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A recent guideline review by Silverstein et al., 2024 found that management recommendations are far more frequently included in psychiatric guidelines than psychiatric guidance appears in cardiovascular guidelines ( Conversely, cardiovascular guidelinesparticularly those from American societies rarely include recommendations regarding psychiatric comorbidities ( However, developing truly comprehensive guidelines for BD is challenging due to the disorders heterogeneity, the sheer volume of treatment modalities (pharmacological, psychosocial), and the predominance of fragmented, expert-opinionbased evidence complicate synthesis into unified algorithms ( 3.2.2 Metabolic monitoring Given the elevated risk of cardiometabolic complications in individuals with BD, systematic and regular metabolic monitoring is essential

Long-term LAC supplementation reduces glucose metabolism to lactic acid, resulting in an increment in energy metabolites and changes in norepinephrine (NE), DA and serotonin (5-HT) in the brain of mice (96, 103)

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doi: 10.4196/kjpp.2014.18.1.1 152

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