Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series

Abstract

Psychopharmacological treatment has been the mainstay in long-term maintenance of bipolar disorder (BD) patients for the last 60 years. Conventionally accepted treatment options are primarily based on expert opinion rather than on well-executed, independently funded research. Investigation of maintaining patients without medications using treatment alternatives has been neglected. This clinical case series examines the outcomes of 7 BD patients who experienced a poor response or significant side effects with conventional treatment modalities. Patients were gradually and safely withdrawn from all medications. Treatment strategies were based on an individualized holistic approach using herbs, nutritional supplements, vitamins, amino acids, acupuncture, dietary recommendations, and behavioral modifications. Multiple treatment modalities were combined addressing the etiological causes for BD symptoms. Upon withdrawal from psychotropic medications, patients were free of medication-induced side effects and obtained psychiatric stability for at least 10 months. Further research is needed to investigate the long-term outcomes of BD treatment modalities based on well-defined successful outcome criteria, such as reduction in symptoms, improvement in quality of life, overall health outcomes, and cost effectiveness.

Keywords: Bipolar, medication-free maintenance treatment, integrative

Abstract

El tratamiento psicofarmacológico ha sido el pilar fundamental en el mantenimiento a largo plazo de los pacientes con trastorno bipolar durante los últimos 60 años. Las opciones terapéuticas aceptadas convencionalmente se basan principal-mente en la opinión de los expertos y no en investigaciones bien realizadas y financiadas de forma independiente. La investigación del mantenimiento de pacientes sin medica-mentos usando tratamientos alternativos no ha recibido mucha atención. Esta serie de casos clínicos examina los resultados de 7 pacientes con trastorno bipolar que experimen-taron una respuesta escasa o efectos secundarios significativos con modalidades de tratamiento conven-cionales. A los pacientes se les retiró toda la medicación de forma gradual y segura. Las estrategias terapéuticas se basaron en un enfoque individual holístico, utilizando productos de herboristería, suplementos nutricio-nales, vitaminas, aminoácidos, acupuntura, recomendaciones dieté-ticas y modifcaciones del comportamiento. Se combinaron múltiples modalidades terapéuticas para abordar las causas etiológicas de los sínto-mas de trastorno bipolar. Tras la reti-rada de la medicación psicotrópica, los pacientes no tenían efectos secundarios inducidos por los fárma-cos y habían conseguido estabilidad psiquiátrica durante al menos 10 meses. Es necesaria más investig-ación para averiguar los resultados a largo plazo de las modalidades tera-péuticas del trastorno bipolar basa-dos en criterios de resultados positivos bien definidos, tales como la reducción de los síntomas, la mejora de la calidad de vida, los resultados generales de salud, y la rentabilidad.

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