Inositol

Q: Bipolar depression

Inositol used based on multiple open-label and controlled trials in bipolar depression, including trials in children and as combination with omega-3 (Nierenberg AA et al, Am J Psychiatry. 2006;163(2):210-216). Inositol side effects reviewed with patient.

Q: Panic disorder

Inositol used based on small controlled trials in panic disorder, where it reduced the frequency of panic attacks (Palatnik A et al, J Clin Psychopharmacol. 2001;21(3):335-9). Inositol side effects reviewed with patient.

Q: Bulimia

Inositol used based on small trials in bulimia (Gelber D et al, Int J Eat Disord. 2001 Apr;29(3):345-8. Inositol side effects reviewed with patient.

Q: Psoriasis

Inositol used based on trials in mood disorders and lithium-induced psoriasis, which is more responsive to insotitol than other forms of psoriasis (Allan SJ et al, Br J Dermatol 2004;150(5):966-9). Inositol side effects reviewed with patient.

CAM (phosphatidylinositol cycle – a mechanism shared with lithium; insulin signaling).

Bipolar Depression³
Psoriasis on lithium¹

Bulimia ²
Panic disorder³

Features

Generic, Non-sedating, Elderly-Safe, Tolerable, Natural, Non-controlled, Weight-Free, Bipolar-Safe, Sexual-free, Child-Studied

Handout

Dosing

Start 3-6 grams qd and raise by 6 grams every week toward target (usually as powder, can mix in smoothie).

Bipolar disorder in adults: 10-16 grams qd.
Bipolar disorder in children: ≥ 25 kg: 2,000 mg qd. < 25 kg: 80 mg/kg (round down to the nearest 500 mg).
Bulimia: 8 grams qd.
Psoriasis on lithium: 6 grams qd.
Panic: 12-18 grams qd
Insomnia: 2 grams qhs.

Cost $5-15/mth.

Note: Myo-inositol and inositol are identical.

Management

In bipolar disorder, works synergestically with omega-3, may reduce lithium and valproate side effects (those meds deplete inositol, contributing to psoriasis and hypothyroidism on lithium).

Low risk. Difficult to take all that powder. Can put in smoothie.

Valproate and lithium both deplete the body of inositol, so in theory it may reduce their side effects (true for psoriasis). Inositol also pairs well with omega-3 (synergestic benefits in mania and depression in RCTs).

EMR Text

Bipolar depression

Inositol used based on multiple open-label and controlled trials in bipolar depression, including trials in children and as combination with omega-3 (Nierenberg AA et al, Am J Psychiatry. 2006;163(2):210-216).

Inositol side effects reviewed with patient.

Panic disorder

Inositol used based on small controlled trials in panic disorder, where it reduced the frequency of panic attacks (Palatnik A et al, J Clin Psychopharmacol. 2001;21(3):335-9).

Inositol side effects reviewed with patient.

Bulimia

Inositol used based on small trials in bulimia (Gelber D et al, Int J Eat Disord. 2001 Apr;29(3):345-8.

Inositol side effects reviewed with patient.

Psoriasis

Inositol used based on trials in mood disorders and lithium-induced psoriasis, which is more responsive to insotitol than other forms of psoriasis (Allan SJ et al, Br J Dermatol 2004;150(5):966-9).

Inositol side effects reviewed with patient.

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