Bipolar Disorder Supplements

With the rise in healthcare costs, you may wonder about using alternative medicine and dietary supplements for the treatment of bipolar disorder and other mood disorders. Alternative medicine views the body and mind as an integrated system, which means they influence each other. With alternative medicine, your commitment to living a balanced life plays a key role in your health and healing.

Many alternative remedies and natural dietary supplements are easy to access, whether on the Internet or at your local pharmacy. Yet before you begin treating bipolar disorder with natural dietary supplements or an alternative remedy, it’s important to do your homework and know what you’re putting into your body. In addition, always discuss any alternative remedy or dietary supplement with your doctor to avoid an herb/drug interaction, which can be quite serious.

What is a dietary supplement?

According to the FDA, in order for an ingredient of a dietary supplement to be a “dietary ingredient,” it must be one or any combination of the following substances:

* Vitamin
* Mineral
* Herb or other botanical
* Amino acid
* Dietary substance to supplement the diet by increasing the total dietary intake (e.g., enzymes or tissues from organs or glands), or
* Concentrate, metabolite, constituent, or extract

Can supplementing with 5-HTP help bipolar depression and/or mania?

5-hydroxytryptophan (5-HTP) may be used to treat mild depression based on the theory that as a precursor to serotonin, the brain chemical (neurotransmitter) that has a calming effect, 5-HTP can increase serotonin levels and influence mood, sleep patterns, and pain control. When serotonin levels are low, the result can be high anxiety, irritability, insomnia, impatience, and depression.

Although the studies are few, some findings show that 5-HTP supplements may help regulate mood and emotions, even comparable to some antidepressants. For instance, a small study of volunteers with anxiety disorders reported that taking supplements of 5-HTP greatly reduced levels of anxiety.

Should you take 5-HTP supplements? Talk to your doctor first because of possible adverse effects, including drug interactions with medications taken for bipolar disorder.

5HTP alone is not an acceptable alternative to your bipolar medications.

What is DHEA and can it help bipolar disorder?

The body naturally produces the hormone dehydroepiandosterone (DHEA) until the mid-20s, at which point the production of DHEA declines. Advertisers claim that supplementing with DHEA may have anti-aging benefits, boost mood, and improve symptoms of depression.

In one study of patients with HIV/AIDS, DHEA supplementation was found to be better than placebo in reducing depression symptoms. In another study of patients with Addison’s disease, researchers reported improvements in both mood and fatigue after supplementation with DHEA. But, because DHEA affects hormone levels in the body, experts believe more studies are necessary before recommending DHEA for use by the public.

Most studies on DHEA supplementation in healthy individuals show few side effects if the supplements are taken orally in recommended doses. DHEA is not recommended for people with abnormal heart rhythms, blood clots, or a history of liver disease. Also, do not take DHEA if you are pregnant or breastfeeding. The long-term effects of regular DHEA use are not known.

DHEA alone is not an acceptable alternative to your bipolar medications.
Can fish oil supplements boost mood with bipolar disorder?

Fish oil contains the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are crucial for the production of hormones and nerve tissue. Results from one study showed positive effects of omega-3 fatty acids in treating depression but not for mania. Supplementing the diet with fish oil is less understood with bipolar disorder, because of the mood swings to mania. If you are using fish oils, you must use a product that contains both EPA and DHA for this to be an effective addition to your medications.

Because there is evidence that omega-3 fatty acids can benefit cardiovascular health, some experts believe taking 1 gram per day of omega-3 fatty acid supplements may be beneficial.

Omega 3 Fatty acids may help, when used with your other medications, in treating your bipolar disorder.

What about St. John’s wort and bipolar disorder?

St. John’s wort (Hypericum perforatum), an herbal therapy that’s been shown in studies to lift symptoms of minor to moderate depression, has been used in Europe for centuries. Minor to moderate depression is a common disorder that’s under diagnosed and undertreated. Not only can minor to moderate depression affect your daily functioning and quality of life, it’s also a serious risk factor for major depression.

Studies show that St. John’s wort may affect various brain chemicals (neurotransmitters), including serotonin, epinephrine, and dopamine. These are the same chemicals affected by the prescription Prozac, a selective serotonin reuptake inhibitor (SSRI). St. John’s wort may also improve sleep because hypericum extract increases the brain’s output of melatonin at night. Melatonin is a hormone produced by the body that influences the circadian rhythm and sleep.

But St. John’s wort is not recommended for the treatment of bipolar disorder. Mood stabilizers such as lithium and Lamictal are the drugs of choice for treating bipolar depression. Because of the risk of triggering a manic episode, doctors warn against using any antidepressant, including St. John’s wort, for treatment of bipolar depression. In addition, St. John’s wort may cause serious herb-drug reactions if taken with other SSRI medications such as Prozac.

Are natural therapies safe and effective?

No matter what the advertising flyer claims at the natural food store, even the most popular medicinal herbs with pharmaceutical compounds have ingredients that have not been tested and are not scrutinized by FDA. Unlike products that have FDA approval, many herbal products have not gone through clinical trials to show that they are safe and effective before going onto the market.

As we learn more about natural remedies, some alternative therapies may emerge as the best strategies for treating health conditions, while others may lead to severe side effects. That said, this does not mean that natural supplements do not work — and there are many natural supplements that are safe and effective. Treatment works differently for some people than for others. You need to pay attention to what works for you.

One of the most common mistakes people make when using alternative therapies is to stop the conventional medical treatment altogether. In most cases, supplements are not an adequate alternative to medication for treating bipolar disorder, but may help in addition to your medicine.

Also, keep in mind that supplements — as natural as they may be — can still interact with your medication. That’s why it’s important to discuss all medications and supplements with your doctor. If your doctor isn’t familiar with any potential interactions, your pharmacist is another good source of information.

And as a rule of thumb, just because something is natural doesn’t mean that it is always safe. Even supplements have side effects.

Herbal therapies are not recommended without medical supervision for pregnant women, children, the elderly, people with ongoing disease processes (basically anyone taking a prescribed medicine regularly) or those with compromised immune systems. In addition, some herbs have sedative or blood-thinning qualities, which may dangerously interact with NSAIDs or other pain medications. Others may cause gastrointestinal upset if taken in large doses.

WebMD
Reviewed by David C. Leopold, MD