Relevance to NICE guidance programmes

Advice

The use of omega-3 fatty acid medicines to treat schizophrenia is not appropriate for referral for a NICE technology appraisal because they are not licensed for this indication.

NICE has published clinical guidelines on:

Schizophrenia: core interventions in the treatment and management of schizophrenia in adults in primary and secondary care (NICE clinical guideline 82). An update of this guideline is currently in progress and is expected to be published in February 2014.
Psychosis and schizophrenia: recognition and management of psychosis and schizophrenia in children and young people (NICE clinical guideline 155).

NICE has also published a technology appraisal on Aripiprazole for the treatment of schizophrenia in people aged 15 to 17 years (NICE technology appraisal guidance 213).

In addition, NICE has published information on omega-3 fatty acids for cardiovascular disease, which was identified as a key therapeutic topic to support the Quality, Innovation, Productivity and Prevention (QIPP) medicines use and procurement work stream. This publication states that several NICE clinical guidelines recommend against prescribing these supplements for the primary preventionof cardiovascular disease. This includes the NICE clinical guideline on lipid modification (currently being updated) , the NICE clinical guideline on familial hypercholesterolaemia and the NICE clinical guideline on type 2 diabetes (currently being updated). The full guideline on type 2 diabetes states that fish oils as a homogeneous therapeutic concept is problematic. There is variation in the fish oil dosage used in studies, and there are financial consequences to prescribing omega-3 supplements when the evidence shows no clear benefit.

For the secondary preventionof cardiovascular disease, the NICE clinical guideline on myocardial infarction: secondary prevention (currently being updated) gives a limited role for omega-3 fatty acid supplements. However, as discussed in the NICE guideline, there were limitations with the trial evidence and further research in this area was needed. Several more recent studies have further questioned the cardiovascular benefits of fatty acid supplementation in both primary and secondary prevention.

This key therapeutic topic publication does not cover the use of omega-3 fatty acid medicines in schizophrenia and is not formal NICE guidance.