When added to mood stabilizers or antidepressants, this mitochondria-stabilizing and anti-inflammatory agent improved rates of response — but not remission — more than placebo. 

Mitochondrial dysfunction may play a role in bipolar illness and preliminary studies have suggested that anti-inflammatory agents may benefit bipolar depression.  In an 8-week, randomized, placebo-controlled trial, researchers in Iran examined the efficacy of augmentation with coenzyme Q10 (CoQ10), which has anti-inflammatory and mitochondria-stabilizing properties, in 89 depressed bipolar patients already taking mood stabilizers and antidepressants.

On a clinician-rated measure, patients typically had moderate depression. Twenty patients dropped out and were not included in analyses (lost to follow-up, 13; nonadherent, 4; adverse effects, 3).

The group treated with adjunctive CoQ10 had greater response than the placebo group at week 8 (72% vs. 12%), although remission was very low and statistically equal in both groups (8% and 0%). No adverse effects were reported.

Other studies have similarly found some benefit from anti-inflammatory medications or supplements such as N-acetylcysteine as part of a treatment regimen for patients with bipolar depression. The strategy is not known to be effective by itself, and so the agents are typically added to standard mood-stabilizing and antidepressant regimens, as was done here. Many patients with this difficult-to-treat illness are interested in trying supplements; this one seems reasonable and harmless and could help.