A new study has found evidence lacking for polyunsaturated fatty acid (PUFAs) supplementation as an effective treatment option for patients with refractory epilepsy.
The study authors conducted an electronic search of multiple databases for randomized and quasi-randomized studies using PUFAs to treat adults and children with a diagnosis of drug-resistant epilepsy. Three trials met the inclusion criteria (Yuen, 2005, Bromfield 2008, and Reda 2015).
The total number patients from the three studies amounted to 155 (85 adults and 70 children). One study randomized 27 adults to 2.2g/day of omega-3 PUFAs or placebo (Bromfield 2008), one randomized 58 adults to 1.7g/day omega-3 PUFAs or placebo (Yuen 2005), and another randomized 70 children to 3mL/day of 1200mg fish oil or placebo (Reda 2015). The follow up time for each study was 12 weeks.
Results showed that seizure freedom was only reported in the study involving children but this had a high risk of bias. Compared to the control group the risk ratio (RR) for the PUFA group was 20.00 (95% CI, 2.84 to 140.99, N=70). The authors stated the trial had a high risk of bias due to no allocation concealment and the assessors not being blinded to the assigned intervention.
No differences in mean seizure frequency were observed when data was pooled from the adult studies (N=78); RR 0.57, 95% CI 0.19 to 1.75). Additionally no differences were noted between the PUFA and control groups in relation to gastrointestinal effects (RR 0.78, 95% CI 0.32 to 1.89).
None of the studies reported adverse bleeding issues, which was one of the primary outcomes, as omega-3 PUFA compounds have the ability to reduce platelet aggregation, and in theory, cause bleeding.
Current research indicates that approximately 25% to 30% of individuals with epilepsy are refractory to pharmacological treatment, indicating the need for effective therapies for this population. However the low quantity and quality of evidence found in this study, the authors state, does not support the use of PUFA supplementation They concluded, “More trials are needed to assess the benefits of PUFA supplementation in the treatment of drug-resistant epilepsy.”
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