Complementary and alternative treatments of bipolar disorder

A large percentage of individuals diagnosed with bipolar disorder use complementary and alternative approaches together with prescription medications however there is little evidence for the safety and efficacy of many CAM therapies. The most appropriate and effective treatment approach should be determined by the type and severity of symptoms—including depressed mood, mania or states involving ‘mixed’ depression and mania, psychotic symptoms, insomnia and agitation—the presence of other medical or psychiatric disorders, response to previous mainstream and CAM treatments, patient preferences and constraints on cost and availability of different treatments.

When prominent symptoms of anxiety, psychosis or agitation are present, effective integrative strategies should prioritize the treatment of those symptoms. For example, reasonable integrative approaches when managing an acutely manic patient who is agitated and extremely anxious include an initial loading dose of valproic acid or another conventional mood stabilizer, high potency benzodiazepines, an antipsychotic that is sedating at bedtime—preferably a newer second generation antipsychotic—and possibly also amino acids known to have calming or sedating effects, such as L-tryptophan, 5-HTP or L-theanine. In general, CAM therapies have limited effectiveness against the hypomanic or manic phase of bipolar disorder however select CAM therapies are beneficial for the depressive phase of the disorder, either alone or when used in combination with antidepressant medications.

To read more about safe and effective uses of natural supplements and other complementary and alternative treatments of bipolar disorder read “Bipolar Disorder: The Integrative Mental Health Solution,” by James Lake M.D.

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