Omega-3 Bipolar — MRCPsych Paper B MCQ
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Correct answer: E — They are not recommended routinely, although adjunctive use may modestly improve depressive symptoms.
Explanation lettering: E = shown as A · C = shown as B · D = shown as C · A = shown as D · B = shown as E
Omega-3 supplements are not part of routine NICE-recommended treatment for bipolar disorder. Research suggests a possible modest benefit when they are added to established treatment during bipolar depression, but findings are inconsistent and the evidence is too limited to support routine use. There is no established benefit for acute mania. They should therefore be regarded, at most, as an optional adjunct rather than a substitute for mood-stabilising treatment. Options A and E overstate their therapeutic status. Option C is incorrect because omega-3 is generally well tolerated and does not reliably precipitate mania or rapid cycling. Option D is incorrect: omega-3 has not demonstrated efficacy equivalent to lithium, which NICE recommends as first-line long-term pharmacological treatment.
Reference: Sarris J, Mischoulon D, Schweitzer I. Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression. Journal of Clinical Psychiatry. 2012;73(1):81–86. https://pubmed.ncbi.nlm.nih.gov/21903025/