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Bipolar disorder is notoriously difficult to treat, but a new natural therapy holds promise for treating the condition in children.

Nearly every child occasionally exhibits "unusual" behavior. And nearly every teen sometimes exhibits extreme "moodiness." A certain amount of emotional distress is normal for growing up. However, some children and teens experience predictable, although not necessarily manageable, patterns of emotional highs and lows that are diagnosed as bipolar disorder.

The problem with treating bipolar disorder is that the medications that treat depression aggravate the hypomanic phase and the medications that treat the hypomanic phase aggravate the depressive phase.

Drugs designed to relieve ups can cause painfully dark and depressing downs and drugs designed to relieve downs can cause uncontrollable ups. However, a combination of two well-known, readily available, inexpensive, and generally side effect free supplements may relieve symptoms in children.

Dr. Joseph Biederman, a doctor of medicine, director of the Pediatric Psychopharmacology Unit at Massachusetts General Hospital in Boston, recently presented finding of a study of omega-3 essential fatty acids from fish oil and a plant-based supplement called inositol in the treatment of bipolar disorder in patients aged 6 to 12 at the American Society of Clinical Psychopharmacology (ASCP) 2014 Annual Meeting. 

"The effects that we saw with these products, particularly the combination of high EPA omega-3 fatty acids plus inositol, were comparable to the effects that we are accustomed to seeing with more toxic drugs. It was quite surprising and quite impressive," Dr. Biederman told reporters attending the meeting.

Biederman and his colleagues conducted a study with 24 children aged 6 to 12 years who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for bipolar spectrum disorder. All of the children were given two kinds of "pills" every day. Seven children were given 3000 mg of fish containing eicosapentaenoic acid and docosahexaenoic acid (EPA and DHA) every day and a placebo. Seven children were given 2000 mg of inositol and a placebo every day. Ten children were given both 3000 mg of fish oil and 2000 mg of inositol every day. Children who weighed less than 25 kilos (55 pounds) were given reduced doses.  The experiment was conducted for 12 weeks.

At the end of the three months of the study, children who were given both supplements scored the greatest improvements on the Young Mania Rating Scale, and on the  Hamilton Rating Scale for Depression. There were no serious side effects from the supplements, although some children experienced minor gastrointestinal problems (flatulence, loose stools, or fishy burps) when taking fish oil. 

Side effects of conventional medications for bipolar disorder are much more severe.

Dr. Biederman admitted that neither he nor other researchers really know how these supplements work in bipolar disorder, just that they do. These products have not been studied enough that doctors know which children with bipolar disorder benefit most from the treatment, or whether the children get any special benefits or experience any special problems when taking them long-term. However, the absence of toxicity of fish oil and inositol make them very attractive. And when used separately, both products have a long track record of efficacy in treating both the ups and the downs of bipolar disorder.

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