Some food supplements, such as taurine, might help in the treatment of first-episode psychosis.
This was the conclusion of a systematic review of data from eight trials involving hundreds of young people who received treatment during the early stages of psychosis.
The review was led by Dr. Joseph Firth, who is a research fellow with the NICM Health Research Institute at the University of Western Sydney in Australia and an honorary research fellow at the University of Manchester in the United Kingdom.
He and his colleagues suggest that supplementing standard treatment with certain nutrients may be more effective than standard treatment alone in alleviating the symptoms of "first-episode psychosis."
They report their analysis, thought to be the first to evaluate trials of nutrient supplementation in first-episode psychosis, in a paper now published in the journal Early Intervention in Psychiatry.
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Psychosis is an umbrella term for symptoms that indicate "loss of contact with reality." Symptoms include: hallucinations, such as seeing, hearing, and sensing things that are not real; disordered thinking and speaking; and delusions, or maintaining that something is real even when the facts show otherwise.
Psychosis can result from a mental illness, such as schizophrenia, or a physical condition. It can also arise from taking certain medications, and abuse of alcohol or drugs.
The symptoms of psychosis often begin during a person's late teenage years and their early to mid-20s, and around 3 percent of people "from all walks of life" will experience psychosis at some point in their lives.
Every year in the United States, around 100,000 teenagers and young adults experience first-episode psychosis.
Mental illness and food supplements
The idea of treating mental illness with nutrient supplements is often met with "cynicism and hype," says Dr. Firth.
"We conducted this review," he explains, "just to see if there is any 'real evidence' if such nutrients can actually help young people with psychosis."
He suggests that the new review's findings offer an "early indication that certain nutrients may be beneficial, not to replace standard treatment, but as an 'add-on' treatment for some patients."
In their study paper, he and his co-authors explain that the effects of "nutrient-based treatments" such as "adjunctive vitamin or antioxidant supplementation" have been studied at length in long-term schizophrenia.
However, there has been no systematic review of trials of nutrient-based treatments in first-episode psychosis, "despite the potential benefits of using these treatments during the early stages of illness," they continue.
Therefore, they decided to conduct an evaluation of all the studies they could find that investigated the tolerability, effectiveness, and biological mechanisms of treatment with nutrient supplements in first-episode psychosis.
Taurine showed the strongest effect
The team searched electronic databases up to July 2017 and found eight randomized controlled trials involving 451 people with first-episode psychosis who met the criteria for inclusion.
Their analysis revealed that one nutrient in particular — the amino acid taurine — "showed significant improvements in positive symptoms and psychosocial functioning."
High levels of taurine are found in the brain and other organs, where it plays a key role in health and disease.
Taurine has many functions in cells and tissues. It serves as a neurotransmitter in the brain, for example, and it also helps to stabilize cell membranes and transport ions.
The researchers describe an Australian clinical trial in which 4 grams of taurine per day for 12 weeks alleviated psychotic symptoms in 121 young people with psychosis.
Combined nutrients may have stronger effect
Results for other nutrient supplements were not so clear or as strong, however. For example, some antioxidant supplements — such as vitamin C and n-acetyl cysteine — only reduced psychiatric symptoms in first-episode psychosis patients who also had "high levels of oxidative stress."
In the case of omega-3 supplements, there was conflicting evidence that they may work to reduce psychotic symptoms in young people, although there was positive evidence that they might improve some markers of brain health.
The analysis found no evidence that people with first-episode psychosis benefited from taking vitamin E supplements.
"Individual nutrients appear to have moderate effects on mental health, at best," concludes Dr. Firth.
He suggests that perhaps a "combined nutrient intervention" designed around the results that they found might have a bigger and better effect.
With this in mind, he and his colleagues are planning to start a new clinical trial in young people with psychosis in Australia. This will test a single supplement that combines all the nutrients that seem to have potential benefit.
"We have to be careful to replicate the results of these initial studies before jumping to firm conclusions."
Dr. Joseph Firth