Bipolar disorder can be incredibly difficult to treat. There are literally hundreds of different combinations of medications available to quell symptoms, but they don’t always work. For some people, medication must be adjusted on a frequent basis in order for the person to remain stable. Even with treatment, most people still experience breakthrough symptoms and even full-blown episodes of depression and mania. Because of this, new types of treatments are being researched in order to find a better way to help those who suffer from bipolar disorder. One recent journal article looked at evidence of four alternative treatments in order to see if there is a potential for a new direction in the treatment of bipolar depression.
The article, published in the journal CNS & Neurological Disorders – Drug Targets and led by Gustavo H. Vázquez, looks at reports and studies from the last decade relevant to four different exploratory treatments for bipolar depression.
Ketamine is a dissociative anesthetic-analgesic. Medically it is used primarily as a sedative during surgical procedures. It is more commonly used in veterinary medicine. It is a schedule III controlled substance often used as a street drug. There is research showing that ketamine can be effective for treatment-resistant major depressive disorder but there is limited research for treatment for bipolar depression.
The current article found examples that showed over half of patients saw results within 24 hours. This included decreased levels of suicidality and lower depressive symptoms. Another study found that ketamine was less effective at treating bipolar depression than major depressive disorder. The effects were relatively short-lived and there is an increased risk of dependency.
Long-chain fatty acids like those found in oily fish, nuts, eggs, flax-seed and soy are important for overall health. They make up part of cell membranes, they store energy, are part of the development of tissues and organs and are essential to brain functioning. Omega 3 fatty acids also have neuroprotective properties.
Using dietary fatty acids as a treatment for bipolar disorder has produced modest and inconsistent results. A few studies have found that fatty acids help reduce symptoms of mania and depression, but others have not been able to replicate this effect.
Research on the correlation between inflammation and bipolar disorder symptoms is growing. It has shown that when cytokine levels are higher and inflammation occurs in the brain, serotonin and dopamine transmission is disrupted. The thought behind treating bipolar depression with anti-inflammatory medications is that this disruption can be corrected and thus relieve depressive symptoms.
The current article found that the use of non-steroidal anti-inflammatory drugs (NSAIDs) showed minimal effect, if any, at treating bipolar depression. Additionally, prolonged use of NSAIDs can cause gastrointestinal bleeding and increases the risk of heart attack and stroke.
Research has found a link between the gut microbiome and symptoms of bipolar disorder. The enteric (gastrointestinal) nervous system is affected by the types of bacteria found in the gut. Those with bipolar disorder tend to have a slightly different microbiome makeup of otherwise healthy people. The hypothesis of treating bipolar depression with probiotic supplements is that the supplements will alter the microbiome and thus relieve symptoms.
Some studies have found slightly improved levels of depression when taking probiotics, but have temporary effects. More research needs to be done to see the effects of probiotics on bipolar depression specifically.
While some of these treatments, especially ketamine, show potential for alternative treatments for bipolar disorder, they do not produce the same results as standard treatments like mood stabilizers and antipsychotics. More research needs to be done to see if treatments like the ones found in this paper can be developed for treatment-resistant bipolar depression.
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