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Bipolar Disorder

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Natural Therapies

Herbs and Supplements to Use Only With Caution

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Bipolar disorder (BD) is a mental health disorder. It causes severe swings in mood, energy, and function. People who swing between happy and full of energy to a low mood with a poor temper. It can affect school, work, and personal relations.

Treatment can help to gain better control of symptoms. A combination of medicine and therapy can help. Alternative therapies can’t take the place of traditional medicine. However, some may use them along with standard treatments.

Natural Therapies

Likely Effective

N-Acetylcysteine (NAC) —likely to ease symptoms and improve function B2, B6, B9, B10
Omega-3 Fatty Acids —may reduce depression (but not mania) in those with BD B1, B4, B5, B9, B11, B12

May Be Effective

Coenzyme Q10—may improve symptoms of depression B13
Pregnenolone —may ease symptoms of depression when used with standard treatment B3, B8

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Use Only With Caution

Talk to your doctor about any supplements or therapy you would like to use. Many can interact with antidepressant medicine. Some herbs and supplements that should be noted include:

Ginseng may worsen symptoms of mania.A1-A2
Inositol (vitamin B8) may worsen symptoms of mania.B7
S-Adenosyl-L-Methionine (SAMe) may worsen symptoms of mania.B7
St. John's Wort may worsen symptoms of mania and interact with certain medicine, such as SSRIs.A1

References►

Herbs

A1. Qureshi N, Al-Bedah A. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639-658.

A2. Norelli LJ, Xu C. Manic psychosis associated with ginseng: a report of two cases and discussion of the literature. J Diet Suppl. 2015 Jun;12(2):119-125.

Supplements

B1. Lin PY, Su KP. A meta-analytic review of double-blind, placebo-controlled trials of antidepressant efficacy of omega-3 fatty acids. J Clin Psychiatry. 2007;68:1056-1061.

B2. Berk M, Copolov DL, et al. N-acetyl cysteine for depressive symptoms in bipolar disorder—a double-blind randomized placebo-controlled trial. Biol Psychiatry. 2008 Sep 15;64(6):468-475.

B3. Osuji IJ, Vera-Bolaños E, et al. Pregnenolone for cognition and mood in dual diagnosis patients. Psychiatry Res. 2010;178(2):309-312.

B4. Sarris J, Mischoulon D, Schweitzer I. Omega-3 for bipolar disorder: meta-analyses of use in mania and bipolar depression. J Clin Psychiatry. 2011 Aug 9.

B5. Sarris J, Mischoulon D, et al. Omega-3 for bipolar disorder: a meta-analyses of use in mania and bipolar depression. J Clin Psychiatry. 2012 Jan;73(1):81-86.

B6. Berk M, Dean OM, et al. Maintenance N-acetyl cysteine treatment for bipolar disorder: a double-blind randomized placebo controlled trial. BMC Med. 2012 Aug 14;10:91.

B7. Qureshi N, Al-Bedah A. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639-658.

B8. Brown ES, Park J, et al. A randomized, double-blind, placebo-controlled trial of pregnenolone for bipolar depression. Neuropsychopharmacology. 2014;39(12):2867-2873.

B9. Rosenblat JD, Kakar R, et al. Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis. Bipolar Disord. 2016 Mar;18(2):89-101.

B10. Fernandes BS, Dean OM, et al. N-Acetylcysteine in depressive symptoms and functionality: a systematic review and meta-analysis. J Clin Psychiatry. 2016 Apr;77(4):e457-466.

B11. Shakeri J, Khanegi M, et al. Effects of Omega-3 supplement in the treatment of patients with bipolar I disorder. Int J Prev Med. 2016 May 19;7:77.

B12. Vesco AT, Young AS, et al. Omega-3 supplementation associated with improved parent-rated executive function in youth with mood disorders: a secondary analyses of the omega 3 and therapy (OATS) trials. J Child Psychol Psychiatry. 2017 Oct 24.

B13. Mehrpooya M, Yasrebifar F, et al. Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical Trial. J Clin Psychopharmacol. 2018;38(5):460-466.

Last reviewed March 2019 by EBSCO NAT Review Board
Last Updated: 3/27/2019

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