Medication and Treatment Reviews

Omega-3 Fatty Acids

Fish-oil supplements for EPA and DHA

What is it?

Omega-3 fatty acids, often delivered via fish oil, boost the body’s synthesis of dopamine, the neurotransmitter stymied by attention deficit disorder (ADHD). Fish oil supplements are also used to prevent heart disease and other ailments.

How does fish oil work?

The body doesn’t make omega-3s, so we must get these essential nutrients from our diet, through food and/or supplementation. Scientists still don’t know the exact mechanism that makes omega-3s and other essential fatty acids improve brain functions. However, omega-3s are concentrated in the brain and essential for overall brain function, especially memory and cognition.

Before starting a fish oil regimen, speak with your physician, who has a holistic view of your or you or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin the supplement.

Who is fish oil for?

Children and adults can take fish oil supplements for ADHD or for other health reasons.

Fish oil dosage recommendations vary widely for both children and adults. The study mentioned below used one gram per day for children, and the ratio of omega-3 fatty acids (EPA) to omega-6 fatty acids (DHA) was 4:1. ADHD expert Dr. Edward Hallowell typically recommends 2.5 grams of an omega-3 supplement for children each day, and up to 5 grams a day for adults. Because the recommendations vary so much, work closely with your doctor to devise a plan that works for you.

How much does it cost?

The cost of fish oil supplements varies widely, depending on the brand and concentration of ingredients. You can expect to pay as little as $5 or as much as $50 for a 1-month supply, depending on which product you choose.

What studies have been done?

A study published in Pediatrics, found a positive correlation between the use of fish oil and reduced symptoms of ADHD. “A lack of certain polyunsaturated fatty acids may contribute to dyslexia and attention-deficit/hyperactivity disorder,” reports one of the study’s authors, Paul Montgomery, D.Phil., a researcher in the psychiatry department at the University of Oxford in England.

For Montgomery’s study, schoolchildren were given fish oil supplements rich in omega-3 essential fatty acids (EFAs) for a period of three months. During this time, the children showed significant improvements in behavior, reading, and spelling.

Are there any side effects?

The most common side effect of taking a fish oil supplement is belching (often referred to as “fish burps”) and bad breath. Other possible side effects of omega-3 supplementation include nausea, heartburn, diarrhea, rash, and nose bleeds.

Are there any precautions or interactions?

Avoid omega-3 supplements if you are allergic or sensitive to fish or products containing fish.

The U.S. Food and Drug Administration (FDA) has deemed omega-3 fatty acids safe up to 3 grams a day. Doses over 3 grams have been known to keep the blood from clotting and to increase bleeding. High doses may also negatively impact immunity and make a patient more susceptible to infections. Fish oil can also impact blood glucose levels, so caution is advised for patients with diabetes or hypoglycemia. Also take caution if you have any of the following: lower blood pressure; hormone imbalance; changes in liver function; vitamin deficiency and/or toxicity; prostate cancer.

Before taking a fish oil or plant-derived omega-3 supplement, discuss all other active supplements and any prescription medications with your doctor. 

Sources:

http://pediatrics.aappublications.org/content/115/5/1360
http://www.mayoclinic.org/drugs-supplements/omega-3-fatty-acids-fish-oil-alpha-linolenic-acid/safety/hrb-20059372
http://www.health.harvard.edu/blog/fish-oil-friend-or-foe-201307126467
http://www.nps.org.au/medicines/complementary-medicines/for-individuals/fish-oil-supplements/for-individuals/side-effects
http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids

10 reviews

  1. I put my son on fish oil last year when I read about it in ADDitude. He was taking 18mg Strattera in the morning and 1 fish oil pill at night, with a Multi-vit. He was on it for about 2 months, but we took him off when we noticed a marked increase in his Obsessive-Compulsive tendencies. Specifically, he started picking at the skin around his finger nails to the point of injury and infection. Upon stopping the fish oil, the OCD type stuff alleviated dramatically. I should say however, that he has a history of OCD; it did however get much worse.

    This summer, he took a medication vacation and I started him on the Omega Complex from GNC. There were no increases in his OCD and I believe there was some improvement of his ADD symptoms, however marginal. I felt it really helped to stabilize his mood, not that he’s overly moody, but he didn’t get the frustrations with his symptoms as much.

    School has started and he’s back on 18mg of Strattera and continuing his Omega Complex. So far, no increase in OCD and again, I see an improvement in mood and frustration levels. I ran it by his pediatrician and he ok’d it. I have to admit, I got a bit lost in that post about the studies and what not. Generally, the tone was negative, but I don’t think the final chapter has been written on this subject. I don’t like the idea of having to put my son on anything, but this world insists on conformity and I’m afraid he’s a square peg, living in a round hole world.

  2. My daughter has ADHD. She took meds, had therapy and a tutor to get through high school. This summer she started to take Nordic type lemon flavored liquid unprocessed fish oil (2 teaspoon a day) and her life has changed. She feels good, has stopped procrastinating and is communicating more effectively. It is short of miraculous and there are no side effects!!! I would give it a try if you are thinking of giving it to your child. The quality and amount is extremely important. (the capsules do not seem to have the same effects)

  3. My son takes a good omega-3 pill from alaskan salmon. He seems to like it & so far it’s the only one he’ll take without gagging. Being a smart parent (that doesn’t want to waste more $ on omega-3’s my son will not take) I tried it myself and it does not have any fishy taste at all! I know, hard to believe especially since I’ve tried so many! I have the website info if anyone’s interested. Just private message me.

    Good luck!

    Jonalyn
    http://Jonalyn.kyani.net
    http://twitter.com/ADHDHawaii

  4. My son is seeing an naturopathic for his ADHD and other issues. He is 7. He has list of 8 different supplements and one of them is Omega 3. After taking his Omega 3 and Alpha Lipoci Acid 100mg ( about 3 weeks) his teacher and his after school care noticed his improvement. As time goes by, he seems claimer and has better response ( less brain flog ) along with other supplements.

    According to my naturopathic, DHA and EPA can be found from Omega 3 oil. However, not all Omega 3 has DHA and EPA in it or has enough of them. I order Nordic Naturals Ultimate Omega from vitacost. It has around 600mg EPA and around 400mg DHA.

  5. First of all if it is cheap then it is probably not as good. If your child is going to use it both Fisol and Omega Red have smaller sized pills that are easier to swallow. The other key thing to look for is enteric coated like buffered aspirin, this helps prevent fish burp. If you have good insurance and a cooperative doctor they can prescribe Lovaza, it is prescription grade fish oil, but some insurances will not pay for it. In general the higher EPA and DHA the better. If possible also look for a label for Mercury Free or Wild Caught which should be better as well. I take 2000mg per day, and have seen better vision, less aches and pains, and better skin as well.

  6. We put my son on Omega-3 EPA in kinder. It really helped improve his motor coordination, but he started to become very impulsive after about a year. He got to the point where he would be outside playing and he would approach strangers who were walking by and try to engage them in conversations. When the strangers did not respond, he might follow them down the street. So, we switched to Omega-3 DHA and the symptoms went away for awhile. Then, his doctor wanted us to try PS. We tried it for a day. needless to say it was not well tolerated. After a single dose, my son’s teacher reported that he became tearful and cried most of the day.

    After that, any Omega-3, even things as benign as chia seeds or flax meal seemed to cause symptoms like anger outbursts and fits of crying especially in school. Things were so bad in January that I had to go to the school and pick my son up to take him home to finish his school work there. But here’s the rub. Those Omega-3 did wonders for his fine motor skills and memory which is making school harder in a different way.

    Now that my son is on Intuniv, which helps with anger outbursts, I have resolved myself to reintroduce the DHA Omga-3 slowly. I have been giving it to him 3X per week and am about to bump it up to five. I may even try the PS again, but only on a weekend when I can be there if something negative occurs.

    I feel guilty about all of this because it feels like I’m making my son the unwitting participant in a pharmacology experiment, but what else can I do? He really seems to need these Omega 3s.

  7. I just started my daughter on Omega 3 and it has been about 2 weeks and I am seeing less impulsivity, more cooperation, and less mood swings. I suppose we have to wait and see since we just began but for me I’m seeing results. Also started her on new vitamins which include B complex at the same time so that might be helping as well.

  8. After several years of giving my son many different fish oil products with no ill results (no real positive results either), I switched to a liquid (Barleans Omega Swirl I think) and the exact same thing happened to my son—he was angry and moody exponentially more than usual. After a few days I stopped giving it to him. We’ve made some med adjustments and then will try it one more time. I couldn’t believe it was the Omega supplement, but it was. My son has extreme and odd reactions to most things though – he gets angry and irritable on B vitamins and calcium supplements too.

  9. My son is 5 and has severe impulsivity, so they have tried to keep him from hurting himself and his baby sister. The omega 3s were introduced about 2 months ago, and we give him 2 gummies in the morning and two in the afternoon to counteract the rebound from the Adderall. I notice a huge change in his impulsivity levels, but until I read this I hadn’t been paying much attention to the mood or emotional outbursts it was causing. He does get more frustrated with baby sister after the Omega 3’s, but not in an unsafe way. My son generally has no oppositional behaviors, besides in reaction to his impulses. Right now it’s a mild reaction, but it seems you are having problems over an extended time of these. I’m interested to see where this leads you. My son’s impulses are the only reason the doctors decided medication at his age would be appropriate. He is so sweet, and tells me when he’s done something impulsively, even knowing that he will get into trouble.

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