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Effectiveness of Omega-3 Fatty Acids Versus Placebo in Subjects at Ultra-High Risk for Psychosis: The PURPOSE Randomized Clinical Trial

  • Inge Winter-van Rossum*
  • , Margot I E Slot
  • , Hendrika H van Hell
  • , Matthijs G Bossong
  • , Gregor Berger
  • , Harald Aschauer
  • , Arija Maat
  • , Susanne Walitza
  • , Orly Lavan
  • , Inmaculada Baeza
  • , Montserrat Dolz
  • , Elena Monducci
  • , Paolo Fiori Nastro
  • , Rune Andreas Kroken
  • , Stephen M Lawrie
  • , Covadonga Martinez Díaz-Caneja
  • , Tobias Renner
  • , Monika Schlögelhofer
  • , Christian Scharinger
  • , Gianfranco Spalletta
  • Nerisa Banaj, Soraya Otero, Maria Schipper, Dorieke Brink- Kwakkel, Rene S Kahn,
*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND AND HYPOTHESES: In the past 2 decades, substantial effort has been put into research on therapeutic options for people at ultra-high risk (UHR) for developing a first episode of psychosis (FEP), focusing on omega-3 polyunsaturated fatty acids (PUFAs) in preventing transition to psychosis. Despite an initial positive finding, subsequent studies failed to find a beneficial effect. The current study aimed to further investigate the effect of omega-3 PUFAs in UHR, to determine whether this line of research is worth pursuing.

STUDY DESIGN: A double-blind, randomized, placebo-controlled study testing the efficacy of 6-month treatment with omega-3 PUFAs in 135 subjects at UHR for FEP, aged 13 to 20 years on the prevention of a transition to psychosis, followed up for 18 months post-treatment. The trial was conducted at 16 general hospitals and psychiatric specialty centers located in 8 European countries and Israel.

STUDY RESULTS: There was no beneficial effect of treatment with omega-3 PUFAs compared to placebo; the rate of transition over 2 years did not differ between treatment arms nor was there a difference in change in symptom severity after 6-month treatment. Dropout rates and serious adverse events were similar across the groups.

CONCLUSIONS: This is the third study that fails to replicate the original finding on the protective effect of omega-3 PUFAs in UHR subjects for transition to psychosis. The accumulating evidence therefore suggests that omega-3 PUFAs do not reduce transition rates to psychosis in those at increased risk at 2 years follow-up.

CLINICAL TRIALS: This trial is registered with ClinicalTrials.gov (NCT02597439; Study Details | Placebo-controlled Trial in Subjects at Ultra-high Risk for Psychosis With Omega-3 Fatty Acids in Europe | ClinicalTrials.gov).

Original languageEnglish
Pages (from-to)1082-1091
Number of pages10
JournalSchizophrenia bulletin
Volume51
Issue number4
Early online date25 Oct 2024
DOIs
Publication statusPublished - 7 Jul 2025

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