Lithium-Associated Psoriasis and Omega-3 Fatty Acids
Abstract
To the Editor: Psoriasis is a well-known cutaneous adverse effect of lithium treatment (1). Among the various options for treatment are infusions with omega-3 fatty acids (2, 3). Recently, we participated in a double-blind, placebo-controlled study on the effects of the addition of a maximum of 6 g/day of omega-3 fatty acids containing eicosapentaenoic acid (EPA) ethyl esters to patients with bipolar disorder. In this study, two patients reported a spontaneous reduction of psoriasis, possibly related to taking omega-3 fatty acids. Ms. A was a woman of 59 years of age with bipolar II disorder, who had been taking lithium for 6 years. After 2 years of lithium treatment, she developed psoriasis on her head, arms, legs, belly, and nails in the form of skin eruptions and scales. In addition to treatment with lithium, carbamazepine, lorazepam, and levothyroxine, she began taking double-blind-study medication because of depression. Initially, she received placebo for 4 months. Because she had not recovered, she was then offered open-label treatment with 6 g/day of omega-3 fatty acids for 4 months, which had no effect on her depression. After Ms. A started treatment with omega-3 fatty acids, her psoriasis disappeared completely within 4 weeks. When