Bipolar Disorder treatment
Bipolar mania fish oils treatment herbs natural therapy for bipolar disease - do vitamins help?

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; hypersexuality; 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.

 

Subscribe to a FREE Supplement Research Update newsletter. Once or twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, including bipolar research, and their practical interpretation by Ray Sahelian, M.D.

 

 

Natural Therapies for Bipolar disorder
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 two nutrients that offer some hope:
  
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 oils may help.
Fish-Oil-Fisol.
   Choline, a nutrient that converts into phosphatidylcholine, has shown to be beneficial in bipolar disease, particularly those who are prescribed lithium.

We are not aware of any other natural supplements that have been tested and found consistently effective in the treatment of bipolar disorder. See depression for more info.

Caution
Some nutrients and herbs have a stimulant effect and (hypothetically) may aggravate bipolar disorder or induce mania. These include SAM-e, ginseng, St. John's wort and others of a stimulatory nature.

Bipolar disorder study
Lower high-density lipoprotein cholesterol and increased omega-6 polyunsaturated fatty acids in first-degree relatives of bipolar patients.
Sobczak S. Department of Psychiatry & Neuropsychology, Maastricht University, Maastricht, The Netherlands. Psychol Med. 2004 Jan;34(1):103-12
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 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 (N = 30) and healthy matched controls (N = 15) (parallel-group design). 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 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.

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.
Lyoo IK. Brain Imaging Center, McLean Hospital, Belmont, MA, USA.
Bipolar Disord. 2003 Aug;5(4):300-6.
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. METHODS: 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 using 1H- and 7Li-MRS. Patients received four to six MRS scans, at baseline and weeks 2, 3, 5, 8, 10 and 12 of treatment (n = 40 scans). Patients were assessed using the Clinical Global Impression Scale (CGIS), the Young Mania Rating Scale (YRMS) and the Hamilton Depression Rating Scale (HDRS) at each MRS scan. RESULTS: 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.

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Bipolar disorder questions
Q. Are there any findings regarding bipolar disorder and pregnenolone? I read a testimonial which related a side effect of rapid mood swings. I do not currently take pregnenolone. If one has a predelection for mood swings would it be a good idea or a bad idea to use it?
   A. Pregnenolone is a powerful hormone and should only be used when all other options have failed. There are other options for bipolar disorder that should be tried first.
 

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