Evidence supporting the use of: EPA (eicosapentaenoic acid)
For the health condition: Bipolar Mood Disorder

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish oil, has been studied for its potential role in supporting or treating Bipolar Mood Disorder. The rationale stems from epidemiological observations suggesting a correlation between higher omega-3 intake and lower prevalence of mood disorders, as well as the known anti-inflammatory and neuroprotective effects of omega-3 fatty acids. Clinical trials have primarily examined combined omega-3 fatty acids (EPA and DHA), but some studies suggest that EPA-predominant formulations may be more effective in mood regulation.

A 1999 double-blind, placebo-controlled study by Stoll et al. showed that omega-3 supplementation significantly improved symptoms in patients with bipolar disorder. Subsequent research produced mixed results, with some studies reporting moderate benefit—particularly for depressive symptoms—while others found no significant effect. Meta-analyses indicate that the therapeutic effect, if present, is modest and may depend on the EPA:DHA ratio, with higher EPA content showing more promise. The proposed mechanisms include modulation of cell membrane fluidity, neurotransmitter function, and inflammatory pathways, all of which are implicated in mood disorders.

Despite some positive findings, the evidence is inconsistent, and omega-3s are not considered a first-line treatment. Guidelines sometimes mention omega-3 supplementation as adjunctive therapy, but emphasize the need for further large-scale, high-quality trials. Thus, while there is a scientific basis for EPA use in bipolar disorder, the strength of evidence is moderate to low.

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