Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Pregnenolone, a neurosteroid precursor, has been explored as a potential adjunct in the treatment of Bipolar Mood Disorder, particularly for its putative effects on mood regulation and cognitive function. Scientific interest in pregnenolone stems from its role in modulating GABAergic and glutamatergic neurotransmission, as well as its downstream conversion to other neuroactive steroids that influence brain function.

Clinical research on pregnenolone in bipolar disorder is limited but promising. Small-scale randomized controlled trials (RCTs) have suggested that pregnenolone supplementation may reduce depressive symptoms and improve cognitive deficits in individuals with bipolar disorder. For instance, a double-blind RCT published in Biological Psychiatry (2010) found that adjunctive pregnenolone significantly improved depressive symptoms in patients with bipolar depression compared to placebo. Subsequent studies have noted cognitive benefits, but sample sizes have been small, and some results have been mixed or inconclusive.

There is not enough large-scale, high-quality evidence to recommend pregnenolone as a standard treatment for bipolar disorder. Most guidelines do not include it, and its use is considered experimental. However, its plausible neurobiological mechanisms and initial positive findings justify ongoing research. At present, evidence supporting its use is preliminary (rated 2/5), and pregnenolone should only be used in this context under medical supervision, typically as part of a clinical trial or when conventional treatments are insufficient or poorly tolerated.

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