Effect of Coenzyme Q10 Supplementation on Urinary and Salivary Oxidative Stress Biomarkers in Bipolar Patients During the Depressive Episode

Background: Although depression is the predominant phase in Bipolar Disorder (BPD) and causes the most psychosocial disability, optimal pharmacotherapy of bipolar depression is not known yet. Advances in research on BPD neurobiology have demonstrated that oxidative toxic stress (OTS) may be involved in the pathophysiology of BPD. Objective: The present study aimed to evaluate the effects of adjuvant CoQ10, supplement with potent antioxidant properties, on salivary and urinary OTS biomarkers in patients with BPD during the depressive episode. Material and Methods: 89 BPD patients with current depressive episode were allocated into either CoQ10 (200 mg/day) or placebo group by block randomization method. The salivary and urinary levels of OTS biomarkers including Total Antioxidant Capacity (TAC) and DNA damage were measured at baseline and 8 weeks after treatment. Results: At baseline, urinary and salivary levels of TAC and DNA damage were statistically comparable between the two groups. After 8 weeks treatment with CoQ10, patients showed significantly higher increment in urinary TAC level compared to placebo, while salivary level of TAC did not display significant differences between the two groups. Although changes in salivary and urinary DNA damage levels were greater in CoQ10 group, the changes reached significant level only in the urine sample. Conclusion: Our findings suggest that CoQ10 can improve OTS status in BPD patients during depressive episode. As activation of oxidative stress is one of the mechanisms responsible for BPD, it seems that CoQ10 due to its proven antioxidant properties, as add on therapy to standard treatment may be a promising agent in treating bipolar depression.