Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical Trial
Abstract
Background: Bipolar disorder (BPD) is a chronic and recurrent mood disorder characterized by episodes of mania, hypomania, and major depression. Based on available evidence, mitochondrial dysfunction, oxidative stress, and inflammation have important roles in the pathophysiology of bipolar depression. More specifically, it seems that coenzyme Q10 (CoQ10), a mitochondrial modulator, as well as an antioxidant and anti-inflammatory agent, might be effective in modulating these pathophysiological pathways. Accordingly, the aim of this study was to investigate whether and to what extent, compared with placebo, adjuvant CoQ10 might improve symptoms of depression in patients with BPD. Methods: A total of 69 patients with BPD with a current depressive episode were randomly assigned either to the adjuvant CoQ10 (200 mg/d) or to the placebo group. Standard medication consisting of mood stabilizers and antidepressants was consistent 2 months prior and during the study. Depression severity for each patient was assessed based on the Montgomery-Asberg Depression Rating Scale scores at baseline, fourth week, and eighth week of the study. Results: Symptoms of depression decreased over time in both groups. Compared with the placebo group, adjuvant CoQ10 to a standard medication improved symptoms of depression after 8 weeks of treatment. In addition, at the end of the study, it turned out that more responders were observed in the CoQ10 group, compared with the placebo group. CoQ10 had minimal adverse effects and was well tolerated. Conclusions: The present pattern of results suggests that among patients with BPD, compared with placebo, adjuvant CoQ10 probably because of its antioxidant and anti-inflammatory properties can improve symptoms of depression over a period of 8 weeks.
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200 mg of Coenzyme Q10 daily for 8 weeks together with medical treatment has benefits in patients with bipolar depression.
“200 mg of Coenzyme Q10 every day for a period of 8 weeks, together with medical treatment explored some benefits in patients with bipolar depression (Mehrpooya et al. 2018).”
From Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging (2023) · cites this paper as Mehrpooya et al. 2018
Cites
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007) · Behavior Research Methods · doi:10.3758/bf03193146 · Cited by 65,971 · see citing works
(1998) · PubMed · Cited by 10,216 · see citing works
Cohen, J. (1992) · Psychological Bulletin · doi:10.1037//0033-2909.112.1.155 · Cited by 8,771 · see citing works
Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative
Merikangas, K. R., Jin, R., He, J.-P., Kessler, R. C., Lee, S., Sampson, N. A., Viana, M. C., Andrade, L. H., Hu, C., Karam, E. G., et al. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.12 · Cited by 2,627 · see citing works
Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., & Kessler, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.543 · Cited by 2,399 · see citing works
Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00241-x · Cited by 1,710 · see citing works
Raison, C. L., Rutherford, R. E., Woolwine, B. J., Shuo, C., Schettler, P., Drake, D. F., Haroon, E., & Miller, A. H. (2013) · JAMA Psychiatry · doi:10.1001/2013.jamapsychiatry.4 · Cited by 1,617 · see citing works
Berk, M., Kapczinski, F., Andreazza, A. C., Dean, O. M., Giorlando, F., Maes, M., Yücel, M., Gama, C. S., Dodd, S., Dean, B., et al. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.10.001 · Cited by 1,178 · see citing works
Tyring, S., Gottlieb, A., Papp, K., Gordon, K., Leonardi, C., Wang, A., Lalla, D., Woolley, M., Jahreis, A., Zitnik, R., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(05)67763-x · Cited by 1,069 · see citing works
Effects of Coenzyme Q10 in Early Parkinson Disease: Evidence of Slowing of the Functional Decline
Shults, C. W. (2002) · Archives of Neurology · doi:10.1001/archneur.59.10.1541 · Cited by 984 · see citing works
Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., Gao, K., Miskowiak, K. W., & Grande, I. (2018) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2018.8 · Cited by 891 · see citing works
Synthesizing standardized mean‐change measures
Becker, B. J. (1988) · British Journal of Mathematical and Statistical Psychology · doi:10.1111/j.2044-8317.1988.tb00901.x · Cited by 889 · see citing works
Biochemical Functions of Coenzyme Q <sub>10</sub>
Crane, F. L. (2001) · Journal of the American College of Nutrition · doi:10.1080/07315724.2001.10719063 · Cited by 869 · see citing works
Berk, M., Copolov, D. L., Dean, O., Lu, K., Jeavons, S., Schapkaitz, I., Anderson-Hunt, M., & Bush, A. I. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.04.022 · Cited by 500 · see citing works
Molecular Evidence for Mitochondrial Dysfunction in Bipolar Disorder
Konradi, C. L., Eaton, M. E., MacDonald, M. L., Walsh, J. P., Benes, F. M., & Heckers, S. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.3.300 · Cited by 499 · see citing works
Mitochondrial dysfunction and pathology in bipolar disorder and schizophrenia
Clay, H. B., Daws, S., & Konradi, C. (2011) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2010.08.007 · Cited by 399 · see citing works
Historical perspectives and natural history of bipolar disorder
Angst, J., & Sellaro, R. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00909-4 · Cited by 393 · see citing works
Mitochondrial dysfunction in bipolar disorder
Kato, T., & Kato, N. (2000) · Bipolar Disorders · doi:10.1034/j.1399-5618.2000.020305.x · Cited by 381 · see citing works
Frangou, S., Lewis, M., & McCrone, P. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.188.1.46 · Cited by 309 · see citing works
Abnormalities in Mitochondrial Structure in Cells from Patients with Bipolar Disorder
Cataldo, A. M., McPhie, D. L., Lange, N. T., Punzell, S., Elmiligy, S., Ye, N. Z., Froimowitz, M. P., Hassinger, L. C., Menesale, E. B., Sargent, L. W., et al. (2010) · American Journal Of Pathology · doi:10.2353/ajpath.2010.081068 · Cited by 269 · see citing works
Functions of coenzyme Q<sub>10</sub> in inflammation and gene expression
Schmelzer, C., Lindner, I., Rimbach, G., Niklowitz, P., Menke, T., & Döring, F. (2008) · BioFactors · doi:10.1002/biof.5520320121 · Cited by 265 · see citing works
Frey, B. N., Valvassori, S. S., Réus, G. Z., Martins, M. R., Petronilho, F. C., Bardini, K., Dal‐Pizzol, F., Kapczinski, F. P., & Quevedo, J. (2006) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0637 · Cited by 238 · see citing works
Sun, X., Wang, J., Tseng, M., & Young, L. T. (2006) · Journal of Psychiatry and Neuroscience · doi:10.1139/jpn.0623 · Cited by 238 · see citing works
Suicidal behavior in bipolar disorder: Epidemiology, characteristics and major risk factors
Gonda, X., Pompili, M., Serafini, G., Montebovi, F., Campi, S., Döme, P., Duleba, T., Girardi, P., & Rihmer, Z. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.04.041 · Cited by 219 · see citing works
Scaini, G., Rezin, G. T., Carvalho, A. F., STRECK, E. L., Berk, M., & Quevedo, J. (2016) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2016.06.040 · Cited by 184 · see citing works
Berk, M., Dean, O., Cotton, S. M., Gama, C. S., Kapczinski, F., Fernandes, B. S., Kohlmann, K., Jeavons, S., Hewitt, K., Allwang, C., et al. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.06.005 · Cited by 181 · see citing works
Clinical applications of coenzyme Q₁₀
Garrido-Maraver, J. (2014) · Frontiers in Bioscience · doi:10.2741/4231 · Cited by 178 · see citing works
Open Label Trial of Coenzyme Q10 as A Migraine Preventive
Rozen, T., Oshinsky, M. L., Gebeline, C., Bradley, K., Young, W., Shechter, A. L., & Silberstein, S. (2002) · Cephalalgia · doi:10.1046/j.1468-2982.2002.00335.x · Cited by 174 · see citing works
Maes, M. H. J., Mihaylova, I., Kubera, M., Uytterhoeven, M., Vrydags, N., & Bosmans, E. (2009) · PubMed · Cited by 160 · see citing works
The underlying neurobiology of bipolar disorder.
Manji, H. K., Quiroz, J. A., Payne, J. L., Singh, J., Lopes, B. P., Viegas, J. S., & Zarate, C. A. (2003) · Europe PMC (PubMed Central) · Cited by 160 · see citing works
Discovery of ubiquinone (coenzyme Q) and an overview of function
Crane, F. L. (2007) · Mitochondrion · doi:10.1016/j.mito.2007.02.011 · Cited by 151 · see citing works
Suicide Attempts in Bipolar Patients
López‐Mahía, P., Mosquera, F., de León, J., Gutiérrez, M., Ezcurra, J., Ramurez, F., & González-Pinto, A. M. (2001) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v62n1208 · Cited by 145 · see citing works
Sanoobar, M., Eghtesadi, S., Azimi, A., Khalili, M., Khodadadi, B., Jazayeri, S., Gohari, M. R., & Aryaeian, N. (2014) · Nutritional Neuroscience · doi:10.1179/1476830513y.0000000106 · Cited by 135 · see citing works
Effects of Coenzyme Q10 on Markers of Inflammation: A Systematic Review and Meta-Analysis
Zhai, J., Bo, Y., Lü, Y., Liu, C., & Zhang, L. (2017) · PLoS ONE · doi:10.1371/journal.pone.0170172 · Cited by 134 · see citing works
Machado‐Vieira, R., Soares, J. C., Lara, D. R., Luckenbaugh, D. A., Busnello, J. V., Marca, G., Cunha, A. B. M., Souza, D. O., Zarate, C. A., & Kapczinski, F. P. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0806 · Cited by 132 · see citing works
Slater, S. K., Nelson, T. D., Kabbouche, M. A., LeCates, S. L., Horn, P. S., Segers, A. M., Manning, P., Powers, S. W., & Hershey, A. D. (2011) · Cephalalgia · doi:10.1177/0333102411406755 · Cited by 125 · see citing works
Effects of lithium on oxidative stress parameters in healthy subjects
Machado‐Vieira, R. (2011) · Molecular Medicine Reports · doi:10.3892/mmr.2011.732 · Cited by 121 · see citing works
Frey, B. N., Stanley, J. A., Nery, F. G., Monkul, E. S., Nicoletti, M., Chen, H., Hatch, J. P., Caetano, S. C., Ortíz, O., Kapczinski, F. P., et al. (2007) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00454.x · Cited by 113 · see citing works
Naydenov, A. V., MacDonald, M. L., Öngür, D., & Konradi, C. L. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.5.555 · Cited by 99 · see citing works
Aboul-Fotouh, S. (2013) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2012.12.027 · Cited by 97 · see citing works
Morris, G., Anderson, G., Berk, M., & Maes, M. (2013) · Molecular Neurobiology · doi:10.1007/s12035-013-8477-8 · Cited by 96 · see citing works
Coenzyme Q10 Reduces β-Amyloid Plaque in an APP/PS1 Transgenic Mouse Model of Alzheimer’s Disease
Yang, X., Dai, G., Li, G., & Yang, E. S. (2009) · Journal of Molecular Neuroscience · doi:10.1007/s12031-009-9297-1 · Cited by 83 · see citing works
Nierenberg, A. A., Kansky, C., Brennan, B. P., Shelton, R. C., Perlis, R. H., & Iosifescu, D. V. (2012) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867412449303 · Cited by 76 · see citing works
Kakiuchi, C., Ishiwata, M., Kametani, M., Nelson, C., Iwamoto, K., & Kato, T. (2005) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145705005213 · Cited by 72 · see citing works
Coenzyme Q10 Effects on Creatine Kinase Activity and Mood in Geriatric Bipolar Depression
Forester, B. P., Zuo, C. S., Ravichandran, C. T., Harper, D. G., Du, F., Kim, H., Cohen, B. M., & Renshaw, P. F. (2012) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988712436688 · Cited by 58 · see citing works
Dissimilar morbidity following initial mania versus mixed-states in type-I bipolar disorder
Baldessarini, R. J., Salvatore, P., Khalsa, H.-M. K., & Tohen, M. F. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.03.014 · Cited by 53 · see citing works
Antidepressant Effects of Open Label Treatment With Coenzyme Q10 in Geriatric Bipolar Depression
Forester, B. P., Harper, D. G., Georgakas, J. E., Ravichandran, C. T., Madurai, N. K., & Cohen, B. M. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000326 · Cited by 46 · see citing works
Ahmadpanah, M., Sheikhbabaei, M., Haghighi, M., Roham, F., Jahangard, L., Akhondi, A., Sadeghi-Bahmani, D., Bajoghli, H., Holsboer-trachsler, E., & Brand, S. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s103869 · Cited by 44 · see citing works
Self-citationFehér, J., Németh, E., Nagy, V., & Lengyel, G. (2008) · Archives of Medical Science · Cited by 19 · see citing works
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Reactive Oxygen Species, Toxicity, Oxidative Stress, and Antioxidants: Chronic Diseases and Aging
Jomova, K., Raptova, R., Alomar, S. Y., Alwasel, S. H., Nepovimova, E., Kuca, K., & Valko, M. (2023) · Archives of Toxicology · doi:10.1007/s00204-023-03562-9 · Cited by 2,638 · see citing works
Bahji, A., Ermacora, D., Stephenson, C., Hawken, E. R., & Vazquez, G. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.030 · Cited by 139 · see citing works
Nutrition and bipolar disorder: a systematic review
Gabriel, F. C., Oliveira, M., Martella, B. D. M., Berk, M., Brietzke, E., Jacka, F. N., & Lafer, B. (2023) · Nutritional Neuroscience · doi:10.1080/1028415x.2022.2077031 · Cited by 59 · see citing works
- Authors
- Mehrpooya, M., Yasrebifar, F., Haghighi, M., Mohammadi, Y., & Jahangard, L.
- Affiliations
- Department of Clinical Pharmacy, School of Pharmacy,
- Research Center for Behavioral Disorders and Substances Abuse, and
- Hamedan University of Medical Sciences (IR)
- Corresponding author
- Mehrpooya, Maryam
- Yasrebifar, Fatemeh
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2018-10
- Volume
- 38
- Issue
- 5
- Pages
- 460-466
- ISSN
- 0271-0749 (ISSN-L)
- 1533-712X
- OpenAlex
- W2886239378
- Cited by
- 57
- References
- 49
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 4 · 2023: 5 · 2022: 9 · 2021: 9 · 2020: 11 · 2019: 7 · 2018: 1
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hamadan University of Medical Sciences
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- coenzyme Q10, bipolar depression, bipolar disorder, adjuvant therapy, mitochondrial dysfunction, oxidative stress, inflammation, antioxidants, anti-inflammatory agents, antidepressant response, treatment response
- MeSH terms
- Adult, Bipolar Disorder, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Ubiquinone, Vitamins, Treatment Outcome
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