Institute of Psychiatry and Neuroscience of Paris (IPNP), Université de Paris, INSERM U1266, F-75014 Paris, France.
GHU Paris Psychiatrie et Neurosciences, F-75674 Paris, France.
Int J Mol Sci. 2021 Jun 26;22(13):6881. doi: 10.3390/ijms22136881.
Schizophrenia typically emerges during adolescence, with progression from an ultra-high risk state (UHR) to the first episode of psychosis (FEP) followed by a chronic phase. The detailed pathophysiology of schizophrenia and the factors leading to progression across these stages remain relatively unknown. The current treatment relies on antipsychotics, which are effective for FEP and chronic schizophrenia but ineffective for UHR patients. Antipsychotics modulate dopaminergic and glutamatergic neurotransmission, inflammation, oxidative stress, and membrane lipids pathways. Many of these biological pathways intercommunicate and play a role in schizophrenia pathophysiology. In this context, research of preventive treatment in early stages has explored the antipsychotic effects of omega-3 supplementation in UHR and FEP patients. This review summarizes the action of omega-3 in various biological systems involved in schizophrenia. Similar to antipsychotics, omega-3 supplementation reduces inflammation and oxidative stress, improves myelination, modifies the properties of cell membranes, and influences dopamine and glutamate pathways. Omega-3 supplementation also modulates one-carbon metabolism, the endocannabinoid system, and appears to present neuroprotective properties. Omega-3 has little side effects compared to antipsychotics and may be safely prescribed for UHR patients and as an add-on for FEP patients. This could to lead to more efficacious individualised treatments, thus contributing to precision medicine in psychiatry.
精神分裂症通常在青少年时期出现，从超高危状态（UHR）进展到精神病首次发作（FEP），然后进入慢性期。精神分裂症的详细病理生理学以及导致这些阶段进展的因素仍然相对未知。目前的治疗依赖于抗精神病药物，这些药物对 FEP 和慢性精神分裂症有效，但对 UHR 患者无效。抗精神病药物调节多巴胺能和谷氨酸能神经传递、炎症、氧化应激和膜脂质途径。这些生物途径中的许多相互沟通，并在精神分裂症的病理生理学中发挥作用。在这种情况下，早期预防治疗的研究探索了ω-3 补充剂在 UHR 和 FEP 患者中的抗精神病作用。这篇综述总结了 ω-3 在涉及精神分裂症的各种生物系统中的作用。与抗精神病药物类似，ω-3 补充剂可减轻炎症和氧化应激，改善髓鞘形成，改变细胞膜特性，并影响多巴胺和谷氨酸途径。ω-3 补充剂还可调节一碳代谢、内源性大麻素系统，并具有神经保护作用。与抗精神病药物相比，ω-3 的副作用较小，可安全地开给 UHR 患者，并作为 FEP 患者的附加药物。这可能会导致更有效的个体化治疗，从而为精神科的精准医学做出贡献。
