FISH OIL FOR DEPRESSION. (This information sheet is somewhat disorganized and redundant because I have added it and altered it over the years). (The best source of EPA is fish oil The other excellent source is eating the brain. Animals have the amount of EPA and DHA that we should have. In contrast to us, cows can manufacture their own EPA and DHA.) For depression take EPA (also called ethyl eicosapentaenoic acid,E-EPA, icosapent ethyl) 1-2 grams per day. It would be better to use much more for the first month. If it seems to help, then try lower doses. For 20 years one of my patients has required 18 pills per day of fish oil for — the equivalent of about 6 grams of EPA. [EPA may constitute only 1/3 of one gram [1000mg].
- Andrew Stoll used 9.6 grams of omega-3 fats in 1999. That was the first double-blind study showing that fish oil helps depression. The results were dramatically positive. He was using all the omega-three fats that fish oil and did not court what portion was EPA, which we have since found his own omega three that depression helps depression. If you take regular fish oil pills that would be well over 10 pills, maybe close to 18 pills. If you take pure EPA pills, I do not know what the amount would be, but probably 6 to 10 pills.
- The eminent Robert Post, MD said, “If you just count the EPA, then the dose should be at least 1 to 2 grams/day; if you are counting the EPA plus DHA, the total should be more like 2 to 5 grams.”
- For heart attacks and stroke, 4 grams of EPA per day significantly decreased cardiovascular events in patients with high triglycerides. —Bhatt, 1/3/19, p 11, NEJM
- SOME TIME, PICK A WEEK, AND FOR THAT ONE WEEK INCREASE THE FISH OIL DRAMATICALLY TO 6 TO 7 PILLS /DAY. when it works for depression, it often works in < one week in my experience, so a one week trial is usually enough to find out if you need more. But if you can stomach it, take it 2-4 weeks in high dose. It is only a food.
- Y.I.: These are my previous usual instructions if I am having people use omega 3 essential fatty acids [found in the fatty oils of ocean fish] to aggressively treat or prevent depression:
- Do omega 3’s —e.g., 5-7 fish oil pills per day—aggressively for 3 months, and then maybe we will stop them abruptly to evaluate if they were working [if every time you stop fish oil you slump and if you recover when you restart, we know it is helping]. You could skip the fish oil pills the days you eat ocean fish. EPA plus DHA should equal 2-5 grams per day = 2000 to 5000mg. The EPA (eicosapentaenoic acid) should be maybe double the DHA (docosahexaenoic acid) . If 2 capsules is a “serving” containing EPA 300mg and DHA 200mg , you are only getting 500mg per two capsules. So you would need 8 capsules to get 2 grams, and 20 capsules to get 5000mg. If eat fish instead of taking pills, then you need to average a minimum of 2 ounces per day, but 4 to 6 ounces is preferable. 4 ounces of ocean fish gives you about 2 grams=2000mg of the omega 3’s, which is usually equal to about 4 capsules. So, you would need to eat about 4 to 10 ounces of ocean fish per day for a good antidepressant effect.]
- Twin EPA is a brand with a high amount of EPA and DHA. It has total of 840mg of EPA and DHA. NordicNaturals.com has a brand called Ultimate Omega 3 has 550mg of EPA plus DHA in each capsule. Liquid Ultimate Omega has 1376mg in each teaspoon. Note: EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the omega 3’s found in ocean fish, and they are the very omega 3’s we preferentially use as building blocks to build the walls of brain cells. EPA is the more important one for depression. [I have heard it said that DHA is more important in brain development, such as in fetuses and infants.] The omega 3’s found on land (e.g., from flax seed oil and canola oil) are only 18 carbons long whereas EPA is 20 carbons long and DHA is 22 carbons long. Basic scientists think it is unlikely that we efficiently add those 2 carbon atoms to produce the desired EPA and DHA. Hence, all the research has been done with fish oil, as we know we are getting a substantial amount of the right omega 3’s. [One ounce =28.35 grams.]
- Buy some little cups that you can pour in the approximate amount. The fish oil is emulsified into tiny droplets so that the fishy taste is almost eliminated. It is usually flavored with lemon or lime. Fish oil lifts depression, reduce heart attacks and Alzheimer’s. It helps depression either b/o the anti-inflammatory effect or because 22% of the brain is made from EPA and DHA. These are omega 3 essential fatty acids. Omega 3’s from land plants do not work for depression because they are 18 carbons long and EPA and DHA are 20 carbons long.
- g., Nutri-Supreme Omega 3 EPA/DHA liquid fish oil – a kosher brand; you want a lot more EPA than DHA in the oil. — If you go to Nutri-Supreme Reseach, 4315 14th Ave, Brooklyn, NY 11219 Phone : 718 853 0644; 888 68NUTRI fax 718 853 4344 firstname.lastname@example.org, then Mr Eliezer Gruber will give you a 50% discount on fish oil or NAC (N-acetyl cysteine) if you say Dr McMullen referred you.