Q. Diagnosed as bipolar/add. Currently taking Lamictal (200mg/day).
Looking at Ginkgo Biloba and Omega-3. What is the avearage theraputic dose for each? How to use meds/herbal together or switch from meds to herbal?

A. A quick bit of research indicates that Ginkgo is contraindicated if you are on Lamictal, so I would not take it until/unless you are off Lamictal.

For Omega-3, you can take either fish oil or flax oil. Each has its pros and cons. You can also take both together, just be wary of dosing instructions.

Fish oil - ready-made source of DHA, your body does not have to synthesize DHA from ALA. You do not need to take as much fish oil as you do flax oil. However, fish oil may take 6-12 weeks to have a noticable difference. Depending on the type of pill you are taking, you may have fish burps or upset stomach.

Flax oil - your body has to make DHA from ALA. You need to take more flax oil than you would fish oil. You may notice a difference in as little as 3-7 days. No fishy burps, but may cause diahrrea. Your body will synthesize DHA better with a source of GLA as well, so pick a brand that includes primrose or borage oil (like Udo's oil) or take a small dose of primrose oil as well.

To find your ideal dosage level, I recommend starting at half a regular dose once a day, and letting your body adjust. You will be less likely to have gastic symptoms if you work your way up gradually (increasing the dose every few days to a week). Do not take more than the maximum recommended dose on the bottle, and if you are taking both flax and fish oil together, I would not take the maximum recommended doses.

Keep in mind that omega-3 oils can have a blood-thinning effect.

I would recommend starting omega-3 supplements while you are still on Lamictal. There are no known interactions that I could find. Once you notice a change in your bipolar symptoms, talk to your doctor about lowering your dose. You may need to stay on a low dose of Lamictal, or you may be able to go off it. Either way, do it under your doctor's supervision. If you are able to go off of Lamictal completely, you can look at Ginkgo Biloba again at that time.

You may also want to consider magnesium and vitamin B complex supplements. I have not double-checked for interactions.

Good luck!

Pam