E-EPA
Encyclopedia
Ethyl eicosapentaenoic acid (E-EPA) is a highly purified, vacuum distilled derivate of the omega-3 fatty acid
eicosapentaenoic acid
(EPA). In Japan E-EPA is often called EPA-E.
Only EPA is considered to exihibit antipsychotic
and antidepressive
effects. E-EPA is a psychotropic omega-3 fatty acid and it is therefore of special interest in psychiatry.
in hyperlipidemic, diabetic patients. According to Japanese mice studies, E-EPA may prevent and correct non-alcoholic fatty liver
.
In schizophrenia
, the trials are based on the so-called membrane theory of the disease. According to the Omega-3 Subcommittee of the American Psychiatric Association (APA), the evidence of the effects is still too weak to recommend the use of E-EPA, but more studies are currently in progress.
Most (but not all) trials have yielded positive results. In one study E-EPA boosted the effect of an antidepressive drug, fluoxetine
. According to a new report from Massachusetts General Hospital in Boston, E-EPA seems to be more effective than placebo as monotherapy in major depressive disorder.
by professor Andrew L. Stoll, published in 1999. His team later demonstrated that rigid cell mebranes in test subjects were smoothed by omega-3 fatty acids. Subsequent studies at London's King's College Institute of Psychiatry have demonstrated the efficacy of E-EPA in bipolar patients. One of the biochemical mechanisms seem to be enhancement of an amino acid called N-acetyl aspartate (NAA) in the brain. E-EPA seems to exert similar effect on the NAA concentration as lithium
which has been used for bipolar depression for decades.
and it's metabolites in the shell of the Nucleus accumbens
. The fatty acid EPA may confer neuroprotection in the amyloid-ß challenged aged hippocampus.
, hepatitis
C, in children with ulcerative colitis
, nonalcoholic fatty liver
(steatohepatisis) in psychological stress in postmenopausal middle-aged women, and in women suffering from menopausal hot flushes.
Omega-3 fatty acid
N−3 fatty acids are essential unsaturated fatty acids with a double bond starting after the third carbon atom from the end of the carbon chain....
eicosapentaenoic acid
Eicosapentaenoic acid
Eicosapentaenoic acid is an omega-3 fatty acid. In physiological literature, it is given the name 20:5. It also has the trivial name timnodonic acid...
(EPA). In Japan E-EPA is often called EPA-E.
Only EPA is considered to exihibit antipsychotic
Antipsychotic
An antipsychotic is a tranquilizing psychiatric medication primarily used to manage psychosis , particularly in schizophrenia and bipolar disorder. A first generation of antipsychotics, known as typical antipsychotics, was discovered in the 1950s...
and antidepressive
Antidepressant
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...
effects. E-EPA is a psychotropic omega-3 fatty acid and it is therefore of special interest in psychiatry.
Cardiovascular diseases, diabetes
The Japan Eicosapentaenoic acid (EPA) Lipid Intervention Study (JELIS) tested the effects of long-term use of E-EPA (1800 mg/day) in addition to a statin in Japanese patients with hypercholesterolemia. The results suggest that the addition of E-EPA to statin therapy prevents major coronary events, angina pectoris and clinical myocardial infarctions, apparently through mechanisms independent from regulation of the lipid metabolism. It has been suggested that the cardioprotective action of E-EPA is probably mediated by its anti-inflammatory properties. In addition, E-EPA may improve the clinical outcome in type 2 diabetes and its cardiovascular complications, such as coronary artery disease and thickening of carotid arteries. E-EPA may on the one hand reduce the platelet-derived microparticles (PDMP) and on the other enhance the cardioprotective hormone adiponectinAdiponectin
Adiponectin is a protein which in humans is encoded by the ADIPOQ gene.- Structure :...
in hyperlipidemic, diabetic patients. According to Japanese mice studies, E-EPA may prevent and correct non-alcoholic fatty liver
Fatty liver
Fatty liver, also known as fatty liver disease , is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis...
.
Acute psychosis
As adjuct therapy, E-EPA has been tested in first-episode psychosis. The daily dosage of E-EPA given in these trials, i.e., 2 gram per day, corresponds to 10 to 15 helpings of Atlantic salmon.In schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
, the trials are based on the so-called membrane theory of the disease. According to the Omega-3 Subcommittee of the American Psychiatric Association (APA), the evidence of the effects is still too weak to recommend the use of E-EPA, but more studies are currently in progress.
Clinical depression
Omega-3 fatty acids have been investigated as adjunct therapy for depression as they are anti-inflammatory agents and chronic low-grade inflammation has been linked to the disease. Moreover, omega-3 content in the cell membranes of depressive persons is often decreased, and supplementation with omega-3 may correct this deficiency and improve the clinical outcome. This hypothesis has been tested in a number of clinical trials using E-EPA, mostly 1 gram daily.Most (but not all) trials have yielded positive results. In one study E-EPA boosted the effect of an antidepressive drug, fluoxetine
Fluoxetine
Fluoxetine is an antidepressant of the selective serotonin reuptake inhibitor class. It is manufactured and marketed by Eli Lilly and Company...
. According to a new report from Massachusetts General Hospital in Boston, E-EPA seems to be more effective than placebo as monotherapy in major depressive disorder.
Bipolar depression
The first placebo-controlled study with ethyl esterized fish oil was carried out at Harvard UniversityHarvard University
Harvard University is a private Ivy League university located in Cambridge, Massachusetts, United States, established in 1636 by the Massachusetts legislature. Harvard is the oldest institution of higher learning in the United States and the first corporation chartered in the country...
by professor Andrew L. Stoll, published in 1999. His team later demonstrated that rigid cell mebranes in test subjects were smoothed by omega-3 fatty acids. Subsequent studies at London's King's College Institute of Psychiatry have demonstrated the efficacy of E-EPA in bipolar patients. One of the biochemical mechanisms seem to be enhancement of an amino acid called N-acetyl aspartate (NAA) in the brain. E-EPA seems to exert similar effect on the NAA concentration as lithium
Lithium
Lithium is a soft, silver-white metal that belongs to the alkali metal group of chemical elements. It is represented by the symbol Li, and it has the atomic number 3. Under standard conditions it is the lightest metal and the least dense solid element. Like all alkali metals, lithium is highly...
which has been used for bipolar depression for decades.
Borderline personality disorder
So far one small clinical trial conducted on women has been published yielding promising results.Psychological stress
Animal tests demonstrate that E-EPA balances the metabolism of glucocorticoids (cortisol and cortisone) and may thus alleviate stress symptoms and attenuate interleukine 1-beta (IL-1b) induced changes in dopamineDopamine
Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this substituted phenethylamine functions as a neurotransmitter, activating the five known types of dopamine receptors—D1, D2, D3, D4, and D5—and their...
and it's metabolites in the shell of the Nucleus accumbens
Nucleus accumbens
The nucleus accumbens , also known as the accumbens nucleus or as the nucleus accumbens septi , is a collection of neurons and forms the main part of the ventral striatum...
. The fatty acid EPA may confer neuroprotection in the amyloid-ß challenged aged hippocampus.
Other conditions
E-EPA has been tested and found beneficial in anorexia nervosaAnorexia nervosa
Anorexia nervosa is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. Although commonly called "anorexia", that term on its own denotes any symptomatic loss of appetite and is not strictly accurate...
, hepatitis
Hepatitis
Hepatitis is a medical condition defined by the inflammation of the liver and characterized by the presence of inflammatory cells in the tissue of the organ. The name is from the Greek hepar , the root being hepat- , meaning liver, and suffix -itis, meaning "inflammation"...
C, in children with ulcerative colitis
Ulcerative colitis
Ulcerative colitis is a form of inflammatory bowel disease . Ulcerative colitis is a form of colitis, a disease of the colon , that includes characteristic ulcers, or open sores. The main symptom of active disease is usually constant diarrhea mixed with blood, of gradual onset...
, nonalcoholic fatty liver
Fatty liver
Fatty liver, also known as fatty liver disease , is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis...
(steatohepatisis) in psychological stress in postmenopausal middle-aged women, and in women suffering from menopausal hot flushes.