Friday, November 11, 2011

Astonishing modification to McGorry study

This article appeared in The Psychiatric Times on Oct. 28, 2011. Treating Mental Illness Before it Strikes details the efforts of the psychiatric community throughout the twentieth century and the beginnings of this century to identify and treat young adults before they become psychotic. Most recently we have heard about the debate on the proposed insertion of a new category of disorder psychosis risk syndrome  into the Diagnostic and Statistical Manual of Mental Disorders (DSM V), and of Dr. Allan Frances's outspoken views on this subject. Some of us have also read about the proposed McGorry medical trial in Australia, which was heavily critized on ethical grounds because the trial involved putting youth as young as age 15 (most of whom would never go on to develop psychosis) on antipsychotics if there was evidence of a family background of psychosis.

In June 2011, a number of Australian newspapers reported that a high-profile medical trial targeting psychosis in young adults would not go ahead. It was to be conducted by Prof. Patrick McGorry, who had been Australian of the year (an honorary and mostly symbolic title bestowed by the Australian government on an unusually deserving citizen advocating worthy causes). In the proposed trial, youths as young as age 15 would receive Seroquel (quetapine) when they were first diagnosed, not with psychosis but with attenuated psychosis syndrome (previously called psychosis risk syndrome). Treating young adults with this syndrome would nip the danger in the bud—their potential psychosis would be treated before it even arose. The trial was to have been sponsored by the drug’s manufacturer, AstraZenaca, which, like many pharmaceutical companies, was probably eager to test its medication on a younger age group to expand the market for its medications. What could be wrong with such a commendable initiative?

The final paragraph of the article reveals that

Dr McGorry has introduced a slight modification to his study, which will now go ahead. Instead of Seroquel, he will now test the efficacy of fish oil.

Slight modification? This is huge! To favor conducting a medical trial with fish oil rather than with Quetiapine (Seroquel) is astonishing, not least because the drug manufacturer is now out of the picture.  Fish oil is becoming popular for its purported benefits in preventing schizophrenia (and depression). Will fish oil be found to do all that its proponents claim it does or will it be found to be ineffective in preventing psychosis? Wouldn't a rather simple solution be to study the prevalence of schizophrenia in Inuit populations where the diet is high in fish oil? Studies show that rates of schizophrenia are pretty much the same (about 1%) in any culture in any part of the world, with some anomalies due to e.g. migration of certain populations. Will this new McGorry trial be properly executed? I have read that, as with niacin and vitamin C, the effectiveness depends on a dosing amount many times in excess of what is considered daily recommended intake.

Read more on the McGorry controversy here.

Inuit eating frozen fish

8 comments:

  1. yes, huge and WOW!

    this has been researched before http://news.bbc.co.uk/2/hi/health/8490937.stm

    the thing with this way of dealing with people...just adding ONE somewhat random natural isn't all that likely to help as many people as providing a foundational regimin for each child...I think that it's very very rarely the absence of one thing of this nature when a child has been raised in a setting that creates such imbalance.

    still it's moving in a more sane direction.

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  2. Andrew Stoll did this work here in the U.S. Interestingly he seems to have gone under cover since publishing his book for the general public. Wonder if those Omega-3's were just too much a threat to the status quo.

    I so want the tide of change to sweep through Psychiatry. I'm praying to be a voice for change in my next community.

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  3. Andrew Stoll - I'll check out that name.

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  4. completely useful..good source, thanks anyway!

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  5. He was at Harvard. The book he wrote was The Omega-3 connection.

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  6. Rossa,

    This post couldn't have come at a better time.
    I needed to be reminded that there is still a little sanity left in the world.

    I hope the study shows some good results, and helps some people/families.

    Smitty - I hope you become "a voice of change in your next community!"

    My best,

    Duane

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  7. I can't understand how the comment about fish oil was buried at the bottom of the article. From the reaction of the commenters, the news doesn't seem to have gotten much air time. Didn't Thomas Insel fly down to Australia in Sept. to support McGorry - I haven't got time right now to figure out what the Insel link may be to this outcome, so if anyone else knows, please enlighten us.

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  8. Rossa,

    This is the link to the 1999 Fish Oil Study done at Harvard (Stoll) -

    http://mason.gmu.edu/~sslayden/curr-chem/fish-oil/fishoil-wp.htm

    I think it would be great if we could see more studies done with nutrient combinations (rather than single nutrients). Apologize for the redundancy, but the Brain Bio Centre is a good place to start for people who are just starting to learn about their benefits -

    http://www.foodforthebrain.org/content.asp?id_Content=1638

    Also, getting the gut strong is a key factor for many... Natasha Campbell-McBride, M.D. -

    http://www.gaps.me/

    Be well,

    Duane

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