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.

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.

A contributor to our Bipolar Blog recently shared her story of living with Bipolar II and how a vegan diet along with 5-HTP and exercise helps her maintain mood stability. That got me thinking that it might be interesting and helpful to hear from others about what works (and what hasn’t) for them.

We’re all on a bipolar journey, and everyone travels a different path. Hearing what works and what doesn’t can often keep others off dead-end roads and provide shortcuts to more effective treatments so they feel better sooner.

Please share. What’s your diagnosis? What works for you – medication and non-medication? What hasn’t worked in the past?

Note: This is just for people with bipolar disorder. On Thursday, family and friends of those with bipolar will have their chance to share.

Photo by Martin Cathrae, available under a Creative Commons attribution license.

When’s the last time you saw your doctor for a med check? A month ago? Six months ago? A year or more? Getting regular med checks, which can vary from weekly to quarterly depending on the level of acuteness of your symptoms, is important for a number of reasons:

• If you were placed on medications to treat acute mania or depression and you’re feeling better now, your doctor may want to remove certain medications and/or decrease dosages to maintenance levels. You don’t want to be taking more medication than necessary. During a major manic episode, for example, doctors often prescribe a mood stabilizer, such as lithium, along with an atypical antipsychotic, such as Zyprexa, and then gradually withdraw the atypical antipsychotic as the patient improves.
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Abilify (aripiprazole) is an atypical antipsychotic medication commonly used to treat schizophrenia and acute mania. In 2005, the Food and Drug Administration (FDA) approved its use in the maintenance treatment of bipolar disorder – to prevent the recurrence of mood episodes. Unfortunately, evidence proving the effectiveness of Abilify as a maintenance medication for bipolar disorder is scarce and questionable.

Exposing the Truth

An article published this week in the open access journal PLoS Medicine (Tsai et al) looks critically at the scientific evidence that supports such widespread use of this medicine for maintenance treatment of bipolar disorder.

If brain chemistry can affect thoughts and behaviors, can thoughts and behaviors affect brain chemistry and perhaps even rewire the brain?

Yes.

An accumulating body of evidence supports the notion that non-medical interventions – especially mindfulness – can create changes in the body and brain that help reduce distress and improve brain function in a variety of ways.

MindfulnessA mental state of heightened awareness, free of distraction, and more conducive to deliberate thought and action.

Kelly Asks…

About a month ago, I was taken off my Lamictal, lithium, Seroquel, and Zoloft. I have a new Dr. who has prescribed me 150mg of Wellbutrin SR and 600mg of Neurontin. I became very depressed, had sleeping problems, and then as the third week hit, I became suicidal.

She increased my Wellbutrin SR to 150 mg twice a day and Neurontin up to 900mg (300mg morning and 600mg in the evening). I feel she is not treating me for my rapid-cycling Bipolar. I am either up or real real down, more down moments than my manic high, which often occurs.

Is she helping me or going to hurt me? I do not want to visit any more hospitals as a result of a doctor not giving me the right doses or too little or, as it is now, I have no antipsychotic meds, which is worrying me. Is this why I feel so depressed and suicidal thinking?

Please help. I am 43. I am not a child with Bipolar. Is this weak for my case? I have been hospitalized twice with Bipolar and I really wish to stay out of them. HELP PLEASE!!!!

Dr. Fink Answers…

Hi, Kelly. I am so sorry to hear that you are struggling like this right now. Most importantly, you should continue to express to your new doctor how badly you are feeling and insist that she explain to you what she is doing and why.

I recently read an interesting article by Kristy Foster on the Farm and Dairy website entitled “A healing place: Farming has a hand in recovery for those suffering from mental illness.” The article shines a spotlight on Hopewell Farm in Mesopotamia, Ohio – a unique 300-acre treatment center for adults with “schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and other forms of serious mental illness.”

Hopewell has the capacity to serve 40 adults, each of whom is expected to work on a crew, when well enough to do so. Each work crew serves a specific need in the community: housekeeping, kitchen, maintenance and grounds, farm and garden. In addition to requiring residents to serve on a work crew, Hopewell’s program includes:

Just read an article out of Glasgow, Scotland entitled “Laughter’s the Best Medicine,” about an interesting supplemental treatment for bipolar disorder and other illnesses – comedy courses.

According to the article, a Glasgow-based charity organization won a three-year £62,500 (approximately $100,000) grant from the Esmee Fairbairn Foundation to “provide free comedy courses aimed at improving confidence and self-esteem, as well as reducing the social isolation and depression, that ill health – mental and physical – can cause.”

I’m not sure how effective this would be in treating acute bipolar symptoms, but it certainly sounds like a great way recover from the fallout and remove a major stressor – the social isolation that often rides the tail of a major mood episode.

What I wonder is, would insurance cover this? Maybe I’ll call just to hear them laugh.

Photo by Cristiano Betta, available under a Creative Commons attribution license.