Condition
Bipolar Disorder
Bipolar disorder is a mood condition in which a person swings between depressive episodes and episodes of mania or milder hypomania, involving changes in brain circuits that regulate mood and energy. Among supplements, the evidence is strongest for fish oil rich in EPA, and five small trials found bipolar symptoms improved. Those trials included only about 260 people, and studies of inositol and CDP-choline found no clear difference, though each was very small.
Sources: PMID 16814257; PMID 15465995
- Supplements studied
- 8
- Graded outcomes
- 9
- Trials
- 12
- People studied
- 1,915
Evidence by supplement
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms Moderate Improvement | Improves (the measure goes down) | Moderate effect | 5 studies | 60 people | ||
Studies that measured anxiety symptoms | ||||||
| Bipolar Disorder Symptoms | Improves (the measure goes down) | 1 study | 60 people | |||
Studies that measured bipolar disorder symptoms | ||||||
| Attention | Improves (the measure goes up) | 60 people | ||||
| Depression Symptoms | Improves (the measure goes down) | 60 people | ||||
| Executive Function | Improves (the measure goes up) | 60 people | ||||
| Memory | Improves (the measure goes up) | 60 people | ||||
| Processing Accuracy | Improves (the measure goes up) | 60 people | ||||
| Processing Speed | Improves (the measure goes up) | 60 people | ||||
Coenzyme Q10
- Anti-Oxidant Enzyme Profile: improves
- Oxidative Stress Biomarkers: improves
- Depression Symptoms: improves
Chromium
- Bipolar Disorder Symptoms: improves
- Depression Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bipolar Disorder Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 30 people | |||
| Depression Symptoms | Improves (the measure goes down) | 4 studies | 30 people | |||
Studies that measured depression symptoms
| ||||||
Uridine
- Bipolar Disorder Symptoms: improves
- Depression Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bipolar Disorder Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 7 people | |||
| Depression Symptoms Small Improvement | Improves (the measure goes down) | Small effect | 7 people |
CDP-Choline
- Bipolar Disorder Symptoms
- Cocaine Addiction Symptoms: changes; see studies
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bipolar Disorder Symptoms No significant effect on bipolar symptoms | NoneNo effect | 1 study | 44 people | |||
Studies that measured bipolar disorder symptoms | ||||||
| Cocaine Addiction Symptoms | Changes; see studies | 1 study | 44 people | |||
Studies that measured cocaine addiction symptoms | ||||||
Inositol
- Bipolar Disorder Symptoms
- Depression Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Bipolar Disorder Symptoms No effect | NoneNo effect | 1 study | 24 people | |||
Studies that measured bipolar disorder symptoms | ||||||
| Depression Symptoms | Improves (the measure goes down) | 5 studies | 24 people | |||
Studies that measured depression symptoms | ||||||
N-Acetylcysteine
- Anxiety Symptoms
- Depression Symptoms: improves
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms No effect | NoneNo effect | 315 people | ||||
| Depression Symptoms | Improves (the measure goes down) | 4 studies | 335 people | |||
Studies that measured depression symptoms
| ||||||
Key findings
- Bipolar Disorder SymptomsImproves (the measure goes down)
- Anxiety SymptomsImproves (the measure goes down)
- Anti-Oxidant Enzyme ProfileImproves (the measure goes up)
The Bipolar Disorder Nutritional Support protocol
2 primary supplements · 6 supporting supplements
- Omega-3 Fatty Acids (High EPA)1–2 g EPA daily (total omega-3: 2–4 g)
- N-Acetylcysteine (NAC)1,000–2,000 mg twice daily
Studies cited
100 studies from PubMed
- Effects of Coenzyme Q10 Supplementation on Depressive Symptoms and Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
- Effects of Withania somnifera supplementation on cognitive function: A systematic review and meta-analysis
- Effects of Ashwagandha (Withania somnifera) Supplementation on Exercise Performance: A Systematic Review and Meta-Analysis
- Ashwagandha (Withania somnifera) and its withanolides attenuate oxidative and inflammatory signaling in the nervous system
- Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis of randomized controlled trials
- Clinical effects of Ashwagandha (Withania somnifera) root extract on human health: A systematic review of reviews
- A Comprehensive Review on Pharmacological Activity of Withania somnifera (Ashwagandha)
- Effects of Ashwagandha (Withania somnifera) on Testosterone Levels: A Systematic Review and Meta-Analysis
- Ashwagandha (Withania somnifera)-Current Research on the Health-Promoting Activities: A Narrative Review
- Withania somnifera (L.) Dunal: A review of chemical composition and pharmacological activities
- Efficacy of Ashwagandha (Withania somnifera) in Improving Cardiorespiratory Endurance and Recovery in Healthy Athletic Adults: A Systematic Review
- Safety of Ashwagandha Root Extract: A Randomized, Placebo-Controlled, Study in Healthy Volunteers
- Examining the Neuroprotective Effects of Ashwagandha: Brain-Derived Neurotrophic Factor in Rats
- Chromium in PCOS: A Systematic Review and Meta-Analysis
- Chromium Supplementation and Metabolic Diseases: Evidence from Clinical Trials
- Effects of Chromium Supplementation on Body Composition: A Systematic Review
- Safety of Chromium Supplementation: Evidence from Clinical Studies
- Myo-Inositol in Patients with PCOS: A Systematic Review and Meta-Analysis
- Myo-Inositol and D-Chiro-Inositol in PCOS Treatment: A Meta-Analysis
- Inositol and Insulin Resistance: Mechanisms and Clinical Evidence
- Inositol and Depression: A Systematic Review
- Effects of Chromium Supplementation on Glucose Metabolism and Lipids: A Systematic Review and Meta-Analysis
- Chromium and Insulin Sensitivity: A Review of Mechanisms
- Chromium Supplementation in Depression and Mood Disorders: A Review
- Chromium Supplementation and Glycemic Control in Diabetes: An Updated Review
- Inositol and PCOS: A Comprehensive Review of Clinical Evidence
- Inositol in Anxiety Disorders: A Systematic Review
- Myo-Inositol in Gestational Diabetes: A Meta-Analysis
- Inositol and Fertility: A Comprehensive Review
- Safety and Efficacy of Inositol in Clinical Practice: A Review
- Chromium Picolinate in Type 2 Diabetes: A Meta-Analysis of Randomized Trials
- Chromium Effects on Blood Pressure: A Meta-Analysis
- Inositol Effects on Metabolic Syndrome: A Systematic Review
- Evaluation of antioxidant potential of Rasayana drugs in healthy human volunteers
- An Overview on Ashwagandha: A Rasayana (Rejuvenator) of Ayurveda
- Effects of acute chromium supplementation on postprandial metabolism in healthy young men
- The effects of inorganic chromium and brewer's yeast on glucose tolerance, plasma lipids, and plasma chromium in elderly subjects
- Effects of resistance training and chromium picolinate on body composition and skeletal muscle in older men
- Effects of Withania somnifera in patients of schizophrenia: A randomized, double blind, placebo controlled pilot trial study
- Adjunctive Use of a Standardized Extract of Withania somnifera (Ashwagandha) to Treat Symptom Exacerbation in Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Study
- Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial
- Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers
- Effects of an Aqueous Extract of Withania somnifera on Strength Training Adaptations and Recovery: The STAR Trial
- Effects of eight-week supplementation of Ashwagandha on cardiorespiratory endurance in elite Indian cyclists
- Effects of Ashwagandha ( Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis
- Body Weight Management in Adults Under Chronic Stress Through Treatment With Ashwagandha Root Extract: A Double-Blind, Randomized, Placebo-Controlled Trial
- Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta-analysis of randomized controlled trials
- A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults
- Adaptogenic and Anxiolytic Effects of Ashwagandha Root Extract in Healthy Adults: A Double-blind, Randomized, Placebo-controlled Clinical Study
- Efficacy of Withania somnifera on seminal plasma metabolites of infertile males: a proton NMR study at 800 MHz
- Withania somnifera Improves Semen Quality in Stress-Related Male Fertility
- Withania somnifera improves semen quality by regulating reproductive hormone levels and oxidative stress in seminal plasma of infertile males
- Clinical Evaluation of the Spermatogenic Activity of the Root Extract of Ashwagandha (Withania somnifera) in Oligospermic Males: A Pilot Study
- Comparative evaluation of the effects of Withania somnifera with pentoxifylline on the sperm parameters in idiopathic male infertility: A triple-blind randomised clinical trial
- A double-blind, placebo-controlled evaluation of the anxiolytic efficacy ff an ethanolic extract of withania somnifera
- Naturopathic care for anxiety: a randomized controlled trial ISRCTN78958974
- Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis.
- Randomized placebo-controlled adjunctive study of an extract of withania somnifera for cognitive dysfunction in bipolar disorder
- Efficacy and Safety of Ashwagandha (Withania somnifera (L.) Dunal) Root Extract in Improving Memory and Cognitive Functions
- Effect of standardized aqueous extract of Withania somnifera on tests of cognitive and psychomotor performance in healthy human participants
- A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha ( Withania somnifera) in Aging, Overweight Males
- Efficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunction
- Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial
- An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study
- In vivo effects of Ashwagandha (Withania somnifera) extract on the activation of lymphocytes
- Evaluation of the efficacy of Withania somnifera (Ashwagandha) root extract in patients with obsessive-compulsive disorder: A randomized double-blind placebo-controlled trial
- Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study
- Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Improving Sexual Function in Women: A Pilot Study
- A randomized, double blind placebo controlled study of efficacy and tolerability of Withaina somnifera extracts in knee joint pain
- Hypoglycemic, diuretic and hypocholesterolemic effect of winter cherry (Withania somnifera, Dunal) root
- Efficacy of Ashwagandha (Withania somnifera [L.] Dunal) in improving cardiorespiratory endurance in healthy athletic adults
- Effect of Withania somnifera (Ashwagandha) on the development of chemotherapy-induced fatigue and quality of life in breast cancer patients
- Evidence of the neuroprotective role of citicoline in glaucoma patients
- A randomized, placebo-controlled trial of citicoline add-on therapy in outpatients with bipolar disorder and cocaine dependence
- Effects of daily treatment with citicoline: a double-blind, placebo-controlled study in cocaine-dependent volunteers
- Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods
- Citicoline improves memory performance in elderly subjects
- Citicoline improves verbal memory in aging
- Effects of chromium supplementation on glycogen synthesis after high-intensity exercise
- Effects of short-term chromium supplementation on insulin sensitivity and body composition in overweight children: randomized, double-blind, placebo-controlled study
- Chromium picolinate supplementation in women: effects on body weight, composition, and iron status
- Effect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and women
- A pilot study of chromium picolinate for weight loss
- Chromium supplementation and polycystic ovary syndrome: A systematic review and meta-analysis
- The Effects of Chromium Supplementation on Endocrine Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial
- Chromium picolinate improves insulin sensitivity in obese subjects with polycystic ovary syndrome
- The effect of chromium intake on oxidative stress parameters: A systematic review and meta-analysis.
- Effect of chromium supplementation on hs-CRP, TNF-α and IL-6 as risk factor for cardiovascular diseases: A meta-analysis of randomized-controlled trials.
- Chromium Supplementation and the Effects on Metabolic Status in Women with Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial
- Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes
- Chromium treatment has no effect in patients with type 2 diabetes in a Western population: a randomized, double-blind, placebo-controlled trial
- Effects of chromium brewer's yeast supplementation on body mass, blood carbohydrates, and lipids and minerals in type 2 diabetic patients
- The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial
- Antioxidant effects and insulin resistance improvement of chromium combined with vitamin C and e supplementation for type 2 diabetes mellitus
- Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance
- Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus
- Chromium supplementation shortens QTc interval duration in patients with type 2 diabetes mellitus
- Role of chromium supplementation in Indians with type 2 diabetes mellitus
- Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese Western population: a randomized, double-blind, placebo-controlled trial