Herbs and Other Supplements Used in the Treatment of Bipolar Disorder

By Candida Fink, Joe Kraynak

Nature provides a host of effective cures and treatments for common ailments, but does it serve up anything for bipolar disorder? Medical research suggests that some of the supplements listed here may provide benefits to people with bipolar disorder:

  • Coenzyme Q10: This substance plays a key role in energy metabolism within cells, which may be disrupted in bipolar disorder. One very small study showed some antidepressant effect to high doses of Coenzyme Q10 in elderly patients with depression. More research is needed.

  • 5-HTP: This supplement provides your body with the building blocks it needs to assemble serotonin (a key mood-related neurotransmitter), and some studies suggest that 5-HTP is helpful in enhancing mood, decreasing anxiety, and improving sleep. The studies aren’t strong or consistent. Potential risks include inducing serotonin syndrome — a potentially deadly effect of very high serotonin levels in the body — if combined with antidepressants such as SSRIs or MAOIs. This risk seems to be low, but talk to your prescriber before taking this in addition to an antidepressant.

  • GABA: GABA (gamma-aminobutyric acid) has been touted as a treatment for mood disorders because it’s a neurotransmitter related to depression, anxiety, and mania. However, GABA taken as an oral supplement doesn’t cross the blood-brain barrier, so it’s useless. This particular “natural” cure is a fraud.

  • Glutathione: Glutathione, one of the most common antioxidants in the human body, may reduce oxidative stress (literally, cell damage), which may be related to bipolar disorder. Glutathione also modulates the effects of glutamate, another important mood-regulating neurotransmitter. Taken orally, glutathione doesn’t significantly raise the levels in the brain, but you can raise glutathione levels by taking N-acetyl cysteine, as explained later in this list.

  • Inositol: This chemical plays an important role in the messenger systems within cells and has long been discussed as having a relationship to manic and depressive symptoms. Lithium and valproic acid, both used to treat bipolar disorder, help to stabilize inositol signaling in cells. Some studies support the use of inositol as an add-on medicine in bipolar depression that hasn’t responded fully to typical medications. It can potentially trigger manic symptoms. Pregnant women shouldn’t use it because it may trigger uterine contractions.

  • Kava: This plant/herbal product purportedly reduces stress and anxiety, but some reports link it to liver damage. As a result, it’s banned in many places. Don’t use kava without a doctor’s permission and supervision.

  • Melatonin: Melatonin is a hormone that the brain produces in response to light and dark; it’s part of the body’s sleep/wake machinery. Supplements may reduce insomnia for sufferers of some types of sleep problems. Melatonin is safe for short-term use, even in children. But check with your doctor before you use melatonin, because it can interact with some psychiatric medications.

  • N-acetyl cysteine (NAC): This chemical is part of the system that produces glutathione (mentioned earlier in this list), which is important as an antioxidant (helping cells recover from various kinds of stress and damage) and as a key factor in the glutamate receptor system, helping to regulate how glutamate communicates between cells. A number of studies have found NAC supplementation to have some benefit in bipolar depression. It takes a long time (several months) to show benefit, and the effect wears off quickly after stopping the supplement. But this chemical may be an important building block of next-generation treatments for bipolar disorder and other psychiatric illness.

  • SAMe: Short for S-adenosylmethionine, SAMe is a natural substance found in your body that has been proved to function effectively as an antidepressant in some studies, but inadequate data are available to support its regular use as an antidepressant. Some research also supports using SAMe along with a traditional antidepressant when the antidepressant isn’t effective enough. SAMe carries the risk of side effects similar to those of antidepressants, so consult your doctor before trying it. Another drawback: It isn’t cheap.

  • St. John’s wort: Reviews of medical literature suggest that St. John’s wort (a medicinal herb called hypericum) is effective in treating mild to moderate unipolar depression, but inconsistencies in the data remain. Some doctors continue to recommend it, particularly in Germany, and some people with depression continue to sing its praises. Be careful, though; like most antidepressants, St. John’s wort may carry the risk of inducing mania. It can also interact with a number of meds.

  • Taurine: Taurine is one of the most abundant amino acids in the brain. It increases activity at GABA receptors. Studies in animals have shown little, if any, support for its use in anxiety and depression. Taurine is found in all of the so-called energy drinks but has been poorly studied in humans. Taken in very high doses on a frequent basis it may carry some risk of toxic effects in the brain.

  • Valerian: Valerian is an herb commonly marketed for the treatment of insomnia. Although studies are currently deemed inconclusive, some report positive results. Valerian appears to be relatively safe, but be cautious, especially if you’re pregnant, nursing, or taking other meds.

Before ingesting any of these natural substances, check with your doctor and do your own research. A reliable information source is the National Institutes of Health’s Office of Dietary Supplements.