Adjunctive nutraceuticals with standard pharmacotherapies in bipolar disorder: a systematic review of clinical trials
Bipolar Disorders, 11/02/2011
Evidence Based Medicine
Sarris J et al. – Bipolar disorder (BD) treatment outcomes may potentially be improved by additional use of certain nutraceuticals with conventional pharmacotherapies. However, caution should be extended in interpreting the large effects of several isolated studies, as they have not yet been replicated in larger trials.Methods
- PubMed, CINAHL, Web of Science, and Cochrane Library databases, and grey literature were searched during mid–2010 for human clinical trials in English using nutraceuticals such as omega–3, N–acetyl cysteine (NAC), inositol, and vitamins and minerals, in combination with pharmacotherapies to treat bipolar mania and bipolar depression.
- In treating bipolar depression, positive evidence with large effect sizes were found for NAC (d = 1.04) and a chelated mineral and vitamin formula (d = 1.70).
- On the outcome of bipolar mania, several nutraceuticals reduced mania with strong clinical effects: a chelated mineral formula (d = 0.83), L–tryptophan (d = 1.47), magnesium (d = 1.44), folic acid (d = 0.40), and branched–chain amino acids (d = 1.60).
- Mixed, but mainly positive, evidence was found for omega–3 for bipolar depression, while no evidentiary support was found for use in mania.