Living the Scientific Life (Scientist, Interrupted)

tags: researchblogging.org, bipolar disorder, manic-depressive illness, mental health, research

Those of you who suffer from bipolar disorder, as I do, will be pleased to learn that some novel treatments are being developed for this illness, thanks to research combined with careful observations.

Bipolar disorder is also known as manic-depressive illness. It is a mood disorder where a person who suffers from it experiences tremendous emotional shifts, from crushing depressions to intense mania and back again. These mood swings often are independent from what is happening in the person's life, and they can be debilitating, destroying careers, relationships and lives. Unfortunately, this disorder is difficult to treat because bipolar depression often does not respond to traditional antidepressants that are effective for treating clinical "unipolar" depression. It is estimated that one in 25 American adults suffer from bipolar disorder.

So far, lithium is the only medication that provides relief to most people with bipolar disorder. But lithium doesn't help everyone, so other medications, such as anticonvulsant medications and antipsychotics, are used, but they have limited effectiveness. Worse, many people can't tolerate current bipolar medications because of side effects like weight gain, sleepiness, tremor, and the feeling of being "drugged".

However, researchers are testing other medications for treatment of bipolar disorder. For example, NIMH researchers Doctors Maura Furey and Wayne Drevets are working with the drug, scopolamine, which normally is used to prevent seasickness or carsickness. Several years ago, they were studying whether scopolamine could improve memory and attention in depressed people. They gave the drug intravenously to depressed patients, trying to find the right dose for a brain-imaging study and found that their patients felt less depressed the night following the injections. This is truly amazing because it takes weeks for antidepressants to reach effective levels in the brain. Skin patches containing this drug are the focus of a special clinical trial.

"Some patients would say it was the best night of sleep they'd had in many years, and the next morning they woke up feeling a substantial lifting of their depression," Drevets reports. "In many cases that improvement persisted for weeks or even months."

It was discovered that riluzole, which is used to treat treat the paralyzing disorder Lou Gehrig's disease, also known as ALS or amyotrophic lateral sclerosis, appears to be effective at reducing the effects of bipolar depression. Apparently, it does this by increasing the amount of glutamate, as noticed in rat brain cells. riluzole is currently the focus of a clinical trial to better determine its effectiveness.

It was noticed that another drug, tamoxifen which is used to treat some forms of breast cancer, inhibits the action of a particular enzyme, protein kinase C, in the brain -- the same enzyme that lithium interacts with. Even though the long-term effects of tamoxifen use are unknown, this drug has opened the door for testing other drugs that also inhibit this enzyme for treating bipolar mania. The best aspect of this pharmaceutical is that it rapidly reduces the symptoms of mania, which makes it a good candidate for use in hospital emergency rooms.

Another treatment for bipolar depression that is currently being studied doesn't rely on medications at all. Instead, it relies on exposing the brain to electrical fields, similar to those used for magnetic resonance spectroscopic imaging. This was based on the observation that people suffering from bipolar depression often experienced improvement in their mood after undergoing MRI.

So in short, there are plenty of new approaches for dealing with bipolar disorder that are being researched, although like you, I can understand the impatience that you might be feeling at the time investment involved before they are shown to be effective and are approved.

Sources

Medscape.

"Low-Field Magnetic Stimulation in Bipolar Depression Using an MRI-Based Stimulator" by Michael Rohan, Aimee Parow, Andrew L. Stoll, Christina Demopulos, Seth Friedman, Stephen Dager, John Hennen, Bruce M. Cohen and Perry F. Renshaw. American Journal of Psychiatry 161:93-98 (January 2004) abstract]

Johns Hopkins.

DrugLib.

HighBeam.

AP (quotes).