A recent article in the American Journal of Psychiatry sheds light on the vexing challenge of treating depression in individuals who have an underlying bipolar disorder: For many people with bipolar disorder, depression occurs more frequently and damages function more severely than mania, but treating bipolar depression with antidepressants carries the risk of triggering manic symptoms.
A study published last month in a journal called Translational Psychiatry entitled “Transcripts involved in calcium signaling and telencephalic neuronal fate are altered in induced pluripotent stem cells from bipolar disorder patients” reported interesting findings about the development of brain cells in people with bipolar disorder compared to controls — people without bipolar disorder. The study was unique in two important ways:
Researchers at the University of Michigan have discovered that antipsychotics may work, at least in part, by restoring normal gene function in people with bipolar disorder. (Chen, H., Wang, N., Zhao, X., Ross, C. A., O’Shea, K. S. and McInnis, M. G. (2013), “Gene expression alterations in bipolar disorder postmortem brains.” Bipolar Disorders, 15: 177–187. doi: 10.1111/bdi.12039)
The research team did post-mortem (after death) examinations on the brains of three groups of people:
Researchers in Denmark have discovered that treatment in specialized mood disorder clinics following a hospitalization significantly reduce hospital readmission rates.
In their study, published in the British Journal of Psychiatry and titled “Treatment in a specialised out-patient mood disorder clinic v. standard out-patient treatment in the early course of bipolar disorder: randomised clinical trial,” Lars Vedel Kessing et al. followed 158 patients who were discharged from their first, second, or third hospital admission with a single manic episode or bipolar disorder.
According to a recent study published in the journal Nature Communications entitled “A safe lithium mimetic for bipolar disorder,” British researchers are exploring a medication called ebselen as a possible treatment for bipolar disorder in humans. Originally developed to treat stroke, ebselen may be as effective as lithium in treating bipolar mania but carry fewer and less serious side effects than lithium.
As the article points out,
Lithium is the most effective mood stabilizer for the treatment of bipolar disorder, but it is toxic at only twice the therapeutic dosage and has many undesirable side effects.
October 15, 2012, researchers at Kings College in London published a study in the journal Biological Psychiatry, entitled “Replication study and meta-analysis in European samples supports association of the 3p21.1 locus with bipolar disorder” Biological Psychiatry. 2012 Oct 15;72(8):645-50. Vassos E, et al.) This study replicates earlier findings that connect changes at a particular gene region on chromosome 3p21.1 to bipolar disorder.
The Fall edition of the NAMI Advocate (2012) contains an interesting article by NAMI Communications Coordinator Brendan McLean entitled “The Hope for Mental Illness Research: Dr. Tom Insel Shares the Latest Data at NAMI Convention.” But it wasn’t the discussion about research that piqued my interest. Instead, it was what Dr. Insel said about stigma and the importance of engaging the family in the recovery process.
In the September issue of the American Journal of Psychiatry, researchers report a series of studies that suggest a strong association between one particular genetic variation and manic symptoms. (Studies in humans and mice implicate neurocan in the etiology of mania. Miró X, Meier S, Dreisow ML, Frank J, Strohmaier J, Breuer R, Schmäl C, Albayram O, Pardo-Olmedilla MT, Mühleisen TW, Degenhardt FA, Mattheisen M, Reinhard I, Bilkei-Gorzo A, Cichon S, Seidenbecher C, Rietschel M, Nöthen MM, Zimmer A. Am J Psychiatry, 2012 Sep 1;169(9):982-90.)
If the human brain were so simple we could understand it, we would be so simple we couldn’t.
–Emerson M. Pugh as quoted by George E. Pugh, The Biological Origin of Human Values, 1977
In a study just published on PLoS One entitled “Lithium Impacts on the Amplitude and Period of the Molecular Circadian Clockwork,” researchers at the University of Manchester (Jian Li, Wei-Qun Lu, Stephen Beesley, Andrew S. I. Loudon, and Qing-Jun Meng) have discovered that lithium works as a pacemaker for the circadian clock, which may help to explain lithium’s mechanism of action – how it works.