If you plan to pursue vitamin therapies, purchase a basic guide to vitamins and minerals that includes information about toxicity symptoms. Some people metabolize vitamins and minerals differently, and may be more or less susceptible to potential toxic effects. Along with your doctor’s guidance, a good reference book can help you avoid problems. Also, take vitamin company sales pitches and dosage recommendations with a grain of salt. The testimonials these companies produce are intended to sell their products, not to help you develop a treatment plan. Consult a physician or a professional nutritionist who does not sell supplements for unbiased, individualized advice.

Vitamin B-1 (Thiamin). Alone, or in addition to a regular B-complex pill, B-1 might be a good idea for bipolar patients who suffer from circulation problems, tingling in the extremities, anxiety, irritability, night terrors, and similar symptoms.Vitamin B-6 (Pyridoxine). In addition to a regular B-complex pill, B-6 might be indicated for bipolar patients who present with a great deal of irritability, and for those with marked premenstrual symptoms and/or motion sickness. If you start to experience tingling in your hands or feet, reduce or discontinue the B-6.Vitamin B-12. Helps your body turn food into energy, and without enough of it you are likely to feel listless and fatigued. Vegetarians may also be deficient in B-12, as it’s found mostly in meat.Vitamin E. An antioxidant that also seems to reduce the frequency of seizures in some people who have epilepsy. It’s especially important to take vitamin E if you take Depakote, Depakene, or another anticonvulsant, as these drugs deplete vitamin E. If you have high blood pressure, monitor it carefully after starting vitamin E, and reduce the dose if your blood pressure rises.

Vitamins A and D are fat-soluble, so they are stored in the body’s fat cells for later use. Having a little socked away for a rainy day is probably okay, but if you take too much, hypervitaminosis may develop. Symptoms of hypervitaminosis A include orangeish, itchy skin; loss of appetite; increased fatigue; and hard, painful swellings on the arms, legs, or back of the head. Symptoms of hypervitaminosis D include hypercalcemia, osteoporosis, and kidney problems. Don’t overdo it with any fat-soluble vitamin, and also be careful with fish-oil supplements (and cod liver oil), which are high in both vitamins A and D. Folic acid can counteract the effects of Depakote, Depakene, and some other anticonvulsants if taken in large amounts. It may also cause manic mood swings.