Nutritional supplements are not drugs, nor do they need U.S. Food and Drug Administration approval. They are often marketed as having certain benefits, but since they aren’t required to meet the rigorous requirements of a drug approval, usually those benefits don’t need to have scientific proof. So such supplements do not offer any cure for a condition like bipolar disorder, and often provide few benefits.
Nutritional supplements that may be of help with certain symptoms associated with bipolar disorder or its treatment include:
- Lecithin (phosphatidyl choline). A phospholipid found mostly in high-fat foods. It is said to have the ability to improve memory and brain processes. Lecithin is necessary for normal brain development; however, double-blind studies of patients with Alzheimer’s disease did not substantiate claims that it can help people recover lost brain function. The ketogenic diet increases the amount of lecithin in the body, which may be one of the reasons for its success in some cases of hard-to-treat epilepsy. Some people with epilepsy have also reported reducing their number and severity of seizures from taking lecithin alone.
Some studies of lecithin-use by people with bipolar disorder indicate that it can stabilize mood, while others indicate that it tends to depress mood (and might therefore be more useful to a person who is manic or hypomanic). It does not appear to cause harm, and there are some logical reasons to think it might help–especially for patients who also have seizures. Lecithin capsules are available, but many people prefer the soft lecithin granules. These are a nice addition to fruit juice smoothies, adding a thicker texture. Lecithin is oil-based, and it gets rancid easily. It should be refrigerated.
- Choline. One of the active ingredients in lecithin. It is needed by the brain for processes related to memory, learning, and mental alertness, as well as for the manufacture of cell membranes and the neurotransmitter acetylcholine. Acetylcholine is involved in emotional control and other regulatory functions. Its effectiveness for bipolar symptoms is unknown.
- Inositol. Another active ingredient in lecithin. It is required by the neurotransmitters serotonin and acetylcholine, and may repair some types of nerve damage. Clinical studies indicate that inositol supplements may be helpful for some people with obsessive-compulsive disorder, depression, and panic disorder. Its effectiveness for bipolar symptoms is unknown.
- Taurine. An amino acid that appears to have antiseizure capabilities, and has gotten good reviews from some adults with bipolar disorders. It inhibits abnormal electrical activity in the brain, and is often found to be deficient in brain tissue where seizures have been occurring. Interestingly, rapid cyclers report the best results. Recommendations range from 500 to 1000 mg per day, divided into as many as three doses. Experts recommend buying only pharmaceutical-quality L-taurine from reputable manufacturers. Unusual EEG activity has been reported in patients using doses over 1000 mg per day.
- GABA. (gaba-amino butyric acid) An amino acid-like compound that acts like a neurotransmitter by inhibiting other neurotransmitters. A number of medications are under development that would affect GABA production or usage; some existing drugs that affect GABA, such as Gabapentin and Depakote, are used to treat manic depression. You should not take these medications with GABA supplements unless your physician recommends it and oversees the process. Supplementation with over-the-counter GABA is sometimes recommended for anxiety, nervous tension, and insomnia, especially insomnia associated with racing thoughts. If you experience shortness of breath, or tingling or numbness in your hands or feet when taking GABA, lower or discontinue this supplement.
- Tyrosine. An amino acid that serves as a precursor to the neurotransmitters norepinephrine and dopamine. It may help the body form more of these neurotransmitters, and is also believed to provide support for optimal thyroid gland function. Tyrosine can raise blood pressure, so talk to your child’s doctor about using it if your child takes other medications that affect blood pressure.
- Phenylalanine. An essential amino acid, as well as the precursor of tyrosine. It has an indirect effect of boosting production of norepinephrine and dopamine. Like tyrosine, phenylalanine can raise blood pressure.
- Methionine. An antioxidant amino acid that has been shown to be helpful for some individuals suffering from depression. It has an energizing effect–and as with SAME, below, that could precipitate mania in bipolar patients.
- SAME (S-adenosyl-methionine). A metabolite of methionine that is used to treat depression and arthritis in Europe. It became available in the US in early 1999. It is believed to affect dopamine and serotonin, and to have anti-inflammatory effects. However, it is not recommended for people with bipolar disorder, as it may cause mania.
As with using any vitamin or mineral supplement, you should be careful and check first with your doctor to ensure what you plan on taking isn’t going to interfere or interact with your existing medications. Some nutritional supplements may cause unintended and possibly harmful side effects when combined with certain medications. Check with your doctor first to be certain.