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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Lao Tzu on June 7, 2008, at 18:03:59
Probably it's too soon to say whether N-acetyl-cysteine works for bipolar. It's only been about 2 and 1/5 weeks since I started. Could be working a little. I'm also taking such a low dose of acetyl-l-carnitine that I don't think that's it. I'm taking 1200mg of NAC per day and I think this may be helping, slowly but surely.
I've noticed that I tend to run low on energy in the afternoon, so I typically take some B1 and 1,000mg of Vitamin C. I've also just added 300mg of NAC with these in the afternoon, which seems to help me stay in a more positive state of mind. Today, I took 1 capsule of fish oil in the morning, which balances my mood, but I can't take more than 1 capsule in a day or I feel lethargic. So today, I thought, hmm, I have some Evening Primrose Oil and many sources say it is good to balance your Omega-3s and Omega-6s. EPO contains gamma-linoleic acid which is an omega-6 essential fatty acid. I actually took 2 capsules and that seemed a bit much because I've discovered that EPO can be somewhat energizing. So then I took my 300mg NAC (afternoon dose) after the EPO and I felt better, not too energized but not lethargic either. Could be a fluke, don't know yet, but I'm thinking that if you want a little more energy, EPO might be the way to go in addition to fish oils because I've found that my energy goes down whenever I take fish oils. The only thing I would suggest is not to take EPO and fish oil at the same time because I heard that they will compete for uptake in your tissues. So what I do is this: I take my B1, B5, vitamin C, NAC and acetyl-l-carnitine in the morning. I wait awhile to see if I'm moody and really need to take the fish oil. This seems to go well until the early afternoon when I have to take more B1 and vitamin C. I figure that's a good time to try a little EPO, then wait maybe a couple hours and then take my afternoon dose of NAC.
Note that I only take 300mg of NAC at any one time during the day because 600mg seems too much. I'm still getting 600mg during the day, just breaking it up into 300mg morning and afternoon. And then at bedtime I take an additional 600mg of NAC because I don't really care how it feels because I'm going to bed and would welcome anything that knocks me out.
Maybe as I start getting used to the ALCAR and NAC, I will be able to increase my dosages, but so far I would say the regimen is pretty good. I've learned you can't expect perfection from supplements, but I'll take pretty good. :)
Posted by llurpsienoodle on June 7, 2008, at 22:00:06
In reply to NAC and Essential oils for Bipolar, posted by Lao Tzu on June 7, 2008, at 18:03:59
> Today, I took 1 capsule of fish oil in the morning, which balances my mood, but I can't take more than 1 capsule in a day or I feel lethargic. So today, I thought, hmm, I have some Evening Primrose Oil and many sources say it is good to balance your Omega-3s and Omega-6s. EPO contains gamma-linoleic acid which is an omega-6 essential fatty acid. I actually took 2 capsules and that seemed a bit much because I've discovered that EPO can be somewhat energizing. So then I took my 300mg NAC (afternoon dose) after the EPO and I felt better, not too energized but not lethargic either. Could be a fluke, don't know yet, but I'm thinking that if you want a little more energy, EPO might be the way to go in addition to fish oils because I've found that my energy goes down whenever I take fish oils. The only thing I would suggest is not to take EPO and fish oil at the same time because I heard that they will compete for uptake in your tissues.
hi L-Tz,
I started taking my supplements again about 2 weeks ago. I've been feeling pretty good (but not hypomanic good either). My only complaint is that I continue to wake up at 3-4 am and feel alert and rested. Then I try to stay awake and crash an hour later. I've been taking 2400mg fish oil and 1200 mg EPO at the same time (evening), but maybe it would be better if I split it and make the evenings fishy and the mornings primrosy.Thanks for the idea,
-Ll
Posted by Lao Tzu on June 7, 2008, at 22:59:08
In reply to Re: NAC and Essential oils for Bipolar » Lao Tzu, posted by llurpsienoodle on June 7, 2008, at 22:00:06
That's funny! Evenings fishy and mornings primrosy. You know, that just might work. The main reason why I added the EPO is because it tends to give me a little more energy, and during the summer months, low energy is a big issue for me, especially when it's really hot like today. 100 F. Where would I be without my air conditioning? I'm sensitive to the heat.
As far as waking up very early this happens to me once in a while, but since spring began I've been more or less waking up about the same time each morning and then staying up all day until about 9:30-10:00 PM when I take my vitamin E, B6, B3, and melatonin. Before I started taking vitamin E in the evening, I wouldn't fall asleep until 1, 2 or 3 am, then wake up anywhere from 10 -12 in the afternoon, so definitely, my sleep cycle is more normal than it was, and I keep saying it's the vitamin E that made it possible, but I don't know for sure. I'm thinking that the change of seasons causes alterations in mood and maybe sleep cycles. It could be that I might start having sleep difficulties again when the winter comes, and only then could I say it really wasn't the vitamin E that helped me sleep. I think I read somewhere that some bipolars cycle more in the spring/summer than in winter. Having frequent hypomanic episodes would probably affect sleep patterns.
I was thinking also that maybe taking all your fish oil and primrose oil in the evening may be affecting your sleep. It's possible. The wisdom I give is that you must seek a regimen of supplements that balances both mood and energy, and if you are feeling too stimulated or irritable or lethargic and moody, then you haven't found the right combination of supplements. If you can balance mood and energy somewhat, you might find your sleep cycles normalize themselves. That's why I say vitamin E is probably the best supplement I've ever taken.
Posted by SLS on July 4, 2008, at 5:32:41
In reply to NAC and Essential oils for Bipolar, posted by Lao Tzu on June 7, 2008, at 18:03:59
1: Biol Psychiatry. 2008 Jun 4. [Epub ahead of print]Click here to read Links
N-Acetyl Cysteine for Depressive Symptoms in Bipolar Disorder-A Double-Blind Randomized Placebo-Controlled Trial.
Berk M, Copolov DL, Dean O, Lu K, Jeavons S, Schapkaitz I, Anderson-Hunt M, Bush AI.The Mental Health Research Institute of VictoriaVictoria, Australia; Department of Clinical and Biomedical SciencesThe University of Melbourne, Geelong, Australia; Orygen Youth HealthMelbourne, Australia.
BACKGROUND: Treatment-resistant subthreshold depression is a major problem in bipolar disorder. Both depression and bipolar disorder are complicated by glutathione depletion. We hypothesized that treatment with N-acetyl cysteine (NAC), a safe, orally bioavailable precursor of glutathione, may improve the depressive component of bipolar disorder. METHODS: A randomized, double-blind, multicenter, placebo-controlled study of individuals (n = 75) with bipolar disorder in the maintenance phase treated with NAC (1 g twice daily) adjunctive to usual medication over 24 weeks, with a 4-week washout. The two primary outcomes were the Montgomery Asberg Depression Rating Scale (MADRS) and time to a mood episode. Secondary outcomes included the Bipolar Depression Rating Scale and 11 other ratings of clinical status, quality of life, and functioning. RESULTS: NAC treatment caused a significant improvement on the MADRS (least squares mean difference [95% confidence interval]: -8.05 [-13.16, -2.95], p = .002) and most secondary scales at end point. Benefit was evident by 8 weeks on the Global Assessment of Functioning Scale and Social and Occupational Functioning Assessment Scale and at 20 weeks on the MADRS. Improvements were lost after washout. There was no effect of NAC on time to a mood episode (log-rank test: p = .968) and no significant between-group differences in adverse events. Effect sizes at end point were medium to high for improvements in MADRS and 9 of the 12 secondary readouts. CONCLUSIONS: NAC appears a safe and effective augmentation strategy for depressive symptoms in bipolar disorder.
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