Omega-3 fatty acids reduce cardiometabolic risk in first-episode schizophrenia patients treated with antipsychotics: Findings from the OFFER randomized controlled study.

Abstract Metabolic syndrome (MetS) increases the risk of premature mortality observed in schizophrenia (SCZ). N−3 polyunsaturated fatty acid (PUFA) deficiency has been reported in different stages of schizophrenia. N−3 PUFA supplementation was found to be beneficial in both chronic SCZ and MetS. No intervention studies based on n−3 PUFA as add-on therapy to antipsychotics have examined the changes in MetS risk in first-episode schizophrenia. Aim This randomized placebo-controlled trial assesses the effect of a 26-week intervention composed of either 2.2 g/day of n−3 PUFA or olive oil placebo on the frequency of MetS and the changes in its constituents as a secondary outcome measure. Methods Seventy-one adult inpatients diagnosed with first-episode schizophrenia were randomly assigned to study groups. The active intervention used a 3:2 mixture of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. Metabolic syndrome components were monitored throughout the study. Results A significant reduction in the frequency of MetS was observed in the EPA + DHA group (p = 0.0408); as well as some specific MetS components: e.g., a decrease in fasting blood glucose (p = 0.045). The beneficial effects of EPA + DHA were even more pronounced in patients treated mainly with olanzapine, e.g. significant reductions of total cholesterol (p = 0.037) and blood glucose levels (p = 0.034). Significant positive correlations were found between the general psychopathology subscale of PANSS (primary outcome) and triglyceride level changes. Conclusion N−3 PUFA supplementation in early SCZ may constitute a safe and affordable intervention that can reduce the risk of MetS and its lethal complications.