Coenzyme Q10
CAM (mitochondrial health, antioxidant)
- Bipolar Depression2
- Major Depression (as monotherapy or augmentation)2
- ADHD (augmented atomoxetine)3
- Autism3
- Developmental disorders (eg Down and Prader-Willi Syndrome)2
- Cognition in dementia, Parkinson’s, elderly3
Features
Dosing
Depression and Bipolar: 200 mg qd, max 500 mg qd
Childhood ADHD and Autism: 1–3 mg/kg/day (adults can use depression dose)
The version with bioperine is better absorbed (Doctor’s Best).
Cost: $7.50/month
INTERACTIONS: None
Management
Coenzyme Q10 is an essential antioxidant involved in mitochondrial repair. People with ADHD, autism, and depression tend to be low in Coenzyme Q10, and have impaired mitochondrial function.
Multiple RCTs in depression, including pure depression and depression in medical illness (MS, polycystic ovarian, fibromyalg), and cognition in Parkinson’s.
TOLERABILITY: Well tolareated. Can cause insomnia, low appetite, reflux, nausea, diarrhea.
RISKS: None
MEDICAL BENEFITS: Congestive heart failures, dyslipidemia, diabetes (glucose control and neuropathy), migraines, cancer prevention, skin wrinkles, cognition in dementia and Parkinson’s.
EMR Text
Bipolar Depression
Coenzyme Q10 use based on a randomized controlled trial in bipolar depression (Toniolo RA et al, J Neural Transm (Vienna). 2018;125(2):247-257).
Coenzyme Q10 side effects reviewed with patient.
Major Depression
Coenzyme Q10 use based on multiple randomized controlled trial in major depressive disorder, including trials of pure depression and depression in medical illness (Sherpa NN et al, Eur Neuropsychopharmacol. 2025;90:28-35; Majmasanaye M et al, J Clin Psychopharmacol 2024;44(3):232-239).
Coenzyme Q10 side effects reviewed with patient.
ADHD
Coenzyme Q10 use based on a small, randomized controlled trial in ADHD (Gamal F et al, CNS Neurol Disord Drug Targets. 2022;21(8):717-723)
Coenzyme Q10 side effects reviewed with patient.
Autism
Coenzyme Q10 use based on observational and preclinical data in autism, as well as trials in ADHD, depression, and neurodevelopmental disorders (Mousavinejad E et al, Psychiatry Res. 2018;265:62-69).
Coenzyme Q10 side effects reviewed with patient.
Developmental disorders
Coenzyme Q10 use based on observational and preclinical data in neurodevelopmental disorders (including Down, Kearns-Sayre, Leigh’s, and Prader-Willi Syndromes, and autism) (Mantle D et al. Front Biosci, 2022;27(12):322).
Coenzyme Q10 side effects reviewed with patient.