Bipolar disorder and complementary medicine: current evidence, safety issues, and clinical considerations.
Study Goal
The researchers aimed to evaluate the effectiveness of N-Acetylcysteine as a complementary treatment for bipolar depression.
Results Summary
The study found provisional support for N-Acetylcysteine in treating bipolar depression, though evidence was based on isolated studies. The effect was noted in combination with conventional mood stabilizers and antipsychotic medications.
Population
Individuals with bipolar disorder (specifically bipolar depression).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
nutrients in combination with conventional mood stabilizers and antipsychotic medications | decrease | BD depression | human participants | - | positive high-quality studies | #1 |
branched-chain amino acids | decrease | mania | human participants | - | effective | #2 |
magnesium | decrease | mania | human participants | - | effective | #3 |
omega-3 | no change | bipolar depression | human participants | - | evidence was mixed | #4 |
multinutrient formula | decrease | bipolar depression | human participants | - | provisional support | #5 |
n-acetylcysteine | decrease | bipolar depression | human participants | - | provisional support | #6 |
l-tryptophan | decrease | bipolar depression | human participants | - | provisional support | #7 |
acupuncture | decrease | mania and depression outcomes | human participants | - | favorable but nonsignificant effects | #8 |
BACKGROUND: Bipolar disorder (BD) is a debilitating syndrome that is often undiagnosed and undertreated. Population surveys show that persons with BD often self-medicate with complementary and alternative medicine (CAM) or integrative therapies in spite of limited research evidence supporting their use. To date, no review has focused specifically on nonconventional treatments of BD. OBJECTIVES: The study objectives were to present a review of nonconventional (complementary and integrative) interventions examined in clinical trials on BD, and to offer provisional guidelines for the judicious integrative use of CAM in the management of BD. METHODS: PubMed, CINAHL,(®) Web of Science, and Cochrane Library databases were searched for human clinical trials in English during mid-2010 using Bipolar Disorder and CAM therapy and CAM medicine search terms. Effect sizes (Cohen's d) were also calculated where data were available. RESULTS: Several positive high-quality studies on nutrients in combination with conventional mood stabilizers and antipsychotic medications in BD depression were identified, while branched-chain amino acids and magnesium were effective (small studies) in attenuating mania in BD. In the treatment of bipolar depression, evidence was mixed regarding omega-3, while isolated studies provide provisional support for a multinutrient formula, n-acetylcysteine, and l-tryptophan. In one study, acupuncture was found to have favorable but nonsignificant effects on mania and depression outcomes. CONCLUSIONS: Current evidence supports the integrative treatment of BD using combinations of mood stabilizers and select nutrients. Other CAM or integrative modalities used to treat BD have not been adequately explored to date; however, some early findings are promising. Select CAM and integrative interventions add to established conventional treatment of BD and may be considered when formulating a treatment plan. It is hoped that the safety issues and clinical considerations addressed in this article may encourage the practice of safety-conscious and evidence-based integrative management of BD.