Opposite changes in predominantly docosahexaenoic acid (DHA) in cerebrospinal fluid and red blood cells from never-medicated first-episode psychotic patients ☆ Anvita Kale a , Sadhana Joshi a , Nilesh Naphade b , Swati Sapkale b , M.S.V.K. Raju b , Anilkumar Pillai c,d , Henry Nasrallah e , Sahebarao P. Mahadik c,d, ⁎ a Interactive Research School for Health Affairs, Bharati Vidyapeeth, Pune 411043, India b Department of Psychiatry, Bharati Medical College, Bharati Vidyapeeth, Pune 411043, India c Department of Psychiatry and Health Behavior, Medical College of Georgia, United States d Medical Research Service, Veterans Affairs Medical Center Augusta, United States e Department of Psychiatry and Neurology, University of Cincinnati, Cincinnati, OH, United States Received 27 September 2007; accepted 29 September 2007 Available online 7 November 2007 Abstract Variable levels of essential polyunsaturated fatty acids (EPUFAs) reported in schizophrenia are likely due to differences in age, sex, ethnicity, diet, life style and treatments. The present study examined the EPUFAs levels in plasma, RBC and CSF in never- medicated first-episode psychotic patients and normal controls matched for ethnicity, diet and life style. The plasma EPUFAs levels were similar in both groups. Among the EPUFAs enriched in the brain, predominantly docosahexaenoic acid (DHA) levels were lower in RBC (p = b 0.01) whereas higher in CSF (p = b 0.01) in male N female patients. This altered DHA metabolism may provide clues for neuropathology and treatment of schizophrenia. © 2007 Elsevier B.V. All rights reserved. Keywords: Schizophrenia; Arachidonic acid; Docosahexaenoic acid; Cerebrospinal fluid 1. Introduction Varying degrees of altered composition of membrane phospholipid fatty acids have been reported in periphery and post-mortem brains from patients at the onset of psychosis as well as on or off drug treatment (Horrobin, 1998; Peet et al., 2003; Mahadik and Yao, 2006; McNamara et al. 2007). A large number of factors that significantly influence the fatty acid metabolism, such as sex, race, diet, life style, years of untreated illness, age, co-morbid substance use have been implicated in this variability. The primary focus has been on the Available online at www.sciencedirect.com Schizophrenia Research 98 (2008) 295 – 301 www.elsevier.com/locate/schres ☆ The author(s) declare that, except for income received from my primary employer, no financial support or compensation has been received from any individual or corporate entity over the past three years for research or professional service and there are no personal financial holdings that could be perceived as constituting a potential conflict of interest. ⁎ Corresponding author. Medical Research Service, VA Medical Center, 1 Freedom way, Augusta, GA 30907, United States. Tel.: +1 706 733 0188x2490; fax: +1 706 823 3949. E-mail address: smahadik@mail.mcg.edu (S.P. Mahadik). 0920-9964/$ - see front matter © 2007 Elsevier B.V. All rights reserved. doi:10.1016/j.schres.2007.09.036