The following article is from our friends at BioConcepts.

Mental health is deteriorating in the younger population in Australia and often the only solution offered is medication.

Every month, almost 45,000 Australians are treated in public health facilities following a psychotic episode.  For the majority of people onset happens in their late teens and early adulthood.  The incidence is higher in males than females and is highest in the 18-24 age group (64.8%).*

For most, onset is gradual and happens over one to six months.  Acute or abrupt onset is seen in about 16% of cases, and half of all cases go on to have multiple episodes.* Symptoms can range from hallucinations, to hearing voices and delusions. Those with psychotic illness also experience other mental health conditions such as depression, anxiety, lack of motivation, poor communication and concentration, irritability and loss of pleasure.*

Physical health can also be affected with one third suffering chronic back and neck pain or severe headaches and migraines.  One quarter have heart and circulatory problems and one fifth have diabetes.*

The use of cannabis or other illicit drugs is very high in this group: 63.2% of men and 41.7% of women have a lifetime history of use or dependence.*

Low levels of vitamins and polyunsaturated fatty acids (PUFAs) are associated with poor outcomes in first episode psychosis (FEP) and may include greater symptom severity and neurocognitive impairment.**

A 2017 review investigated the use of nutrients in FEP and their efficacy, tolerability and mechanisms of action as an adjuvant to medical treatment.

Omega-3:
Patients receiving 2grams of EPA daily alongside antipsychotic drugs were more likely to achieve remission within six weeks. Participants in the study were also able to reduce their medication dose by 20% after 12 weeks.**

Another study with 71 patients gave 2.2mg of Omega-3 daily as an adjunctive to initial antipsychotic medication over a period of 26 weeks. The study showed that using Omega-3 as an adjuvant improved total symptoms, functioning and depression more than placebo. The study concluded that the ability of Omega-3 to improve antioxidant capacity and reduce oxidative markers was significantly associated with the reduction in psychotic symptoms and measures of depression.**

Amino Acid: Taurine  
A high quality randomised, controlled trial found 4 grams of Taurine daily over 12 weeks significantly improved total symptoms, psychotic symptoms, depression and functioning more than placebo. The authors concluded Taurine’s role as an NMDA receptor antagonist and neuroprotective agent was the mechanism.**

Antioxidant vitamins: Vitamin C
500mg daily for eight weeks was administered and examined for its effect on lipid peroxidation and symptoms in FEP. It was found to significantly reduce total symptoms and reductions were correlated with higher plasma Vitamin C levels post treatment.**

The authors of the review concluded that nutritional supplementation for those with FEP was safe and well tolerated.  There was strong evidence that Taurine improved outcomes of FEP and that Omega-3 and antioxidants mainly benefited the FEP patients with high oxidative stress. They recommend further studies are needed to examine how inadequate nutrient intake influences outcomes in FEP and that poor nutrition could contribute to poor recovery rates in those with psychosis.**

References
*Department of Health 2011, People Living With Psychotic Illness, report on a survey, Commonwealth of Australia, Canberra, viewed 17 October 2018, http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-p-psych10-toc~mental-pubs-p-psych10-exe

**Firth J, Rosenbaum S, Ward PB, et al. Adjunctive nutrients in first-episode psychosis: A systematic review of efficacy, tolerability and neurobiological mechanisms. Early Interv Psychiatry. 2018;(August 2017):774-783. doi:10.1111/eip.12544