Eleven studies (from eight independent randomized controlled trials) with a total of 451 participants in the early stages of psychosis or FEP were included in the systematic review by researchers at NICM Health Research Institute, Western Sydney University.
The researchers found that certain nutrient supplements given in combination with standard treatment for psychosis improved the mental health of the participants more than standard treatment alone.
Nutritional deficiencies are recognized as a risk‐factor for various psychiatric disorders as individuals with schizophrenia have generally low-quality diets, the study said.
"Nutrient supplementation in the treatment of mental illness is something which can be surrounded by both cynicism and 'hype',” lead researcher Dr. Firth, research fellow at NICM Health Research Institute, Western Sydney University, said.
"We conducted this review just to see if there is any 'real evidence' if such nutrients can actually help young people with psychosis.”
Previous psychosis research findings
There has been some research into certain food-derived nutrients and effects on psychosis conditions in the past. For example, a double‐blind randomized controlled trial in 2008 showed that 2000 mg per day of the amino‐acid “n‐acetylcysteine” (NAC) significantly reduced negative symptoms in patients with an established illness.
Another clinical trial found that four grams of the amino acid taurine per day reduced psychotic symptoms within 12 weeks.
The potential benefits of B-vitamins (15mg of vitamin B9) in treating schizophrenia has also been reported to reduce negative symptoms scores along with improved brain structure and connectivity after 12 weeks of treatment, according to a 2017 randomized trial published in Molecular Psychiatry.
“The effects of nutrient‐based treatments, including adjunctive vitamin or antioxidant supplementation, have been explored extensively in long‐term schizophrenia,” researchers wrote in the study.
“However, no systematic evaluation of trials in FEP has been conducted, despite the potential benefits of using these treatments during the early stages of illness.”
Review conclusions
“Across the 11 studies that were identified, there are some encouraging findings for certain nutrient‐based adjunctive treatments in FEP,” researchers said.
Evidence supporting the nutrient supplementation of Omega-3 – the most widely used nutrient to treat FEP, according to researchers – was conflicting after reviewing six studies examining the link between PUFA consumption and brain health.
Two other trials citing dietary antioxidants NAC and vitamin C were determined by researchers to need further large-scale studies, but it is a “promising avenue for future research” that my prove to be effective for individuals with high levels of oxidative stress.
Taurine was found to “significantly improve” psychotic symptoms and depression but had no significant effect on cognition. Similarly, adjunctive treatment with antioxidant vitamins (C and E) did not result in any adverse events or side‐effects.
What comes next?
The research team said it will be a launching a new clinical trial in Sydney, Australia, later this year in which all of the potentially beneficial nutrients are combined within a single supplement, and provided to young people with psychosis.
"Individual nutrients appear to have moderate effects on mental health, at best,” Firth said.
"A combined nutrient intervention, explicitly designed from the evidence-base in psychosis, may therefore confer larger and more beneficial effects for young people with this condition.”
Source: Early Intervention in Psychiatry
https://doi.org/10.1111/eip.12544
“Adjunctive nutrients in first‐episode psychosis: A systematic review of efficacy, tolerability and neurobiological mechanism”
Authors: Joseph Firth, Simon Rosenbaum, Philip B. Ward, Jackie Curtis, Scott B. Teasdale, Alison R. Yung, Jerome Sarris