Bipolar Disorder

Pharmacotherapies for cannabis use disorder.

Spiga F, Parkhouse T, Tang VM, Savović J, Le Foll B, Nielsen S · The Cochrane database of systematic reviews · 2025 · n=3201

Globally, cannabis use is prevalent and widespread. There are currently no pharmacotherapies approved for the treatment of cannabis use disorder (a problematic pattern of cannabis use that leads to clinically significant impairment or distress). This is the second update of a Cochrane Review first published in the Cochrane Library in Issue 12, 2014. To assess the effectiveness and safety of pharmacotherapies as compared with each other, placebo or no pharmacotherapy (supportive care) for reducing symptoms of cannabis withdrawal and promoting cessation or reduction of cannabis use. We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and PsycINFO in May 2024. Randomised controlled trials (RCTs) and quasi-RCTs of medications to treat cannabis withdrawal and/or to promote cessation or reduction of cannabis use, in comparison with other medications, placebo or no medication in people diagnosed as cannabis dependent or who are likely to

Causal relationship between B vitamins and neuropsychiatric disorders: A systematic review and meta-analysis.

Ye M, Yang X, Yan J, Yao Y, Lv H, Yue Z · Neuroscience and biobehavioral reviews · 2025

Recently, there has been an increasing interest in how diet and nutrition influence both physical and mental health. Numerous studies have highlighted the potential role of B vitamins in neuropsychiatric disorders (NPDs), yet the exact causal relationship between these nutrients and NPDs remains unclear. In our Mendelian randomization (MR) meta-analysis, we examined the links between B vitamins (VB6, VB12, and folate) and NPDs, utilizing data from previous MR studies, the UK Biobank, and FinnGen databases. Our MR analysis revealed a complex, multifaceted association: VB6 appears to protect against Alzheimer's disease (AD) but may increase the risk for conditions such as major depressive disorder and post-traumatic stress disorder. VB12 seems protective against autism spectrum disorder (ASD) but may heighten the risk for bipolar disorder (BD). Folate has shown protective effects against AD and intellectual disability (ID). The meta-analysis suggests that B vitamins may protect against c

Cognitive Behavior Therapy for Mental Disorders in Adults: A Unified Series of Meta-Analyses.

Cuijpers P, Harrer M, Miguel C, Ciharova M, Papola D, Basic D · JAMA psychiatry · 2025 · n=968

Cognitive behavior therapy (CBT) is a first-line treatment for most mental disorders. However, no meta-analytic study has yet integrated the results of randomized clinical trials on CBT across different disorders, using uniform methodologies and providing a complete overview of the field. To examine the effect sizes of CBT for 4 anxiety disorders, 2 eating disorders, major depression, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and psychotic and bipolar disorders on symptoms of the respective disorders using uniform methodologies for data extraction, risk of bias (RoB) assessment, and meta-analytic techniques. Major bibliographical databases (PubMed, PsycINFO, and Embase for all disorders) were searched up to January 1, 2024, for each disorder separately. Data analysis was performed from August 2024 to January 2025. Randomized clinical trials comparing CBT with inactive control conditions in adults with 1 of the mental disorders established through a c

The Efficacy of Pharmacological Interventions in the Treatment of Major Depressive Disorder and Bipolar Depression With Mixed Features: A Systematic Review.

Xiao N, Yin L, Lee S, Teopiz KM, Wong S, Le GH · Bipolar disorders · 2025

There is a need to provide up-to-date, clinically translatable data as it relates to the treatment of a major depressive episode (MDE) with mixed features. PubMed and OVID were searched from inception to July 22, 2024. Randomized controlled trials (RCTs) investigating the efficacy of pharmacological agents for adults with bipolar disorder (BD) or major depressive disorder (MDD) in an MDE with mixed features were included. Risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomized Studies (RoB2). A total of seven studies were included in this systematic review. The studies identified were all short-term acute studies ranging from 6 to 8 weeks. Treatment with lurasidone, olanzapine, cariprazine, lumateperone, quetiapine, and ziprasidone was associated with statistically significant reduction of depressive symptoms in MDEs with mixed features. Only lumateperone is studied in both BD subtypes [bipolar I disorder (BD-I), bipolar II disorder (BD-II)] and MDD, wher

EPA guidance on lifestyle interventions for adults with severe mental illness: A meta-review of the evidence.

Maurus I, Wagner S, Spaeth J, Vogel A, Muenz S, Seitz V · European psychiatry : the journal of the Association of European Psychiatrists · 2024

There is growing interest in lifestyle interventions as stand-alone and add-on therapies in mental health care due to their potential benefits for both physical and mental health outcomes. We evaluated lifestyle interventions focusing on physical activity, diet, and sleep in adults with severe mental illness (SMI) and the evidence for their effectiveness. To this end, we conducted a meta-review and searched major electronic databases for articles published prior to 09/2022 and updated our search in 03/2024. We identified 89 relevant systematic reviews and assessed their quality using the SIGN checklist. Based on the findings of our meta-review and on clinical expertise of the authors, we formulated seven recommendations. In brief, evidence supports the application of lifestyle interventions that combine behavioural change techniques, dietary modification, and physical activity to reduce weight and improve cardiovascular health parameters in adults with SMI. Furthermore, physical activi

The Role of the Gut Microbiota in the Development and Progression of Major Depressive and Bipolar Disorder.

Knuesel T, Mohajeri MH · Nutrients · 2021

A growing number of studies in rodents indicate a connection between the intestinal microbiota and the brain, but comprehensive human data is scarce. Here, we systematically reviewed human studies examining the connection between the intestinal microbiota and major depressive and bipolar disorder. In this review we discuss various changes in bacterial abundance, particularly on low taxonomic levels, in terms of a connection with the pathophysiology of major depressive and bipolar disorder, their use as a diagnostic and treatment response parameter, their health-promoting potential, as well as novel adjunctive treatment options. The diversity of the intestinal microbiota is mostly decreased in depressed subjects. A consistent elevation of phylum Actinobacteria, family Bifidobacteriaceae, and genus Bacteroides, and a reduction of family Ruminococcaceae, genus Faecalibacterium, and genus Roseburia was reported. Probiotics containing Bifidobacterium and/or Lactobacillus spp. seemed to impr

Synopsis of the 2023 US Department of Veterans Affairs and US Department of Defense Clinical Practice Guideline for the Management of Bipolar Disorder.

Ostacher MJ, Miller CJ, Edwards-Stewart A, Cazares PT, Owen RR, Fuller MA · The Journal of clinical psychiatry · 2025

Objective: The US Department of Veterans Affairs (VA) and Department of Defense (DOD) Work Group revised the 2013 VA/DOD Clinical Practice Guideline (CPG) for the Management of Bipolar Disorder (BD). This paper reviews the 2023 CPG and its development process, including how recommendations were made for evidence-based treatment in BD. Methods: Subject experts and key stakeholders developed 20 key questions and reviewed the published literature after a systematic search using the PICOTS (population, intervention, comparator, outcomes, timing of outcomes measurement, and setting) method. The evidence was then evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method. Recommendations were based on quality and strength of evidence and informed by other factors, including feasibility, patient perspectives, and the unique needs of people with BD. Peer review by an external group of experts then resulted in completion of the CPG. Recommendations: Whi

2025

Practice Guidelines for Bipolar Disorder by the JSMD (Japanese Society of Mood Disorders).

Kato T, Ogasawara K, Motomura K, Kato M, Tanaka T, Takaesu Y · Psychiatry and clinical neurosciences · 2024

The Japanese Society of Mood Disorders (JSMD) published treatment guidelines of bipolar disorder in 2011. The present guidelines incorporating new findings were developed to comply to the guidelines of the National Academy of Medicine (NAM) by utilizing systematic reviews and meta-analysis and taking patient and family opinions as well as insights from multiple professional fields into account. They support combination therapy using mood stabilizers and second-generation antipsychotics in many aspects. They also have limitations, including the grouping of mood stabilizers and second-generation antipsychotics when meta-analysis was performed despite their distinct properties, due to the scarcity of drug-specific evidence. Despite the limitations, these guidelines provide clinical decision support for psychiatrists in Japan.

The Potential Effects of the Ketogenic Diet in the Prevention and Co-Treatment of Stress, Anxiety, Depression, Schizophrenia, and Bipolar Disorder: From the Basic Research to the Clinical Practice.

Chrysafi M, Jacovides C, Papadopoulou SK, Psara E, Vorvolakos T, Antonopoulou M · Nutrients · 2024

The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders. This is a comprehensive literature review that intends to critically collect and scrutinize the pre-existing research basis and clinical data of the potential advantageous impacts of a KD on stress, anxiety, depression, schizophrenia and bipolar disorder. This literature review was performed to thoroughly represent the existing research in this topic, as well as to find gaps in the international scientific community. In this aspect, we carefully investigated the ultimate scientific web databases, e.g., PubMed, Scopus, and Web of Science, to derive the currently availab

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial.

Sethi S, Wakeham D, Ketter T, Hooshmand F, Bjornstad J, Richards B · Psychiatry research · 2024

The ketogenic diet (KD, also known as metabolic therapy) has been successful in the treatment of obesity, type 2 diabetes, and epilepsy. More recently, this treatment has shown promise in the treatment of psychiatric illness. We conducted a 4-month pilot study to investigate the effects of a KD on individuals with schizophrenia or bipolar disorder with existing metabolic abnormalities. Twenty-three participants were enrolled in a single-arm trial. Results showcased improvements in metabolic health, with no participants meeting metabolic syndrome criteria by study conclusion. Adherent individuals experienced significant reduction in weight (12 %), BMI (12 %), waist circumference (13 %), and visceral adipose tissue (36 %). Observed biomarker enhancements in this population include a 27 % decrease in HOMA-IR, and a 25 % drop in triglyceride levels. In psychiatric measurements, participants with schizophrenia showed a 32 % reduction in Brief Psychiatric Rating Scale scores. Overall Clinica

Nutrition and schizophrenia: associations worthy of continued revaluation.

Tang M, Zhao T, Liu T, Dang R, Cai H, Wang Y · Nutritional neuroscience · 2024

Accumulating evidence have shown that diet and nutrition play significant roles in mental illness, such as depression, anxiety and bipolar disorder. However, comprehensive evaluation of the relationship between nutrition and schizophrenia is lacking. The present review aims to synthetic elaborate the associations between nutrition and schizophrenia. Relevant studies on dietary patterns, macronutrients, micronutrients were performed through a literature search to synthesize the extracted data. Dietary interventions may help prevent the occurrence of schizophrenia, or delay symptoms: Healthy diets like nutritious plant-based foods and high-quality protein, have been linked to reducing the risk or symptoms of schizophrenia. Moreover, diet high in saturated fat and sugar is linked to more serious outcomes of schizophrenia. Additionally, when N-acetylcysteine acts as an adjuvant therapy, the overall symptoms of schizophrenia are significantly reduced. Also nascent evidence showed mental d

Dietary intake and five types of mental disorders: a bidirectional Mendelian randomization study.

Zhang Y, Zhang M, Guan Q, Liu P, Zhang W, Yang S · BMC psychiatry · 2025

Mental illness has been presenting serious public health concerns. Studies have linked mental disorders to poor dietary patterns. The study aimed to estimate the causal relationship between dietary macronutrient intake and mental disorders using a bidirectional two-sample Mendelian randomization (MR) analysis. The causal relationships between dietary macronutrient intake (i.e., carbohydrate, fat, protein and sugar) and mental disorders (i.e., anxiety, bipolar disorder, depression, neuroticism and schizophrenia) were explored on the basis of UK Biobank and 5 datasets. Inverse-variance weighted (IVW) and weighted median (WM) methods were applied to calculate the potential causation between macronutrient and mental disorders. MR-Egger's intercept and MR-PRESSO approaches were used to verify the MR assumptions. Outcomes were reported as odds ratios (OR) and regression coefficients (β), which were adjusted by False Discovery Rate (FDR) corrections. Forward MR analyses revealed that

Occurrence of Psychosis and Bipolar Disorder in Individuals With Attention-Deficit/Hyperactivity Disorder Treated With Stimulants: A Systematic Review and Meta-Analysis.

Salazar de Pablo G, Aymerich C, Chart-Pascual JP, Solmi M, Torres-Cortes J, Abdelhafez N · JAMA psychiatry · 2025

Individuals with attention-deficit/hyperactivity disorder (ADHD) may present with psychosis or bipolar disorder (BD) following treatment with stimulants. The extent to which this occurs is currently unclear. To meta-analytically quantify the occurrence of psychosis or BD after exposure to stimulants in individuals with ADHD and assess possible moderating factors. PubMed, Web of Science, Ovid/PsycINFO, and Cochrane Central Register of Reviews were searched from inception until October 1, 2024, without language restrictions. Studies of any design with DSM or International Classification of Diseases-defined ADHD populations exposed to stimulants, where psychosis or BD outcomes were evaluated. PRISMA Preferred Reporting Items for Systematic Reviews and Meta-analyses and MOOSE Meta-analysis of Observational Studies in Epidemiology guidelines were followed, the protocol was registered, and the Newcastle-Ottawa scale and Cochrane risk of bias-2 tool were used for quality appraisal. Random

The efficacy of lithium in the treatment of suicidal ideation, behavior and suicide: An updated systematic review and meta-analysis of randomized controlled trials.

Wang JX, Le GH, Wong S, Teopiz KM, Kwan ATH, Rosenblat JD · Journal of affective disorders · 2025

Lithium is a first-line treatment for bipolar disorder, especially BD-I. In addition to efficacy in treating acute mania and recurrence prevention in bipolar disorder, lithium's anti-suicide effects have been documented in studies showing reduced rates of completed suicide and serious attempts. To update current knowledge on the topic, we conducted a systematic review and meta-analysis of lithium's impact in randomized controlled trials on suicidality (i.e., suicidal ideation, attempts, and suicide). Herein we followed Cochrane protocols and PRISMA guidelines to search OVID databases (Embase, MedLine, PsychINFO) from January 2013 to July 2024 for randomized trials evaluating lithium's effect on suicidality, specifically reporting suicidal ideation, attempts, or related mortality outcomes. We identified earlier studies from manual reference searching. Two reviewers independently extracted data and assessed quality. From 1793 articles, 15 studies (eight placebo-controlled, n =&#xa

Nutrition-based interventions for mood disorders.

Martins LB, Braga Tibães JR, Sanches M, Jacka F, Berk M, Teixeira AL · Expert review of neurotherapeutics · 2021

Introduction: 'Nutritional Psychiatry' is an emerging area of research that has great potential as an adjunctive tool for the prevention and treatment of diverse neuropsychiatric disorders. Several nutrition-related aspects, such as obesity, dietary patterns, gut microbiome composition and gut permeability, bioactive food compounds, and nutrients can influence pathways implicated in the pathophysiology of mood disorders.Areas covered: Here, the authors review the current evidence on nutrition-mood interaction and nutrition-based treatments for the two main mood disorders, i.e., major depressive disorder and bipolar disorder.Expert opinion: Consistent evidence from observational studies has pointed out the association between a 'healthy' diet, generally characterized by a higher intake of fruits, vegetables, legumes, nuts, whole grains, and good quality sources of protein (i.e. fish and/or seafood), and decreased risk of mood disorders and the parallel association between a 'Western' di

Bipolar Disorder

PubMed/MedlinePlus

MedlinePlus provides information on bipolar disorder, including causes, symptoms, diagnosis, treatment, and living with the condition. It offers reliable, up-to-date health information.

A Randomized Controlled Trial of the Fatty Acid Amide Hydrolase Inhibitor Palmitoylethanolamide in Bipolar Depression

n=34 · NCT06229977 · COMPLETED · COMPLETED

The purpose of this study is to o evaluate the antidepressant efficacy of the PEA in Bipolar Depression and the association between antidepressant response with endogenous cannabinoids and cytokine levels

Adjunctive Acupuncture as a Treatment for Bipolar Depression

n=30 · NCT00071669 · COMPLETED · COMPLETED

The purpose of this study is to evaluate the effectiveness of acupuncture in the treatment of Bipolar Depression.

RCT to Improve Post-Hospital Treatment Adherence for Comorbid Substance Use and Bipolar Disorders

n=178 · NCT04202393 · COMPLETED · COMPLETED

This trial aims to evaluate the effectiveness of a novel intervention for patients with co-occurring bipolar and substance use disorders following a psychiatric hospitalization. Half of the participants will receive a specialized psychosocial intervention program, while the other half will receive an enhanced safety monitoring program, both provided in addition to their routine care.

TRIP Database: Bipolar

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice, including numerous resources on bipolar disorder.

Cochrane Library: Bipolar disorder

Cochrane

A collection of systematic reviews and meta-analyses investigating the effectiveness of various treatments and interventions for bipolar disorder.

TRIP Database: Bipolar disorder

TRIP Database

A clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice, including on bipolar disorder.