Mood stabilizers are usually effective in treating acute mania. Treating bipolar depression, however, is often more challenging for two reasons:

• Antidepressants tend to be less effective in treating bipolar depression than in treating unipolar depression, especially in people who have the Bipolar I diagnosis (characterized by severe episodes of depression alternating with manic episodes).
• Antidepressants carry some risk of unmasking mania in people who are prone to it, especially people who have the Bipolar I diagnosis.

According to a recent press release entitled “New Study Finds that Add-On Therapy Improves Depressive Symptoms in Bipolar Disorder,” however, an over-the-counter (OTC) supplement called N-acetyl cysteine (NAC) may help. According to researchers who performed the study, individuals who experience depression or bipolar disorder experience a glutathione deficiency. NAC increases the levels of glutathione in the brain.

In the study, which is due to appear in the September 15th edition of Biological Psychiatry, Dr. Michael Berk and colleagues provided half of the study’s participants with NAC as an add-on therapy. Over the course of 24 weeks, they observed that there was a “marked and significant improvement in depressive symptoms” of those receiving the NAC as opposed to those who were given the placebo.

Additionally there were no significant side effects reported in the group taking NAC compared to the group taking a sugar pill. The study only looked at results for up to 20 weeks of treatment with NAC (20 weeks on NAC and 4 weeks after stopping it). The benefits were lost when the NAC was stopped.

The authors of the study are careful to point out that additional research is necessary to confirm the preliminary findings.

Caution: As always, we caution against self-medicating, even with over-the-counter medications and supplements. Discuss this option with the doctor in charge of managing your medications before adding it to your treatment regimen.

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    Last reviewed: 9 Sep 2008