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PUFAs for Epilepsy
By Dr McIntyre Burnham
Over the years, I've been asked, "Is there something I can eat or not eat to control seizures?" At first, I had to say "no"—that except for the ketogenic diet, which is hard to maintain, I knew of no dietary way to control seizures. More recently, I've been able to mention the less radical Atkins and Low Glycemic Index diets, since both of these have had success at controlling seizures in some patients.
Very recently, I have been able to add something quite new: that the addition of fish oil to a normal diet might elevate seizure threshold. This has not been proven in humans as yet, but our laboratory has produced some interesting animal data.
The animal data related to this new approach have come from my laboratory at the University of Toronto. It's an interesting story that relates to my graduate student, Mr Ameer Taha. Ameer came to my lab with an M.Sc. in nutrition. In his undergraduate years, he had worked with Dr Stephen Cunnane of the Department of Nutrition, and during his undergraduate work, he and Dr Cunnane had evolved the idea that the omega 3 polyunsaturated fatty acids—usually called "omega-3 PUFAs"—should have anticonvulsant effects. They came to believe this because the omega-3 PUFAs control the cardiac arrhythmias. The cardiac arrhythmias result from an over-excitable heart, just as seizures result from an over-excitable nervous system. It seemed logical that a treatment that worked for one might also work for the other.
When Ameer came to my epilepsy research laboratory, he wanted to test the anticonvulsant effects of the omega-3 PUFAs. I was a little skeptical, since there had been previous reports on the anti-seizure effects of omega-3 PUFA's and these could not be replicated. Ameer gave replication another try, and he also could not produce anti-seizure effects using the techniques reported in the literature. Dr Carol Greenwood of the Department of nutrition, however, pointed out that the amounts of PUFAs we were administering were far too low to have any physiological effects. Ameer tried higher doses, and we began to see elevations in seizure thresholds in our experimental animals. It is, as yet unproven, but similar elevations in seizure threshold might occur in humans who took omega-3 PUFAs. We are currently beginning a clinical trial to determine whether this is true.
An important thing to say is that not all PUFAs would work. It is the omega-3 PUFAs that have anti-seizure effects. The omega-6 PUFAs would not. The principal omega-3 PUFAs are decosahexanoic acid (usually called "DHA") and eicosapentanoic acid (usually called "EPA"). Mixtures of these PUFAs can be found in the fish oil extracts that can be purchased at drug stores or health food stores. Some brands taste very fishy, but others do not. Ameer calculates that the human dose will probably be something like 3-6 grams per day.
Another important thing to say is that the anti-seizure effects would probably take three or more months to develop, at least they do in our rats. Thus the omega-3 PUFAs will not be a "quick fix" for seizures. It is also probable that they would not be as strong as the anticonvulsant drugs. If our tests work out, we will probably suggest that the PUFAs be combined with anticonvulsant drugs, rather than replacing the anticonvulsant drugs.
On the plus side, however, the omega-3 PUFAs are relatively cheap, have no known long-term side effects, and are generally good for your health. They are anti-inflammatory and they have been shown to promote a healthy heart. This may be a win/win situation.
Since the PUFAs are diet supplements, not drugs, they do not require a prescription. They are easily obtainable at drug and health food stores, and there is nothing stopping people from experimenting with them. It needs to be reiterated, however, that the omega-3 PUFAs have not yet been shown to raise seizure threshold in humans, and, also, that any experimentation should done with the permission of your doctor.
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