Note: The U.S. Food and Drug Administration (FDA) does not approve supplements for safety or effectiveness. Talk to a healthcare professional about whether a supplement is the right fit for your individual health, and about any potential drug interactions or safety concerns.
Medications and psychotherapy are the standard treatments for bipolar disorder — a mental health condition characterized by episodes of highs (mania) and lows (depression). But if you have bipolar disorder, you may wonder if taking vitamins or other supplements can improve your mood and boost your health, too.
“While nutritional and supplement-based strategies are an exciting frontier, they should be viewed as complementary tools within a comprehensive treatment plan, says Zishan Khan, MD, a board-certified psychiatrist based in Frisco, Texas, and the regional medical director of Mindpath Health, an independent provider of outpatient mental healthcare services.
“It's critical for patients to consult with a qualified mental health professional before starting any supplement, as interactions with psychiatric medications or underlying medical conditions may pose risks,” Dr. Khan adds.
Here’s what you should know if you’re interested in trying supplements to help with bipolar disorder.
“The body of research on using vitamins and minerals as adjunctive treatments for bipolar disorder has grown in recent years, but it remains limited and inconclusive,” says Khan. “This is primarily because much of the data comes from small studies, short durations, or specific subgroups, and often the results are inconsistent or lack replication.”
The review also notes that the studies that do exist offer “promising, albeit conflicting, evidence” for the efficacy of various supplements, particularly in treating the depressive phase of bipolar disorder, but the evidence remains preliminary.
Khan agrees, adding that these encouraging preliminary findings highlight the need for large-scale, disorder-specific, randomized clinical trials.
Some vitamins and supplements have more evidence of their effectiveness for bipolar disorder than others. Here are seven options that may be worth considering, according to experts. Be sure to talk to your doctor before adding any supplement to your treatment plan.
1. Omega-3 Fatty Acids
Omega-3 fatty acids are healthy fats that your body needs to function at its best. They’re beneficial for heart and brain health.
Foods or supplements containing omega-3 fatty acids appear to improve bipolar symptoms in people who consume them, according to a systematic review of 33 studies related to nutrition and bipolar disorder.
“This review highlights some encouraging data,” says Khan. “However, many of the trials cited suffer from small sample sizes, short durations, and lack of replication.”
The current research suggests that people with bipolar depression (instead of mania) and those with low omega-3 levels could benefit the most from supplementation, says Khan. But differences in dosing and the variety of patient populations studied (such as bipolar I vs. bipolar II, two different subtypes of the disorder) make it difficult to pinpoint exactly who would benefit the most from omega-3 supplements.
“Until more conclusive research is available, omega-3s may be safely considered as adjunctive treatment, especially in those with low dietary intake or depressive symptoms, but should not completely replace standard psychiatric care,” says Khan.
2. Folate (Vitamin B9)
Folate (vitamin B9) helps your cells grow and stay healthy. The synthetic form of folate, called folic acid, is used in supplements.
Overall, there’s limited research related to B vitamins like folate and bipolar disorder. One study found an association between low levels of folic acid and bipolar disorder.
In a review, investigators reported that 3 milligram (mg) folate supplements were effective and safe when used with medication to treat mania among people with bipolar I disorder, which is a subtype of bipolar disorder that involves manic episodes and and sometimes depressive episodes.
More research with longer follow-up is needed to confirm these findings, the review notes. Khan agrees, citing the need for studies with larger sample sizes and durations.
A recent randomized controlled trial also supported the short‐term use of folate as a beneficial additional medication in treating acute manic episodes in bipolar I disorder, noting that further research is needed. Khan also emphasizes the importance of studying more people over longer periods of time to get clearer, more reliable results.
Additionally, taking folate supplements as a complement to traditional bipolar disorder treatment appears to be significantly better than taking a placebo for depressive symptoms among people with either bipolar disorder or major depressive disorder (MDD), according to a systematic review of studies on folate for mental health conditions.
Ultimately, for those with bipolar disorder, confirmed folate deficiency, or gene variations, supplementation may be considered, ideally under close supervision from an experienced healthcare provider, says Khan. “However, more targeted research is needed before routine use is advised,” he explains.
3. N-Acetyl Cysteine (NAC)
N-acetyl cysteine (NAC) is an antioxidant that may help prevent cancer and is often used to treat acetaminophen poisoning.
Some studies have shown no benefits of NAC supplements for bipolar disorder. But a review of six clinical trials suggested that taking NAC supplements in addition to standard treatments for bipolar depression was better than placebo. Larger studies are needed to confirm these results, the researchers wrote.
According to Khan, these studies have several strengths, including moderate sample sizes, randomized-controlled designs (the gold standard for research), and longer study durations. However, he says results are mixed and the exact way NAC works still isn’t fully understood, so more research is needed.
“NAC appears to be safe and potentially beneficial as an adjunct to standard treatments, particularly for bipolar depression,” says Khan. “However, it too should be used with realistic expectations and not as a primary treatment strategy.”
4. Vitamin D
Vitamin D helps your gut absorb calcium and maintain appropriate calcium levels for bone health. It’s found naturally in foods such as trout and salmon, added to foods like milk, and produced naturally in the body when your skin is exposed to the sun’s rays.
A recent meta-analysis found that Vitamin D supplementation has a benefit of improving depressive symptoms in adults with major depressive disorder, but the effect was only seen in adults with higher baseline vitamin D levels, and more research is needed. It’s not clear whether the findings might apply to bipolar disorder as well as major depressive disorder.
“The evidence is not consistent in quality with heterogeneity in study size, population, and design,” says Hamilton Gaiani, MD, double-board-certified psychiatrist and chief medical officer of Firepit Health in New Haven, Connecticut. This makes it harder to understand the potential benefits of vitamin D supplements, he explains.
What does that mean for you? “Patients should be screened for vitamin D status before supplementation, and supplementation should be used as a complement to other standard treatments, not a replacement,” says Dr. Gaiani.
Vitamin D is fat soluble, which means it’s stored in the body’s fatty tissues and liver, and can build up in the body, thus the level can become toxic. It should never be taken without instruction and monitoring by a physician.
5. Coenzyme Q10 (CoQ10)
Coenzyme Q10 (CoQ10) is an antioxidant that helps keep the cells in your body healthy.
In a clinical trial, 200 mg of CoQ10 per day, taken alongside standard mood stabilizers and antidepressant medication, was better than placebo at reducing bipolar depression over eight weeks.
The study authors theorized that CoQ10 may benefit bipolar depression because of its antioxidant and anti-inflammatory properties. Previous research has shown that inflammation may play a role in the development of bipolar depression, they noted.
This research is limited, but promising, says Gaiani. “The sample sizes are small, and larger studies are needed to establish its effectiveness.”
While there are hints that CoQ10 is neuroprotective, it should only be taken under medical supervision as a complement to standard treatment, he says.
6. Magnesium
Magnesium is a mineral that your body needs to keep your muscles, bones, nerves, blood pressure, and blood sugar levels healthy.
Research suggests that magnesium levels are lowered in the course of several mental disorders, especially depression, notes one systematic review of 32 studies.
The review also found that supplementation with magnesium could potentially be beneficial in treating depression, but notes that more research is necessary, including larger and more homogeneous studies. It’s also not clear whether magnesium supplements could be as helpful for bipolar depression as they could be for major depressive disorder.
Another systematic review also found that magnesium supplementation can have a beneficial effect on depression, but notes that future high-quality randomized controlled trials with larger sample sizes are necessary.
Gaiani emphasizes the need for larger studies to determine whether these benefits hold up across broader populations.
“While the evidence is inconsistent, repeated positive findings in small studies suggest that it may be helpful as an adjunct,” he says. “As a relatively low-risk medication, magnesium supplementation is generally a safe adjunct to treatment, especially in the case of deficiency.”
7. Melatonin
Melatonin is a hormone that the brain makes in response to darkness, sending important signals to your body that it’s time to sleep.Melatonin supplements are most often used as a sleep aid.
Up to 70 percent of people with bipolar disorder experience insomnia. One article suggests that there is scientific justification to propose taking melatonin (as a complement to the standard treatments for bipolar disorder) in order to treat sleep disorders in bipolar disorder. The article also notes that doing so could possibly prevent relapses in bipolar disorder, as sleep problems can be a sign of a forthcoming mood episode.
Gaiani agrees that research suggests melatonin may be useful for improving sleep quality and addressing the circadian rhythm disruptions often seen in bipolar disorder. However, he notes that its evidence for treating core mood symptoms is weaker.
Another systematic review notes that there are few studies examining drug interventions for sleep disturbance in bipolar disorder, and suggests that melatonin may be a promising candidate to treat the manic stage of bipolar depression in conjunction with standard treatments. But studies with larger sample sizes are needed, according to the review’s authors.
Furthermore, because these findings are mixed, melatonin must be used with caution, particularly in the manic state, because it might not be ideal for all patients, says Gaiani. “It is useful in improving sleep hygiene, but must always be started under the psychiatrist's supervision,” he explains.
Food is generally the best source of vitamins, since nutrients from whole foods are often more easily absorbed by the body than supplements. Supplements can also come with downsides: They may not always contain what the label claims and can interact with medications.
Moreover, the U.S. Food and Drug Administration (FDA) doesn’t have the authority to regulate the safety or effectiveness of vitamins and supplements, which means it’s hard to know whether a product is high-quality.
To choose a quality supplement, check the label for USP, NSF, or ConsumerLabs Approved. This means the product has undergone third-party testing for quality and purity.
While supplements may be helpful in certain cases, they should always support, not replace, standard treatments. Be sure to talk to your doctor before taking any supplements for bipolar disorder.
Supplements and vitamins may help people with bipolar disorder, but they aren't a replacement for medical treatment, and more research is still needed about how effective they are, even as complementary therapies.
Some research suggests omega-3s may benefit some people with bipolar depression; folate may help treat bipolar mania and depression; NAC may help with bipolar depression; and magnesium and vitamin D may be useful for people with deficiencies. Melatonin may also help with sleep disturbances among people who have bipolar disorder.
Eating vitamin-rich foods can be a better solution than taking vitamins or supplements as they're more easily absorbed by the body.
Talk to your doctor before you take any supplements to ensure they safely enhance your current management plan for bipolar disorder.
