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Fish oil (n-3 fatty acids) in drug resistant epilepsy: a randomised placebo-controlled crossover study
Christopher M DeGiorgio1, Patrick R Miller1, Ronald Harper1
1Departments of Neurology, Cardiology and Neurobiology, UCLA School of Medicine, Los Angeles, California, USA.
Background:
n-3 fatty acids inhibit neuronal excitability and reduce seizures in animal models. High-dose fish oil has been explored in two randomised trials in drug resistant epilepsy with negative results. We performed a phase II randomised controlled crossover trial of low-dose and high-dose fish oil in participants with drug resistant epilepsy to explore whether low-dose or high-dose fish oil reduces seizures or improves cardiovascular health.
Methods:
Randomised placebo-controlled trial of low-dose and high-dose fish oil versus placebo (corn oil, linoleic acid) in 24 participants with drug resistant epilepsy. A three-period crossover design was utilised lasting 42 weeks, with three 10-week treatment periods and two 6-week washout periods. All participants were randomised in double-blind fashion to receive placebo, high dose or low dose in different sequences. The primary outcome was per cent change in total seizure frequency.
Findings:
Low-dose fish oil (3 capsules/day, 1080 mg eicosapentaenoic acid+docosahexaenoic acid) was associated with a 33.6% reduction in seizure frequency compared with placebo. Low-dose fish oil was also associated with a mild but significant reduction in blood pressure. High-dose fish oil was no different than placebo in reducing seizures or improving cardiac risk factors.
Interpretation:
In this phase II randomised crossover trial, low-dose fish oil was effective in reducing seizures compared with placebo. The magnitude of improvement is similar to that of recent antiepileptic drug trials in drug resistant epilepsy (DRE). The results indicate that low-dose fish oil may reduce seizures and improve the health of people with epilepsy. These findings justify a large multicentre randomised trial of low-dose fish oil (n-3 fatty acids <1080 mg/day) in drug resistant epilepsy.
Trial Registration Number:
NCT00871377.
Insights
Low-dose fish oil significantly reduced seizure frequency in individuals with drug-resistant epilepsy. This finding suggests a potential new treatment for epilepsy, warranting further large-scale trials.
Area of Science:
- Neurology
- Nutritional Science
- Cardiovascular Health
Background:
- n-3 fatty acids are known to inhibit neuronal excitability and reduce seizures in animal models.
- Previous trials using high-dose fish oil in drug-resistant epilepsy yielded negative results.
- A phase II randomized controlled crossover trial investigated low-dose and high-dose fish oil for drug-resistant epilepsy.
Purpose of the Study:
- To determine if low-dose or high-dose fish oil reduces seizures in drug-resistant epilepsy.
- To assess the impact of fish oil on cardiovascular health in epilepsy patients.
Main Methods:
- A 42-week, three-period crossover trial involving 24 participants with drug-resistant epilepsy.
- Participants were randomized to receive placebo (corn oil, linoleic acid), low-dose fish oil, or high-dose fish oil in a double-blind manner.
- The primary outcome measured was the percentage change in total seizure frequency.
Main Results:
- Low-dose fish oil (1080 mg EPA+DHA/day) was associated with a 33.6% reduction in seizure frequency compared to placebo.
- Low-dose fish oil also demonstrated a mild but significant reduction in blood pressure.
- High-dose fish oil showed no significant difference from placebo in reducing seizures or improving cardiac risk factors.
Conclusions:
- Low-dose fish oil effectively reduces seizures in drug-resistant epilepsy, with results comparable to current antiepileptic drug trials.
- The findings suggest that low-dose fish oil may improve seizure control and overall health in individuals with epilepsy.
- A large multicenter randomized trial of low-dose fish oil (n-3 fatty acids <1080 mg/day) in drug-resistant epilepsy is justified.
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