Polyunsaturated Fatty Acid Supplementation for Drug-Resistant Epilepsy

Summary

A Cochrane review [Abstract] 1 included 3 studies with a total of 155 subjects (85 adults and 70 children). Two placebo-controlled, double blind trials on adults were conducted in developed countries, while one placebo-controlled, single blind trial on children was conducted in a developing country (Egypt). In one trial adults received 2.2 g/day of omega-3 polyunsaturated fatty acid (PUFA) (EPA:DHA in a 3:2 ratio) or placebo. In another trial they got approximately 1.7 g/day omega-3 PUFAs (1g EPA and 0.7g DHA) or placebo. In the third trial the children received 3 ml/day of 1200 mg fish oil (providing 0.24 g DHA and 0.36 g EPA) or placebo. All participants were followed for up to 12 weeks. Seizure freedom was reported by only one study, the risk estimate for this outcome was significantly higher in the children receiving PUFA compared to the control group (RR 20.00, 95% CI 2.84 to 140.99; 1 study, n=70). Similarly, PUFA supplementation was associated with a significant difference in the proportion of children with at least 50% reduction in seizure frequency (RR 33.00 95% CI 4.77 to 228.15; 1 study , n=70). However, this effect was not observed when the data from two studies including adult participants were pooled (RR 0.57, 95% CI 0.19 to 1.75; 2 studies, n=78). One of 3 primary outcomes, adverse effects related to bleeding, was not assessed in any of the studies included. There were no significant differences between the PUFA and control groups in relation to gastrointestinal effects (RR 0.78, 95% CI 0.32 to 1.89; 2 studies, n=85). Supplementation with PUFA did not produce significant differences in mean frequency of seizures, quality of life or other side effects.