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Abuknesha, Nada R. and Searle, Andrew J. (2024) Seizure amelioration effect of omega-3 EPA and DHA fatty acid supplementation on patients with drug resistant epilepsy: a scoping review using the GOED clinical study database. Current Developments in Nutrition, 8 (2) (103221). pp. 455-456. ISSN 24752991
Objectives:
70% of patients with epilepsy are successfully treated with one or a combination of anti-seizure medications (ASMs). The latter 30%, do not respond to ASMs and continue to have uncontrollable seizures. They are known to have drug-resistant epilepsy (DRE). There is an unmet need for non-pharmacological treatment options to be considered. The objective of this scoping review is to assess the seizure amelioration effect of omega-3 (n-3) polyunsaturated fatty acids (PUFAs): eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids on patients with DRE from randomized human clinical trials (RCTs).
Methods:
The Global Organization for EPA & DHA Omega-3s (GOED) Clinical Study Database was used as the primary search tool to generate a list of RCTs using the following terms: seizures, seizure severity, drug resistant epilepsy, refractory epilepsy, and intractable epilepsy. Subsequently, PubMed and Google Scholar English databases were searched for publications using the additional keywords: eicosapentaenoic acid and docosahexaenoic acid.
Results:
Eleven RCTs published before October 2023 were included in this review. EPA and DHA formulations administered to patients ranged between 0.3-2.9g/day, with 90.9% of RCTs investigating the fatty acids at a comparable ratio. A supplementation period of 3 months or less was employed by 72.7% of RCTs. 54.5% of RCTs reported a positive outcome of at least 50% or more significant reduction in seizure frequency compared to placebo or baseline. 27.2% of RCTs reported significant seizure freedom in patients during or at the end of the supplementation period, compared to placebo. Positive outcomes regarding seizure severity remain inconsistent with only 18.1% of RCTs reporting a significant reduction compared to placebo or baseline.
Conclusions:
N-3 EPA and DHA have the potential to be a simple add-on treatment intervention for the management of uncontrollable seizures in DRE. Additional RCTs are required to determine the optimal dosage for patients, the effect of long-term treatment duration and separately enriched preparations of EPA/DHA on seizure frequency and severity.
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