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.
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
REFA1 Qureshi N, Al-Bedah A. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639-658.
REFA2 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
REFB1 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.
REFB2 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.
REFB3 Osuji IJ, Vera-Bolaños E, et al. Pregnenolone for cognition and mood in dual diagnosis patients. Psychiatry Res. 2010;178(2):309-312.
REFB4 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.
REFB5 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.
REFB6 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.
REFB7 Qureshi N, Al-Bedah A. Mood disorders and complementary and alternative medicine: a literature review. Neuropsychiatr Dis Treat. 2013;9:639-658.
REFB8 Brown ES, Park J, et al. A randomized, double-blind, placebo-controlled trial of pregnenolone for bipolar depression. Neuropsychopharmacology. 2014;39(12):2867-2873.
REFB9 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.
REFB10 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.
REFB11 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.
REFB12 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.
REFB13 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.