Are Supplements a Viable Part of Bipolar Depression Treatment?

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It is highly common for patients to come to their mental health care providers with questions about incorporating nutritional supplements into their pharmacological regimen. There is widespread skepticism of psychotropics in the public opinion and many prefer natural products which seem more consistent with their values and beliefs about health. It doesn’t help that numerous television doctors promote supplements with minimal testing or only anecdotal support for their effectiveness.

Fish Oil PillsConsidering the wide variety of nutritional supplements and products available as close-by as your grocery store, or your internet connection, it is important for psychiatrists to be prepared and informed on the effectiveness of these supplements and be able to respond to any questions patients have. Patients with bipolar depression are especially likely to come to you with questions about the effectiveness of these supplements, as there are very few FDA-approved treatments for their ailment.

Jeffrey J. Rakofsky, MD, and his co-author Boadie W. Dunlop, MD, recently went through the most commonly suggested or promoted nutritional supplements for the treatment of bipolar depression. They went through all the randomized clinical trials of the supplements and evaluated their status and effectiveness.

The most surprising part of the findings are how contradictory they may seem. Omega-3-fatty acids were particularly complicated, ad they had the strongest evidence for efficacy, but some studies found no positive effects whatsoever. Meanwhile, vitamin C, widely “known” to offer relief had very weak evidence to support the claim.

You can view all of supplements Rakofsky and Dunlop evaluated in their analysis from Psychiatric Times, but in the end there was very little evidence to support the use of any supplements. It can be difficult to balance the small number of approved treatments for bipolar disorder with the patient’s need for relief. It is up to each psychiatrist to decide whether supplements may offer some support for their patients, but sadly much of the relief may only be the placebo effect.

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