Inositol may be reduced in depressed and bipolar patients (Am J Psychiatry, 1997; 154: 1148-50), and can have significant antidepressant effects at a high dose of 12 g/day (Am J Psychiatry, 1995; 152: 792-4; Isr J Psychiatry Relat Sci, 1995; 32: 14-21). However, some bipolar patients have reported either little benefit (Br J Psychiatry, 1994; 164: 133-4) or a worsening of their symptoms (Am J Psychiatry, 1996; 153: 839).

Orthomolecular treatment can take weeks before a change in symptoms becomes evident - or it may not work at all. It is said to be most effective in those who have significant biochemical imbalances, but such patients may also have the most severe symptoms and may be resistant to the more aggressive forms of conventional care. For these individuals, using nutrition to balance glitches in their genetic make-up may help, at the very least, to reduce dependence on medication and, as such, can be considered a positive step on the road to good mental health. Pat Thomas