Bipolar Disorder Supplements and Medication Interactions

For someone with bipolar disorder, finding the most effective bipolar medications is key for normalizing mood swings. Of course, it's important to take them as prescribed. And it's also important to be aware of what else you are taking when you do. Taking bipolar medications with over-the-counter herbs and natural supplements may be dangerous. Some herbs and supplements can render bipolar medication ineffective. In addition, these natural therapies may also cause more serious health problems.

Which bipolar medicines are commonly prescribed?

Lithium has been used for decades to treat manic depression, also known as bipolar disorder. Anticonvulsants are also prescribed for bipolar disorder. Common anticonvulsants include:

• valproic acid ( Depakote)
• carbamazepine ( Tegretol)
• lamotrigine ( Lamictal)
• oxcarbazepine ( Trileptal)

Newer, atypical antipsychotic drugs used to treat bipolar disorder include:

• olanzapine ( Zyprexa)
• quetiapine ( Seroquel)
• ziprasidone (Geodon)
• aripiprazole ( Abilify)

These drugs are generally given during the agitated state of mania or depression.

In addition, the doctor may prescribe an antidepressant, an antianxiety medication, or a sleep medication.

Is it safe to take herbs and supplements with bipolar medications?

Even though herbs and natural dietary supplements are sold over the counter, they are not 100% safe. For instance, some over-the-counter weight loss supplements contain ephedra. They have been known to produce symptoms consistent with bipolar mania. Those symptoms include extreme elation with reduced need for sleep.

Herbs and natural dietary supplements have not been tested or regulated by the FDA. So it's important to use caution when taking them. Most credible manufacturers list contraindications or warnings on the product label. But some manufacturers do not. When the wrong herb or supplement is taken with bipolar medications, there can be dangerous drug-herb interactions. The result of these interactions can include:

• bleeding
• high or low blood pressure
• organ liver damage
• rapid heart rate
• reduced delivery of the bipolar medications

Which herbs are unsafe when taken with bipolar medications?

The herb evening primrose oil may sometimes be unsafe when taken with some anticonvulsants. Lamictal, an anticonvulsant prescribed to treat bipolar disorder, is one. The herb ginkgo biloba -- taken by some to increase memory and attentiveness -- may reduce the effect of Depakote, another bipolar medication.

If you take the anticonvulsants Trileptal or Abilify for bipolar disorder, then avoid taking St. John's wort. St. John's wort is normally taken to boost mood with depression. There are reports that it may decrease the levels of Trileptal and Abilify in the blood. In addition, taking anticonvulsants with St. John's wort may also increase depression of the central nervous system.

St John's wort can also cause serotonin syndrome when it's taken with an SSRI antidepressant. Symptoms can include hallucinations, fluctuating blood pressure, nausea, and vomiting.

Patients who take anticonvulsants or anxiety medications such as Klonopin, Valium, Xanax, or Buspar should avoid the following herbs:

• valerian
• kava
• gotu kola

All three are known to cause sedation or drowsiness. Taking kava -- which causes a relaxed state -- with some anxiety medications may lead to a semi-comatose state.