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While most patients better health in the study were on mood stabilizers, eight patients received no concomitant medications. Of those better health eight, the four patients who received omega-3 monotherapy remained in remission for a significantly longer time than did the four patients who received placebo monotherapy. However, Stoll cautioned against using omega-3 as first-line monotherapy. "I wouldn't recommend it first for people. The patients in the study had failed other [medications]. The only way I better health would use omega-3s by themselves is in someone with an extremely mild form of the illness where treatment is almost optional. Otherwise, we use omega-3s as an adjunct," he said. The most common adverse effect in both the omega-3 and olive oil groups was mild gastrointestinal distress, generally characterized by loose stools. In an accompanying commentary to the published study, Stoll and co-author Marangell noted the high patient interest and acceptance of omega-3 fatty acids as mood stabilizers (Stoll and Marangell, 1999).
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