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Alcohol and tobacco use

Branded high EPA fish oil blend improves anger scores among substance abusers

L Buydens , M Branchey, A Roy. N-3 Polyunsaturated Fatty Acids Decrease Feelings Of Anger In A Population Of Substance Abusers. Neuropsychopharmacology, 2005;30(1):S87-S88.

Background:
It has been suggested that low levels of some polyunsaturated fatty acids (PUFAs) play a role in the pathophysiology of depressive, suicidal and aggressive behaviors, including homicides. This can be understood in light of the fact that PUFAs are structural components of neuronal membranes phospholipids and influence neuronal function. The evidence linking low levels of PUFAs and aggression is however still scant. Because aggressive behaviors are intensively bound up with drug use, we studied the effects of the administration of PUFAs of the n-3 series in a group of substance abusers.

Methods:
Thirteen patients were given on a daily basis capsules containing 3 grams of n-3 PUFAs (2,250 mg of eicosapentaenoic acid (EPA, 20:5n-3), 500 mg of docosahexaenoic acid (DHA, 22:6n-3) and 250 mg of other n-3 PUFAs). Eleven patients received similarly looking placebo capsules containing vegetable oils.

The treatment duration was 3 months. Capsules were given in a double-blind manner. A modified version of the Profiles of Mood States (POMS) questionnaire was administered at baseline and every month thereafter for a period of 3 months.

Six patients in the PUFA group and 8 patients in the placebo group were followed up for an additional 3 months after treatment discontinuation and were administered the same questionnaire every month. At baseline, a life long history of aggressive behavior and a history of problems with the law were obtained.

Results:
The 13 patients who received n-3 PUFAs and were followed for 3 months showed a progressive decline in the POMS anger subscale scores. This was not the case for the 11 patients who received placebos. A comparison of the 2 groups by repeated measures ANCOVAs (with baseline value as covariate) revealed a significant difference (p<.025).

The 6 patients in the PUFA group who were followed for 6 months showed a progressive increase in anger scores from the 4th to the 6th month, but their scores did not return to baseline levels. No trend was observed in the anger scores fluctuations recorded from the 4th to the 6th month in the 8 patients who had received placebo capsules. A comparison of the 2 patient groups followed for 6 months was significant at a trend level. Four of the 13 patients in the PUFA group and 4 of the 11 patients in the placebo group had a history of assaultive behavior and 7 patients in each of these groups had been jailed for offences ranging from drug possession to theft, DWI, weapon possession and assaults.

Discussion:
This study, which needs to be replicated in larger samples, showed that the daily administration of 3 grams of n-3 PUFAs for a period of 3 months significantly decreased feelings of anger in a population of substance abusers by comparison with the administration of a placebo. This decrease was followed by an increase in anger scores in a subgroup of patients who were followed for an additional 3 months.

These data give support to epidemiological studies showing a decrease in homicides in countries where the consumption of foods rich in n-3 PUFAs such as fish is high. Angry feelings can lead to aggressive behaviors. Supplements of n-3 PUFAS, that are both inexpensive and well tolerated, might be considered as treatment adjuncts in patients displaying these behaviors.