Twenty years since the publication of the first medical journal article on the psychiatric use of inositol, to the best of my knowledge, we are still lacking an article in the medical literature on the
proper use of inositol in the pediatric population.
This is truly unfortunate, especially when the alternative is the SSRI class of medication. I suspect that inositol would have great clinical utility in the pediatric population (I do not see young children in my office: I will sometimes, with proper arm twisting, see teenagers). Therefore, I am throwing a challenge out to pediatricians and pediatric psychiatrists: please, at the very least, try inositol in your practice, and after doing so, publish a case report on your experience, so that we can get this discussion going within the medical community.
Proper use is, as I explain in the body of my article, where "looping" is a key feature (e.g. OCD, GAD).
Congratulations to the authors of the following article for their efforts: unfortunately however, I think they are studying the wrong population.
J Clin Psychiatry. 2015 Nov;76(11):1548-55.
A randomized clinical trial of high eicosapentaenoic acid omega-3 fatty acids and inositol as monotherapy and in combination in the treatment of pediatric bipolar spectrum disorders: a pilot study.
Abstract
OBJECTIVE:
We conducted a 12-week, randomized, double-blind, controlled clinical trial to evaluate the effectiveness and tolerability of high eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) omega-3 fatty acids and inositol as monotherapy and in combination in children with bipolar spectrum disorders.
METHOD:
Participants were children 5-12 years of age meeting DSM-IV diagnostic criteria for bipolar spectrum disorders (bipolar I or II disorder or bipolar disorder not otherwise specified [NOS]) and displaying mixed, manic, or hypomanic symptoms. Subjects with severe illness were excluded. Subjects were randomized to 1 of 3 treatment arms: inositol plus placebo, omega-3 fatty acids plus placebo, and the combined active treatment of omega-3 fatty acids plus inositol. Data were collected from February 2012 to November 2013.
RESULTS:
Twenty-four subjects were exposed to treatment (≥ 1 week of study completed) (inositol [n = 7], omega-3 fatty acids [n = 7], and omega-3 fatty acids plus inositol [n =10]). Fifty-four percent of the subjects completed the study. Subjects randomized to the omega-3 fatty acids plus inositol arm had the largest score decrease comparing improvement from baseline to end point with respect to the Young Mania Rating Scale (P < .05). Similar results were found for the Children's Depression Rating Scale (P < .05) and the Brief Psychiatric Rating Scale (P <.05).
CONCLUSION:
Results of this pilot randomized, double-blind, controlled trial suggest that the combined treatment of omega-3 fatty acids plus inositol reduced symptoms of mania and depression in prepubertal children with mild to moderate bipolar spectrum disorders. Results should be interpreted in light of limitations, which include exclusion of severely ill subjects, 54% completion rate, and small sample size.
--------------------------------------------------------------------------------------------------
With regards to bipolar disorder, it is interesting to note that the medications used to treat the condition may deplete inositol.
