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The efficacy of adjunctive Garcinia mangostana Linn. (mangosteen) pericarp extract for bipolar depression: 24-week randomised controlled trial.

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Title: The efficacy of adjunctive Garcinia mangostana Linn. (mangosteen) pericarp extract for bipolar depression: 24-week randomised controlled trial.
Authors: Dean, Olivia M. (AUTHOR), Cotton, Susan M. (AUTHOR), Ashton, Melanie M. (AUTHOR), Turner, Alyna (AUTHOR), Saunders, Lucy (AUTHOR), Ng, Chee H. (AUTHOR), Hopwood, Malcolm (AUTHOR), Dodd, Seetal (AUTHOR), Khoo, Jon-Paul (AUTHOR), Walker, Adam J. (AUTHOR), Chatterton, Mary Lou (AUTHOR), Kavanagh, Bianca E. (AUTHOR), Nadjidai, Sarah E. (AUTHOR), Lo Monaco, Samantha L. (AUTHOR), Harvey, Brian H. (AUTHOR), Malhi, Gin S. (AUTHOR), Brown, Ellie (AUTHOR), Skvarc, David R. (AUTHOR), Diao, Danica (AUTHOR), Jacka, Felice N. (AUTHOR)
Source: British Journal of Psychiatry. Dec2025, Vol. 227 Issue 6, p854-863. 10p.
Subjects: Bipolar disorder, Mangosteen, Randomized controlled trials, Quality of life, Therapeutics, Mental depression, Treatment effectiveness
Abstract: Background: Bipolar depression remains difficult to treat, and people often experience ongoing residual symptoms, decreased functioning and impaired quality of life. Adjunctive therapies targeting novel pathways can provide wider treatment options and improve clinical outcomes. Garcinia mangostana Linn. (mangosteen) pericarp has serotonogenic, antioxidant anti-inflammatory and neurogenic properties of relevance to the mechanisms of bipolar depression. Aims: The current 28-week randomised, multisite, double-blind, placebo-controlled trial investigated mangosteen pericarp extract as an adjunct to treatment-as-usual for treatment of bipolar depression. Method: This trial was prospectively registered on the Australia New Zealand Clinical Trials Registry (no. ACTRN12616000028404). Participants aged 18 years and older with a diagnosis of bipolar I or II and with at least moderate depressive symptoms were eligible for the study. A total of 1016 participants were initially approached or volunteered for the study, of whom 712 did not progress to screening, with an additional 152 screened out. Seventy participants were randomly allocated to mangosteen and 82 to a placebo control. Fifty participants in the mangosteen and 64 participants in the placebo condition completed the treatment period and were analysed. Results: Results indicated limited support for the primary hypothesis of superior depression symptom reduction following 24 weeks of treatment. Although overall changes in depressive symptoms did not substantially differ between conditions over the course of the trial, we observed significantly greater improvements for the mangosteen condition at 24 weeks, compared with baseline, for mood symptoms, clinical impressions of bipolar severity and social functioning compared with controls. These differences were attenuated at week 28 post-discontinuation assessment. Conclusions: Adjunctive mangosteen pericarp treatment appeared to have limited efficacy in mood and functional symptoms associated with bipolar disorder, but not with manic symptoms or quality of life, suggesting a novel therapeutic approach that should be verified by replication. [ABSTRACT FROM AUTHOR]
Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The efficacy of adjunctive Garcinia mangostana Linn. (mangosteen) pericarp extract for bipolar depression: 24-week randomised controlled trial.
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  Data: <searchLink fieldCode="AR" term="%22Dean%2C+Olivia+M%2E%22">Dean, Olivia M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cotton%2C+Susan+M%2E%22">Cotton, Susan M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ashton%2C+Melanie+M%2E%22">Ashton, Melanie M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Turner%2C+Alyna%22">Turner, Alyna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Saunders%2C+Lucy%22">Saunders, Lucy</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ng%2C+Chee+H%2E%22">Ng, Chee H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hopwood%2C+Malcolm%22">Hopwood, Malcolm</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dodd%2C+Seetal%22">Dodd, Seetal</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Khoo%2C+Jon-Paul%22">Khoo, Jon-Paul</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Walker%2C+Adam+J%2E%22">Walker, Adam J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chatterton%2C+Mary+Lou%22">Chatterton, Mary Lou</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kavanagh%2C+Bianca+E%2E%22">Kavanagh, Bianca E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nadjidai%2C+Sarah+E%2E%22">Nadjidai, Sarah E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lo+Monaco%2C+Samantha+L%2E%22">Lo Monaco, Samantha L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Harvey%2C+Brian+H%2E%22">Harvey, Brian H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Malhi%2C+Gin+S%2E%22">Malhi, Gin S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brown%2C+Ellie%22">Brown, Ellie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Skvarc%2C+David+R%2E%22">Skvarc, David R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Diao%2C+Danica%22">Diao, Danica</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jacka%2C+Felice+N%2E%22">Jacka, Felice N.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22British+Journal+of+Psychiatry%22">British Journal of Psychiatry</searchLink>. Dec2025, Vol. 227 Issue 6, p854-863. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Bipolar+disorder%22">Bipolar disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Mangosteen%22">Mangosteen</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Quality+of+life%22">Quality of life</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Bipolar depression remains difficult to treat, and people often experience ongoing residual symptoms, decreased functioning and impaired quality of life. Adjunctive therapies targeting novel pathways can provide wider treatment options and improve clinical outcomes. Garcinia mangostana Linn. (mangosteen) pericarp has serotonogenic, antioxidant anti-inflammatory and neurogenic properties of relevance to the mechanisms of bipolar depression. Aims: The current 28-week randomised, multisite, double-blind, placebo-controlled trial investigated mangosteen pericarp extract as an adjunct to treatment-as-usual for treatment of bipolar depression. Method: This trial was prospectively registered on the Australia New Zealand Clinical Trials Registry (no. ACTRN12616000028404). Participants aged 18 years and older with a diagnosis of bipolar I or II and with at least moderate depressive symptoms were eligible for the study. A total of 1016 participants were initially approached or volunteered for the study, of whom 712 did not progress to screening, with an additional 152 screened out. Seventy participants were randomly allocated to mangosteen and 82 to a placebo control. Fifty participants in the mangosteen and 64 participants in the placebo condition completed the treatment period and were analysed. Results: Results indicated limited support for the primary hypothesis of superior depression symptom reduction following 24 weeks of treatment. Although overall changes in depressive symptoms did not substantially differ between conditions over the course of the trial, we observed significantly greater improvements for the mangosteen condition at 24 weeks, compared with baseline, for mood symptoms, clinical impressions of bipolar severity and social functioning compared with controls. These differences were attenuated at week 28 post-discontinuation assessment. Conclusions: Adjunctive mangosteen pericarp treatment appeared to have limited efficacy in mood and functional symptoms associated with bipolar disorder, but not with manic symptoms or quality of life, suggesting a novel therapeutic approach that should be verified by replication. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of British Journal of Psychiatry is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=189411708
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        Value: 10.1192/bjp.2025.108
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        Text: English
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