Acids: A Key Feature for Schizophrenia Preventive Treatment? Int J Mol Sci. 2021 Jun 26;22(13):6881

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Micronutrients and Childhood Psychosis (2012)

 

This study investigated micronutrients in childhood psychosis. Childhood psychosis is difficult to address effectively with conventional pharmaceuticals, many of which have adverse long-term health consequences. In contrast, there are promising reports from several research groups of micronutrient treatment (vitamins, minerals, amino acids and essential fatty acids) of mood, anxiety and psychosis symptoms using a complex formula that appears to be safe and tolerable. The study reviews previous studies using this formula to support mental symptoms, and presents an 11-year-old boy with a 3-year history of mental illness whose parents chose to transition him from medication to micronutrients. Symptom severity was monitored in three clusters: anxiety, obsessive compulsive disorder and psychosis. Complete remission of psychosis occurred, and severity of anxiety and obsessional symptoms decreased significantly (p<0.001); the improvements are sustained at 4-year follow-up. A cost comparison revealed that micronutrient treatment was <1% of his inpatient mental healthcare. Additional research on broad-spectrum micronutrient treatment is warranted.

Click here for the full abstract

Efficacy and cost of micronutrient treatment of childhood psychosis. Rodway et al. (2012). British Medical Journal Case Reports, doi:10.1136/bcr-2012-007213 

 

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Omega 3 and anxiety (2011)

This study investigated omega 3 and anxiety. The study set out to determine if omega-3 fish oil supplementation could improve both anxiety levels and inflammation in a group of 68 medical students who didn’t have a diagnosis of an anxiety disorder but could be expected to be experiencing some level of anxiety as medical exams were coming up. The researchers measured anxiety levels, and took blood tests to measure markers of inflammation (known as proinflammatory cytokines). The subjects were given either a high dose fish oil (2g of the omega-3 EPA and 348mg of DHA) or a placebo capsule daily for 12 weeks. At this point, the measurements were taken again and these showed that those who had taken the fish oil had both lower levels of anxiety and lower levels of proinflammatory cytokines.

Click here for the abstract

Omega-3 supplementation reduces anxiety and inflammation in healthy young adults. Kiecolt–Glaser et al., 2011

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Omega 3 and wellbeing (2007)

This 2007 New Zealand study investigated omega 3 concentrations and wellbeing. 2,416 people participating in the 1997 National Nutrition Survey. Researchers investigated if a relationship existed between the composition of fats in the blood and the mental and physical well-being.

They found that the higher the proportion of Omega 3 fats, the better the physical and mental wellbeing of the person. Specifically they measured EPA levels in the blood as well as the ratio of EPA to arachidonic acid (AA).

EPA is the fatty acid found in oily fish and fish oil supplements while AA is mostly found in meat and dairy products.

Click here for the abstract

Crowe FL et al.,’Serum phospholipid n 3 long-chain polyunsaturated fatty acids and physical and mental health in a population-based survey of New Zealand adolescents and adults’.  Am J Clin Nutr. 2007 Nov;86(5):1278-85

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Fish oil & psychosis (2008)

The study investigated fish oil & psychosis. Individuals at extremely high risk of developing psychosis appear less likely to develop psychotic disorders following a 12-week course of fish oil capsules containing long-chain omega-3 polyunsaturated fatty acids. Those taking the capsules also showed signs of reduced positive, negative and general symptoms of schizophrenia. Schizophrenic patients may have an underlying dysfunction in fatty acid metabolism and the potential effects of omega-3 polyunsaturated fatty acids on psychosis development may result from changes to cell membranes and interactions with neurotransmitter systems in the brain.

Click here for the abstract

Fish oil may reduce psychotic disorders in high risk individuals. Amminger et al. (2010). Archives of General Psychiatry, 67(2); 146-154.

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Sleep Deprivation & Adolescence (2010)

This study investigated sleep deprivation & adolescence. Later parent-set bedtimes and correspondingly shorter sleep duration appears to be related to the development of depression in adolescence, a cross-sectional analysis showed. In the sample 24% of adolescents were shown to experience depression when going to sleep at midnight or later. In addition to depression, adolescents with later bedtimes also had a greater risk of having a 20% increased incidence of suicidal thoughts, compared with adolescents who went to bed before 10:00pm.

Click here for the abstract

Gangwisch, J. E., Babiss, L. A., Malaspina, D., Turner, J. B., Zammit, G. K., & Posner, K. (2010). Earlier parental set bedtimes as a protective factor against depression and suicidal ideation. Sleep, 33(1), 97–106. https://doi.org/10.1093/sleep/33.1.97

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Tryptophan & Emotional Processing (2006)

This study assessed  tryptophan & emotional processing. It explored whether tryptophan (TRP) induces cognitive changes opposite to the negative biases found in depression and characteristic of those induced by serotonergic antidepressants in healthy volunteers. Thirty eight healthy volunteers were randomised to receive 14 days double-blind intervention with TRP (1g for 3x a day) or placebo. On the final day, emotional processing was assessed using four tasks: facial expression recognition, emotion-potentiated startle, attentional probe and emotional categorisation and memory. The results showed that TRP increased the recognition of happy facial expressions and decreased the recognition of disgusted facial expressions in female, but not male, volunteers. TRP also reduced attentional vigilance towards negative words and decreased baseline startle responsivity in the females. It concludes that these findings provide evidence that TRP supplementation in women induces a positive bias in the processing of emotional material that is reminiscent of the actions of serotonergic antidepressants. This highlights a key role for serotonin in emotional processing and lends support to the use of TRP as a nutritional supplement in people with mild depression or for prevention in those at risk.

Murphy SE et al. ‘Tryptophan supplementation induces a positive bias in the processing of emotional material in healthy female volunteers’. Psychopharmacology (Berl). 2006 Jul;187(1):121-30. Epub 2006 May 4

Click here for the abstract

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