Bipolar disorder vitamins,
herbs, and supplement
that may offer some help and relief,
natural therapy
and remedy using nutritional supplementation
June 2 2018
by
Ray Sahelian, M.D.
Bipolar disorder is a long-term illness with a variable course. Some of the symptoms may include mania, an excessively elevated, expansive, and irritable mood; increased libido; decreased need for sleep; rapid speech; racing thoughts; increased activity and agitation; occasional delusions. It may also include periods of depression and other symptoms such as excessive guilt; anhedonia (absence of pleasure); or thoughts of death or suicide. This condition has a high relapse rate. A vast majority of the hospitalizations for treatment of bipolar disorder are repeat admissions. Patients with bipolar disorder spend more time depressed than manic.
Natural
therapies
for bipolar disorder, vitamins, herbs, supplements and natural remedy
We are slowly beginning to discover that natural supplements may play a
role in the therapy of bipolar disease. Much has yet to be learned, but there
are at least three nutrients that offer some hope.
I am not aware of any other natural supplements that have been tested and found
consistently effective in the treatment.
Fish oils, omega-3 fatty acids
It's quite possible that one of the biochemical abnormalities in bipolar
disorder is a higher amount of omega-6 fatty acids and a shortage of omega-3
fatty acids. If this is the case,
fish oil supplements may help.
It is difficult to predict in any one person whether fish oils
would help and if so how many softgels would be
required. Under medical supervision a person can start with 3 softgels a day and
gradually increase over time as needed.
Other options are krill oil or flax seed oil.
Omega-3 fatty acid treatment and T(2) whole brain relaxation times in
bipolar disorder.
Am J Psychiatry. 2004.
The authors hypothesized that changes in brain membrane composition resulting
from omega-3 fatty acid administration in patients with bipolar disorder would
result in greater membrane fluidity, as detected by reductions in T(2) values. Women with bipolar disorder (N=12) received omega-3 fatty acids for 4
weeks. A cohort of bipolar subjects (N=9) and a group without bipolar disorder
(N=12) did not receive omega-3 fatty acids. T(2) values were acquired at
baseline and after 4 weeks. Bipolar subjects who received omega-3 fatty
acids had significant decreases in T(2). There was a dose-dependent effect when
the bipolar omega-3 fatty acid group was subdivided into high- and low-dose
cohorts. Omega-3 fatty acids lowered T(2) values, consistent with
the hypothesis that the fluidity of cell membranes was altered. Further studies
are needed to clarify the significance of alterations in brain physiology
induced by omega-3 fatty acids, as reflected in T(2) values.
Lower high-density lipoprotein cholesterol and increased omega-6
polyunsaturated fatty acids in first-degree relatives of bipolar patients.
Psychological Medicine. 2004
Lower serum high-density lipoprotein cholesterol and increased ratio
of omega-6 / omega-3 fatty acids have been reported in unipolar and bipolar
depressed patients. Changes in cholesterol and fatty acids have been suggested
to affect membrane viscosity and consequently serotonergic neurotransmitter
expression. The goal of this study was to investigate whether lower baseline
cholesterol and increased omega-6 and lower omega-3 fatty acids are present in
healthy first-degree relatives of bipolar disorder patients compared with controls and
whether these changes were associated with neuroendocrine responses to an i.v.
tryptophan challenge or mood. Baseline cholesterol, fatty acids and mood
were determined in healthy first-degree relatives of patients with bipolar
disorders and healthy matched controls. Prolactin and cortisol were measured following tryptophan infusion.
First-degree relatives showed significantly lower plasma high-density
lipoprotein cholesterol and increased total omega-6 fatty acids in
phospholipids. Lower total omega-3 and higher total omega-6 fatty acids in
phospholipids were positively correlated with peak prolactin response to
tryptophan. Lower total omega-3 fatty acids in phospholipids and cholesteryl
esters were associated with lower mood. Abnormalities of lower
plasma high-density lipoprotein cholesterol and increased total omega-6 fatty
acids in phospholipids in these subjects are in agreement with findings in
bipolar disorder and major depressed patients. Changes in fatty acids show an association
with central serotonergic parameters. It is suggested that these abnormalities
in cholesterol and fatty acids may constitute a trait marker for bipolar
disorders.
Testimonial
Last year my
psychiatrist suggested fish oil for bipolar disorder and I have been taking
twelve fish oil 1200mg softgels a day for almost a year and have felt great!
Thanks for letting us know. Sometimes it is good to have your
doctor re-evaluate to see if fewer softgels would work as well.
I'm sure my son has bipolar disease, he has
been diagnosed with depression, but the doctors hesitated giving him anything
until he went to a psychiatrist, which he can't afford (no insurance) will
taking the supplement fish oil help him?
It is not possible for us to predict whether fish oils will
treat his bipolar disease or depression, but fish oils do have a positive effect
on mood for some users.
Ashwagandha herb
J Clin Psychiatry. 2013. Randomized placebo-controlled adjunctive study of an
extract of withania somnifera for cognitive dysfunction in bipolar disorder. We
assessed the cognitive effects of a standardized extract of the medicinal herb
Withania somnifera (WSE) in bipolar disorder. Sixty euthymic subjects with
DSM-IV bipolar disorder were enrolled in an 8-week, double-blind,
placebo-controlled, randomized study of WSE (500 mg/d) as a procognitive agent
added adjunctively to the medications being used as maintenance treatment for
bipolar disorder. Although results are preliminary, WSE appears to improve
auditory-verbal working memory (digit span backward), a measure of reaction
time, and a measure of social cognition in bipolar disorder.
Choline supplement
Choline, a
nutrient that converts into phosphatidylcholine, has shown to be beneficial in
bipolar disease, particularly those who are prescribed lithium. More studies are
needed to confirm this initial finding.
Oral choline decreases brain purine
levels in lithium-treated subjects with rapid-cycling bipolar disorder: a
double-blind trial using proton and lithium magnetic resonance spectroscopy.
Brain Imaging Center, McLean
Hospital, Belmont, MA, USA.
Bipolar Disord. 2003.
Oral choline administration has been reported to increase brain
phosphatidylcholine levels. As phospholipid synthesis for maintaining membrane
integrity in mammalian brain cells consumes approximately 10-15% of the total
adenosine triphosphate (ATP) pool, an increased availability of brain choline
may lead to an increase in ATP consumption. Given reports of genetic studies,
which suggest mitochondrial dysfunction, and phosphorus (31P) magnetic resonance
spectroscopy (MRS) studies, which report dysfunction in high-energy phosphate
metabolism in patients with bipolar disorder, the current study is designed to
evaluate the role of oral choline supplementation in modifying high-energy
phosphate metabolism in subjects with bipolar disorder. Eight
lithium-treated patients with DSM-IV bipolar disorder, rapid cycling type were
randomly assigned to 50 mg / kg/day of choline bitartrate or placebo for 12 weeks.
Brain purine, choline and lithium levels were assessed.
Patients received four to six MRS scans, at baseline and throughout treatment. Patients were assessed using the Clinical
Global Impression Scale and the Hamilton Depression Rating Scale at each MRS scan. There were no
significant differences in change-from-baseline measures of CGIS, YMRS, and HDRS,
brain choline / creatine ratios, and brain lithium levels over a 12-week
assessment period between the choline and placebo groups or within each group.
However, the choline treatment group showed a significant decrease in purine
metabolite ratios from baseline (purine / n-acetyl aspartate; purine / choline
compared to the placebo group, controlling for brain lithium level changes.
Brain lithium level change was not a significant predictor of purine ratios.
The current study reports that oral choline supplementation
resulted in a significant decrease in brain purine levels over a 12-week
treatment period in lithium-treated patients with DSM-IV bipolar disorder,
rapid-cycling type, which may be related to the anti-manic effects of adjuvant
choline. This result is consistent with mitochondrial dysfunction in bipolar
disorder inadequately meeting the demand for increased ATP production as
exogenous oral choline administration increases membrane phospholipid synthesis.
5HTP
Is 5HTP helpful for people with bipolar
disorder? What about ashwagandha herb or
kava
root extract?
As of 2018 I have not seen any studies regarding the
treatment of bipolar disorder with
5-HTP supplements,
kava root, or
ashwagandha. However, if your doctor
approves, you could try a daily dose of 5HTP 50 mg or 100 mg for a week or two to see if there
are any effects. 5HTP is best tried by itself since the combination of this
supplement with prescription medications could lead to unexpected side effects.
Lithium orotate
The swings in mood from depression to mania that afflict people
with bipolar disorder can be tempered with drugs such as lithium, but adding an
antidepressant drug to ease the depression component is not helpful.
I have come across lithium
orotate and there may be some possibility that this supplement could help
but long term benefit and side effects are not yet fully known.
Caution
Some nutrients and herbs have a stimulant effect and (hypothetically) may aggravate
bipolar disorder or induce mania.
These include SAM-e pills, ginseng, St. John's wort and others of a stimulatory
nature.
Bipolar symptom
Symptom of bipolar disorder are characterized by recurrent episodes of
depression, mania, and/or mixed symptom states. These episodes cause unusual and
extreme shifts in mood, energy, and behavior that interfere significantly with
normal, healthy functioning.
Bipolar Disease Manic symptoms include:
* Increased energy
* Severe changes in mood, either extremely irritable or overly silly and elated
* Overly-inflated self-esteem; grandiosity
* Decreased need for sleep, ability to go with very little or no sleep for days
without tiring
* Increased talking, talks too much, too fast; changes topics too quickly;
cannot be interrupted
* Distractibility, attention moves constantly from one thing to the next
* Increased sexual desire or high
libido, increased sexual
thoughts, feelings, or behaviors; use of explicit sexual language
* Increased goal-directed activity or physical agitation
* Disregard of risk, excessive involvement in risky behaviors or activities
Bipolar Depression symptoms include:
* Loss of energy
* Persistent sad or irritable mood
* Loss of interest in activities once enjoyed
* Significant change in appetite or body weight
* Difficulty sleeping or oversleeping
* Physical agitation or slowing
* Feelings of worthlessness or inappropriate guilt
* Recurrent thoughts of death or suicide
Bipolar medication treatment
A number of medications are available to treat this condition. The most
common are mood stabilizers like
lithium and anticonvulsant medications. Many
people who have bipolar disorder keep taking these medications for years or
decades after their last mood swing to stay healthy. This is called maintenance
therapy. During a period of depression or mania, a person may need other
medications, like antipsychotic drugs and sometimes antidepressants.
Olanzapine-fluoxetine combination, quetiapine, and lurasidone are FDA-approved treatments for bipolar depression.
Weight
gain side effects
Obesity and weight gain in bipolar disorder patients are partly related to
prescribed drugs with a strong effect by clozapine and olanzapine. Lesser but
still relevant weight gain is caused by quetiapine, risperidone, lithium,
valproate, gabapentin and by some antidepressants. Ziprasidone, aripiprazole,
carbamazepine and lamotrigine do not seem to cause significant weight gain.
University attendance and stress
The rituals of college -- making new friends, studying until dawn, excessive
partying -- can stress out any young adult. But students with bipolar disorder,
or those at risk for the condition, are even more vulnerable in a college
environment. Academic pressures, social concerns, and sleep disruptions can lead
to bouts of depression as well as mania, the euphoric, revved-up state
characteristic of bipolar disorder.
Smoking related to risk for
suicide
People with bipolar disorder who smoke appear to have a heightened risk of
suicidal behavior -- possibly because they are generally prone to impulsive
acts. Bipolar Disorders journal, November 2009.
Having a family member who committed suicide increases the likelihood that patients with bipolar disorder will themselves attempt suicide.
Research
Prescribing anti-depressants alone to bipolar patients can trigger manic
behavior and rapid "cycling" between mania and depression that could lead to
suicidal thoughts.
Bipolar disorder, a sometimes misdiagnosed mental
illness characterized by wide emotional swings, may be identifiable by chemical
abnormalities visible in victims' brains. Detailed brain scans performed on 42
adults, half of whom had been previously diagnosed as bipolar, showed
consistently different levels of five chemicals in areas of the brain that
control behavior, movement, vision, reading and sensory information, they said.
The Mayo Clinic study used a high-power magnetic resonance imaging scanner that
had twice the magnetic field strength of scanners previously used to examine the
brains of bipolar patients. Roughly 2 million Americans suffer from bipolar
disorder, according to the National Institute of Mental Health.
Emails
Q.
Could you elaborate on the use of SSRI's and bipolar. 2 physicians (one a
psychiatrist) told me recently that bi-polar patients should not use SSRIs -
nor SAMe. I could not find this in your book. How about St. John's Wort?
A. Both SAM-e and St. John's wort are strong antidepressants, and they can shift
a bipolar person into a manic state, that is possible.
My wife has no sex drive at all and we are
investigating herbal treatments such as Passion Rx. She has been under treatment
for bipolar disorder for about 20 years and is very stable in that regard, and
under the care of a psychiatrist to monitor her meds, which include Lithobid and
Depakote. I suppose she should ask her psychiatrist first, but are you aware of
any special issues for such patients with regard to herbal remedies?
There can be unexpected reactions when herbal aphrodisiacs are
mixed with pharmaceutical drugs. It is not possible for us to predict such
reactions or possible side effects that could occur. Many herbs have stimulating
properties, they can increase body temperature, and can increase heart rate or
cause insomnia in high doses.
I suffer from bipolar disorder and take Geodon,
Lamictal, Welbutrin and lorazepam to help my condition. I'm pretty sure one of
the drugs is causing me to not have a sex drive. The drugs work well for me and
I really don't want to change any of them. I was wondering if taking an
aphrodisiac herb will help me even though I'm on medication?
Sexual enhancing herbs are potent and could interact with the
medications. With so many medications in the body it is difficult to predict the
response to any sexual herb or formula. There are no easy answers when so many
prescription drugs are involved.
I have seen a few warnings against using rhodiola
rosea herb if you are diagnosed with bipolar disorder. I’ve seen the warning on
some labels and online.
There are many herbs, when used in high concentrations, that can
cause overstimulation, restlessness, and perhaps induce mania. Rhodiola rosea
herb may theoretically fall in this category, along with ginseng, tongkat ali,
horny goat weed, and others, but we have not seen, as of August 2008, any
specific human research that has evaluated the role of rhodiola herb in inducing
mania. As with many herbs that increase energy levels, it is best to use lower
dosages to avoid side effects of restlessness and insomnia.
My wife was diagnosed bipolar disorder about 22 years
back. She just got relapse after sever years. She had been on Lithium and
Risperdal medications. Her doctor has now put her on Geodon with Lithium, and
apparently she is getting side effects like feeling short of breath, loss of
energy, etc. I gave her Flax seed oil (with Omega 3,6 & 9) and saw positive
outcome. Shall I continue flaxseed oil, or also give her fish oil? Will
appreciate your response.
I can't give specific advice but it is worth trying each
separately for 2 or 3 weeks and then a combination, if her doctor approves. It
is difficult to predict the interaction between supplements and medications.
My son shows signs of extreme mood swings, mania in the form of extreme irritability, depression, mild learning disabilities, inability to keep job due to irritability. He has improved somewhat on Empower by Truehope but duration is only 3-4 hours and product is outrageously expensive. Not sure it is doing the job.
I take Zoloft and Lamictal but not happy with the results, I am looking for some natural products.
Q. I am a medical doctor and writing this letter from India. I want to seek your help for treatment of my brother who is suffering from Bipolar disorder, mainly manic. He is taking many drugs for suppression of his manic conditions apart from these he is also taking Sodium Valpouric acid 2000 mg in a day. I have added three tablets of Lithium Oratate of 120 mg in his list. Still when ever we reduce the medications, he goes into manic stage as a rebound effect. Due to side effects of medicines he has developed hypothyroidism, high blood sugar and obesity.