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Inositol for Mental Health Conditions

Summary: Inositol is a type of sugar that may possibly be helpful for various conditions such as mood and anxiety conditions, along with polycystic ovarian syndrome (PCOS) and related metabolic conditions. Evidence is limited however, and thus it is important to always consult with a health care provider first.
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What is Inositol?

Inositol is a type of sugar with several important functions:

  • It is a major component of cell membranes
  • It influences insulin, a hormone essential for blood sugar control.
  • It affects brain chemicals such as serotonin and dopamine.

Inositol naturally occurs in certain foods and your body can also produce inositol from glucose.

Where Can You Get Inositol?

It has been estimated that a typical North American diet has around 1 gram of inositol per day.

Foods that are a good source include (Clements, 1980):

  • Fruits (such as oranges, cantaloupe, peaches, pears, bananas)
  • Vegetables such as bell peppers, tomatoes, potatoes, asparagus, and green leafy vegetables
  • Eggs
  • Whole grains (as opposed to processed, refined grains)
  • Beans, legumes and sprouts
  • Nuts and seeds.

When to Consider Inositol?

Research shows that inositol may possibly be helpful for a variety of conditions, such as:

  • Depression
    • Early study showed promise (Levine, 1995).
    • Later meta-analyses appear to indicate that inositol is more effective when there are symptoms of premenstrual dysphoric disorder (PMDD) (Mukai, 2014). In other words, if patients do not have PMDD or metabolic issues, inositol may be less likely to be effective.
  • Bipolar disorder (Wozniak, 2015)
  • Obsessive compulsive disorder (Fux, 1996)
  • Polycystic ovarian syndrome (PCOS) (Unfer, 2017) and related metabolic conditions

It appears that if it is helpful, that it is in conditions where serotonin (and thus medications such as serotonin selective reuptake inhibitors (SSRIs)) play a role.

It is not felt helpful in other conditions such as schizophrenia, Alzheimer's, ADHD, autism or ECT-induced cognitive impairment -- which are conditions where serotonin medications play less a role.

Note that it is not a panacea or a cure-all.

Availability

Inositol is available over the counter, from some drug stores but also from stores selling nutritional supplements.

Dosage

Studies have used the following ranges of dosages:

Condition

Dosage

Study

Adults



  • Depression in adults

6-12 g daily

Levine, 1995

  • Obsessive compulsive disorder in adults

Up to 18 g daily

Fux, 1996

  • Panic disorder in adults

Up to 18 g daily

Palatnik, 2001

  • Bulimia nervosa and binge eating

18 g daily

Gelber, 2001

Children/youth



  • Bipolar disorder in children aged 5-12

Up to 2 g daily

Wozniak, 2015

There are no official guidelines for the dosage of inositol.

However, Dr. Harold Pupko, psychiatrist in Toronto recommends the following:

  • Start at a low dosage (e.g. 500 mg daily)
  • Increase dosage every 3-4 days
  • When you notice improvement, keep that dosage (and stop increasing).
  • Maximum dosage of 12-18 mg daily
  • For example
    • Day 1,2,3: 500 mg daily
    • Day 4,5,6: 1000 mg daily
    • Day 7,8,9: 1500 mg daily
    • Day 10,11,12: 2000 mg daily
      • Do you notice improvement at this dosage? If so, then keep at this dosage.

Where to Find Inositol

Inositol can be found in many pharmacies, health food stores, and online retailers.

References

Chengappa et al.: Inositol as an add-on treatment for bipolar depression, Bipolar Disorders 2001; 2(1): 47-55. Pilot study showing inositol 12 g/day helpful as adjunctive treatment.

Clements R et al.: Inositol content of common foods: development of a high-myo-inositol diet. The American Journal of Clinical Nutrition. 33 (9): 1954–1967. doi:10.1093/ajcn/33.9.1954. PMID 7416064. S2CID 4442333.

Fux et al.: Inositol treatment of obsessive-compulsive disorder, Am. J. Psychiatry 1996 ; 153:1219-1221.

https://www.ncbi.nlm.nih.gov/pubmed/8780431

Double-blind, controlled crossover trial of 18 g/day of inositol or placebo for 6-weeks, with those on inositol showing significant improvement compared to placebo.

Gelber D et al.: Effect of inositol on bulimia nervosa and binge eating. Int. J. Eat Disord. 2001 Apr; 29(3): 345-8.

https://www.ncbi.nlm.nih.gov/pubmed/11262515

“Inositol is as therapeutic in patients with bulimia nervosa and binge eating as it is in patients with depression and panic and obsessive-compulsive disorders. This increases its parallelism with serotonin selective reuptake inhibitors.”

Levine et al.: Double-blind, controlled trial of inositol treatment of depression, Am. J. Psychiatry, 1995; 152: 792-794. Trial involving 12 g/day of inositol, with 13 patients receiving inositol, and 13 receiving placebo, showing significant improvement for inositol compared to placebo.

Levine et al.: Combination of inositol and serotonin reuptake inhibitors in the treatment of depression, Biological Psychiatry 45(3): 270-273. Study with 27 patients on inositol or inositol + SRI showed no additional benefit from combination treatment.

Nemets et al.: Inositol does not improve depression in SSRI treatment failures. J. Neural Transmission 1999; 106(7): 1435-63. In patients who did not respond to SSRI, inositol does not offer additional benefit.

Palatnik A et al.: J Clin Psychopharmacol. 2001 Jun;21(3):335-9.

Double-blind, controlled, crossover trial of inositol versus fluvoxamine for the treatment of panic disorder.

https://www.ncbi.nlm.nih.gov/pubmed/11386498

Inositol (dosages of up to 18 g /day) was more effective than fluvoxamine (up to 150 mg daily) for panic symptoms in adults with panic disorder.

Wozniak J et al.: 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. J Clin Psychiatry. 2015 Nov;76(11):1548-55. doi: 10.4088/JCP.14m09267.

https://www.ncbi.nlm.nih.gov/pubmed/26646031

Dosages used were 3 grams of omega-fatty acids, and 2 grams inositol.

Review Articles and Meta-Analyses

Mukai T et al.: A meta-analysis of inositol for depression and anxiety disorders, Human Psychopharmacol Clin Exp 2014; 29:55-63.

https://www.ncbi.nlm.nih.gov/pubmed/24424706

Our results suggest that inositol may be beneficial for depressed patients, especially those with PMDD. The main limitation of this report is that a small number of studies were included in this meta-analysis.

Unfer V et al.: My-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials, Endocrine Connections, 6(8): 647-658.

https://ec.bioscientifica.com/view/journals/ec/6/8/EC-17-0243.xml

Results highlight the beneficial effect of MI in improving the metabolic profile of women with PCOS, concomitantly reducing their hyperandrogenism.

For More Information

Dr. Harold Pupko is a psychiatrist in Toronto who has written about inositol in the Medical Post and other sources. Website: http://www.inositolpage.blogspot.com/

About this Document

Written by health professionals at CHEO in Ottawa, Ontario, Canada.

License

Under a Creative Commons License. You are free to share, copy and distribute this work as in its entirety, with no alterations. This work may not be used for commercial purposes. View full license at http://creativecommons.org/lic...

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

Date Posted: Jan 5, 2021
Date of Last Revision: Jan 5, 2021

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