Ritalin + Evening Primrose + Fish Oil (omega 3)

[Anonymous]

Hi there,

I’m interested to hear Dr J’s opinion on taking Evening Primrose Oil and/or Fish Oil while taking Ritalin and Fluoxetine (complicated, I know). I have just started taking Ritalin again, and will start on Fluoxetine again soon, and have stopped taking my usual Evening Primrose Oil (3000mg per day) and Fish Oil for now. I would like to start up with the Evening Primrose again though, as I find it really helps with PMS symptoms. I would also be keen to keep taking the Fish Oil, although that isn’t as important to me as the Evening Primrose oil. Obviously this is something I will discuss with the psychiatrist at my next appointment, but it isn’t for a month and i would be interested to hear Dr J’s thoughts…

As far as I can tell, it should be ok but there is some ancedotal evidence that the fish Oil might increase the serotonergic effects of the Fluoxetine?

Thanks for any help or advice. Even if you can point me in the direction fo a good paper about this issue (I ahve access to most journals online), I would be grateful.

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[Anonymous]

Hi, Zoe.

There have been increasing number of studies and review of studies since about 2006. Basically, there is no clear evidence pointing to it being good but all studies show that it is not bad or harmful.

When thinking about science, the first question asked is “Does it make sense?” Sitting on an eraser curing ADHD doesn’t make sense, for example. But there is some sense to the idea that if you have better insulation (which is what Omega 3 fatty acids in fish oil afford us), then presumably the circuits should work more efficiently. The literature in dementia, for example, shows a trend in this direction. Is it the answer for ADHD?There is no study thus far that shows that it is superior to ADHD medications. Most studies suggest that it is a useful adjunctive treatment and part of a comprehensive treatment approach.

Regarding fish oil improving the serotonin effects of fluoxetine…….there is nothing convincing.

Having said all that, there is some data emerging from the UK that points a much better picture and it was a very well controlled study. But, it needs replication. One of my concerns is that they don’t always show teacher improvement but they do show parental improvement.

Primose Oil in PMS? I don’t know enough about this but it has been thrown around along with B complex vit. supplementation.

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