Mood Stabilizer-induced Metabolic Abnormalities in Bipolar Disorder

Inclusion Criteria:

• Bipolar disorder outpatients (aged 18-65 years) who meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) diagnostic criteria and start to receive valproate (VPA) will be enrolled consecutively by trained psychiatrists.

Exclusion Criteria:

• Exclude are patients who had DSM-V diagnosis for substance abuse within the past three months
• Had treated with antibiotics and/or functional foods (probiotics and/or prebiotics) for at least one month before entering study
• Presence of stomach/gut problems such as chronic diarrhea, constipation, gas, heartburn, bloating, etc.
• Had an organic mental disorder, mental retardation, dementia, or other diagnosed neurological illness
• Had a surgical condition or a major physical illness
• Were pregnant or breast-feeding
• Had any concomitant DSM-V Axis I diagnoses together with somatic or neurologic illnesses interfering psychiatric evaluation.