In addition to medication and talk therapy for treating bipolar disorder it is worth considering augmenting your treatment with nutritional supplements. Many supplements are unproven and potentially harmful in treating bipolar disorder, so it is worth researching the actual scientific studies to determine which ones provide benefit. The only supplements mentioned in this article are harmless at the levels recommended in this article. Nevertheless, any supplements that you choose to make part of your regimen should be discussed with your psychiatrist and noted in your medication list at your physician’s office (primary care provider).
I’m serious. Treat supplements taken at higher than normal doses as medications. They may have interactions with the meds you already take. Your doctor(s) need to know about them.
The focus of this article is fish oil. Fish oil has the greatest number of scientific studies showing a proven benefit for bipolar disorder (and depression). It appears to have the benefits of decreasing depressive symptoms, preventing psychosis (manic symptoms), as well as preventing relapse. These benefits have been shown in a large number of studies, many of which are noted in the table in this article on PsychEducation.org:
The highlights of those studies are that 1-2 grams of EPA are shown to have an effect on Bipolar Disorder in 3 out of 4 studies. In one study, in 2005, a very impressive 8 out of 10 patients responded.
Patients with Major Depressive Disorder improved in 7 out of 9 studies. In one of those studies, 62% of depressed patients improved versus 27% on placebo, a very significant response rate.
EPA has also been shown to prevent psychosis among patients with Schizophrenia. 2 out of 41 developed psychosis on 1.2 grams of fish oil versus 11 of 40 in the control group in one study. The implications of this for schizophrenia and manic psychosis require further research.
Fish oil contains both EPA and DHA, as well as other Omega-3s. EPA is the most studied for bipolar disorder and depression. A dose of typically 1-2 grams and up to 6 grams of EPA has been shown to have proven benefit for bipolar disorder and major depressive disorder.
Up to 2 grams of DHA has also been studied for depression, although no studies for bipolar disorder seem to be available. Regardless, it does not seem to hurt. Its presence does not interfere with the benefits of EPA, and it may have some benefit of its own.
Recommended Best Value Fish Oil:
Amazon: Carlson Labs Fish Oil (says 200 ml but choose 16.9 oz size for best value)
Take 3 teaspoons a day to equal 2400 mg EPA. This gives you a little over 30 days in the 16.9 oz (500 ml) size. The number of servings in the nutrition facts is for the 200 ml size, not the 16.9 oz (500 ml) size.
Folic acid is another important supplement to complement medication and therapy in treating bipolar disorder. While it is possible to receive the Recommended Daily Intake (RDI) of 400 mcg of folic acid in your diet by eating leafy green vegetables and cereals, some people still suffer from a deficiency and there may be some benefit in receiving more than that for those with a mental disorder. Amounts that have been studied range from 800 mcg to 2500 mcg (2.5 mg).
Folic acid alternatively may be obtained through a proper diet, but perhaps not at the most beneficial levels unless you double up your cereal intake to get more than 100%.
Recommended dosage for bipolar disorder and major depressive disorder to start is 800 mcg.
More information is available on BipolarLives.com:
Recommended Folic Acid Supplement:
Supplements Worthy of Consideration
Additional supplements that may show statistically significant improvement for patients with bipolar disorder (generally at higher than normal doses) include inositol, vitamins B1, B2, B6, B9 (folic acid, mentioned previously) and B12, vitamin C, magnesium, SAM-e, and tryptophan.
These deficiencies are discussed on McManWeb.com at:
Amino acid deficiencies may also play a role, but because of the potential harm of taking too much of any of them, you should discuss which ones to take with your doctor.
There are many supplements which have no proven efficacy in treating bipolar disorder and many of them are harmful to individuals with this disorder. It is worth looking at the published studies and deciding for yourself which ones are worth taking. And of course, discuss these with your doctor before starting your regimen.
This article may be updated as I research these supplements further and find more studies. Additional supplements may be added if they are found to be safe and beneficial. I will note the updates here.