Human brain

UC Health psychiatry residents are investigating the use of dietary supplements in curing mild depression and increasing brain function in young people who are at increased risk for bipolar disorder.

Bipolar disorder is very heritable, according to the National Institutes of Health. Children of a bipolar patient are at a much higher risk of experiencing bipolar disorder or depression themselves. It is these children who are the targets of the study.

“This is not for a person who is already severely depressed, for that person they would have to go on established medication,” said principal researcher Fabiano Nery, a fourth-year resident of psychiatry at the UC Department of Psychiatry.

The supplement, N-acetyl-cysteine (NAC), might modulate a neurotransmitter in the brain – glutamate – that is involved in the neurobiology of bipolar disorder. It might help with depression in bipolar disorder, said Nery.

The idea of the study is to find out if NAC seems to help in curing depression. If the results are positive, then long-term studies will be conducted, said Nery.

“A group from Australia is studying its effects on bipolar [disorder]. The group found out that it might help with depression and functionality. It might be because it is an anti-oxidant, and there is a whole theory about problems with oxidation. There is a big interest now in alternative strategies (dietary, omega-3, etc.) to help with mental health symptoms, and NAC is an example of that,” said Nery.

Test subjects first pass a phone screening to make sure that a subject meets some initial requirements, said Nery. After this, the subjects are brought in for a two-hour interview where they are asked about mental health symptoms. An interview with the parents of the subject is conducted to confirm a diagnosis of bipolar disorder. If a subject qualifies, he or she is given an initial MRI scan. “We want to see brain changes before and after using NAC,” said Nery.

The subjects are given NAC in a low dose, and then they come in once a week to talk about mood changes, anxiety and side effects. Initially, the subject comes once a week for four weeks. They are then given a larger dosage and come twice a month for the second month. At the end of two months, the subject is given another MRI scan.

The study will stretch through this year and the next. The goal is to have 22 participants, said Nery.  

Nery stressed that NAC is a supplement, not a drug. The difference is that it is a simple amino acid, not a compound created in a pharmacy. “It is not a complex molecule created with the idea of being a drug. It is available over the counter, at nutritional stores,” he said.

“It is still under investigation. It is not FDA approved because it is still investigational,” said Nery. “It holds some promise.”