• Manic-Depression, Manic-Depressive Disease
• Choline, Fish Oil, Flaxseed Oil, Folate, Inositol, Lecithin, Vitamin B12, Vitamin C
• Chromium Picolinate, Ginseng, Glutamine, Inositol, S-adenosylmethionine (SAMe), St. John's Wort, Vanadium
Previously known as manic-depressive disease, bipolar disorder is a relatively common mental health condition manifested in its classic form by alternating periods of mania—extreme high energy—and deep depression. In the "up" or manic phase, people may sleep little, talk fast, develop grand and unworkable plans, and sometimes behave bizarrely—for example, giving away all their money overnight. In the "down" phase, they may contemplate suicide. In many people with this disorder, the "down" phase predominates, and for that reason, the diagnosis may be missed. Other, more subtle versions of the condition also exist.
Bipolar disorder is dangerous unless treated, leading to a high rate of suicide and injury. The mineral lithium has been shown to dramatically improve symptoms of mania and reduce the rate of suicide. Various antiseizure medications also appear to help against mania.
Proposed Natural Treatments for Bipolar Disorder
Note: There are no natural treatments that can substitute for medications in the treatment of bipolar disorder. However, some might help enhance the effectiveness of standard treatment.
In a double-blind study reported in 1999, 30 people with bipolar disorder took either fish oil capsules or placebo for 4 months, in addition to their regular medications. 1 Those taking the fish oil had longer symptom-free periods than those taking placebo. The researchers used five different standardized tests to measure symptoms, examining levels of depression, mania, and overall progress. The people taking fish oil proved emotionally healthier than those taking placebo on all but one of these tests. Another study found that ethyl-EPA (a modified form of a constituent of fish oil) was helpful along with standard treatment for the depressed phase of bipolar disorder. 19 A third study failed to find ethyl-EPA helpful for rapid cycling bipolar disorder. 24 Overall, the evidence for benefit is not yet convincing. 23
The same researchers who conducted the fish oil study have also experimented with flaxseed oil for bipolar disorder. 5 Flaxseed oil contains alpha-linoleic acid (ALA), an omega-3 fatty acid related to the fatty acids in fish oil. In the researchers' informal observations of 22 people with bipolar disorder, all but four appeared to benefit from flaxseed oil. However, lacking a double-blind study, these results can't be taken as meaningful. When a double-blind study is finally performed, flaxseed oil may turn out not to be helpful at all.
One somewhat questionable study reported that an herbal combination utilized in traditional Chinese medicine ("Free and Easy Wanderer") may augment the effectiveness of carbamazepine treatment for bipolar disorder. 20
Very weak evidence suggests possible benefits with choline , 6lecithin , 7vitamin C , 8-10 and inositol . 14 Inositol may also reduce psoriasis symptoms caused by lithium. 21 (However, caution is advised with inositol. See Herbs and Supplements to Use Only With Caution .)
Interestingly, use of an anion generator (an air ionizer that produces negative ions) has shown promise for mitigating the symptoms of acute mania. 22
Note: Lithium is sometimes sold as a mineral supplement for treating bipolar disorder. However, this proposed use is based on a misunderstanding. When lithium is used medically as treatment for bipolar disorder, it is taken at doses far above any possible nutritional need. No researcher has seriously suggested that lithium deficiency causes bipolar symptoms, and low doses of lithium are unlikely to have any effect at all.
Herbs and Supplements to Use Only With Caution
Antidepressant drugs may cause manic episodes in people with bipolar disorder. For this reason, herbs and supplements with antidepressant properties might also be risky. Case reports suggest that SAMe , 16,17,18St. John's Wort , 7,8 and inositol15 can indeed trigger manic episodes.
The supplement L-glutamine , while not normally considered to have antidepressant properties, has reportedly triggered episodes of mania in two people not previously known to have bipolar disorder. 4 A ginseng product has also been associated with an episode of mania. 6
The supplement chromium is often sold in the form of chromium picolinate. Picolinate can alter levels of neurotransmitters. 5 This has led to concern among some experts that chromium picolinate might be harmful to people with bipolar disorder. 2
It has been suggested that the drug lithium works, in part, by reducing the body's level of vanadium . 1 For this reason, it might be advisable for people with bipolar disorder to avoid using supplements that contain vanadium.
Finally, numerous herbs and supplements may interact adversely with drugs used to prevent or treat bipolar disorder. For example, people who use lithium should avoid herbal diuretics. For more information on this potential risk, see the appropriate individual drug articles in the Drug Interactions database.
20. Zhang ZJ, Kang WH, Tan QR, et al. Adjunctive herbal medicine with carbamazepine for bipolar disorders: A double-blind, randomized, placebo-controlled study. J Psychiatr Res. 2005 Aug 1. [Epub ahead of print].
24. Keck PE Jr, Mintz J, McElroy SL, et al. Double-blind, randomized, placebo-controlled trials of ethyl-eicosapentanoate in the treatment of bipolar depression and rapid cycling bipolar disorder. Biol Psychiatry. 2006;60:1020-102. Epub 2006 Jun 30.
Last reviewed October 2007 by EBSCO CAM Review Board
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