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Home > Health Conditions > Bipolar Disorder.

Bipolar Disorder

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  • Differences in the prophylactic effect of serum lithium levels on depression and mania in bipolar disorder: A dose-response meta-analysis - Eur Neuropsychopharmacol 2022 Feb 11 - "The dose-response curve showed that increased serum concentrations were associated with a gradual decrease in the risk of any mood episodes (OR 0.50 at 0.60 mmol/l, OR 0.15 at 1.20 mmol/l). The risk of depression decreased slightly with a concentration of 0.60 mmol/l (OR 0.83) but dropped rapidly as the concentration increased to 1.20 mmol/l (OR 0.39). By contrast, the risk for mania initially decreased steadily (OR 0.44), but decreased only marginally (OR 0.30) as the concentration increased. To reduce the recurrence risk to 56%, prevention of depression required a higher concentration than that required for mania (1.13 mmol/l vs. 0.60 mmol/l). Our results suggest a negative dose-response relationship between serum lithium levels and risk of recurrence. In particular, the different preventive effects of serum concentration on depression and mania will be an important clinical reference" - See lithium supplements at Amazon.com.
  • 'Remarkable' Response to Diabetes Drug in Resistant Bipolar Depression - Medscape, 6/7/21 - "The study needs replication, but this early clinical trial suggests that the mitigation of insulin resistance by metformin significantly improves depressive symptoms in a significant percentage of treatment resistant bipolar patients ... Patients were titrated up to 2000 mg of metformin, which was the full dose, over 2 weeks and then maintained on treatment for a further 24 weeks ... Those who reversed their insulin resistance showed a remarkable resolution in their depressive symptoms. The reduction in MADRS scores began at week 6, and were maintained through to the end of the study, and the Cohen's d effect size for MADRS depression scores for converters was 0.52 at week 14 and 0.55 at week 26 ... All had failed, on average, 8 or 9 trials in their lifetime. When they came to us, nothing else would work. That's one of the remarkable things about our results, just how well they responded when they had not responded to any other psychotropic medications" - See metformin at ReliableRX.
  • 'Calcium Imbalance' Linked to Bipolar Severity - Medscape, 5/11/21 - "The findings also highlight the importance of routinely assessing PTH, vitamin D, and calcium levels in patients with BD as a marker of clinical severity ― and may point to vitamin D "as a valid add-on treatment for these patients," Palummo added" - See vitamin D at Amazon.com.
  • Probiotics May Reduce Rehospitalization in Bipolar Disorder - Medscape, 4/15/19 - "Patients receiving the probiotic had a significantly decreased risk of being hospitalized. About 24% of patients were rehospitalized in the treatment group, compared with approximately 73% in the placebo group. Also, individuals receiving the probiotic were rehospitalized for much shorter periods of time (2.8 vs 8.3 days) ... Another part of this study that was quite interesting, which I haven't really seen in a lot of trials to date, was that the researchers looked at a number of biomarkers to establish what's called a neuroinflammatory index. They looked at a group of antigens to things like gliadin, toxoplasmosis, or the Mason‐Pfizer monkey virus. They stratified their sample and found that individuals with high neuroinflammatory markers who received the probiotic had a 90% reduced risk of being rehospitalized for mania." - See probiotic products at Amazon.com.
  • Probiotics could help millions of patients suffering from bipolar disorder - Science Daily, 12/13/18 - "a probiotic supplement may reduce inflammation of the gut, which is known to exacerbate bipolar disorder ... In recent years, research has demonstrated a strong link between the gastrointestinal tract and the central nervous system. This connection, named the "gut-brain axis" (GBA), allows for crosstalk between the endocrine, immune, and autonomic nervous systems ... There is also mounting evidence linking imbalances in the microbial species that make up the gut microbiome to a number of health problems including allergies, autoimmune disorders, and psychiatric mood disorders ... Overall, these results indicate that changes in intestinal inflammation can alter the trajectory of psychiatric mood disorders and that modulating the intestinal microbiota may be a new avenue of treatment for patients suffering from these diseases" - See probiotic products at Amazon.com.
  • Lower availability of omega-3 fatty acids in the body associated with bipolar disorder - Science Daily, 11/24/15 - "the availability of omega-3 in the body is lower in bipolar subjects ... Omega-3 and omega-6 fatty acids can shift the balance of inflammation, which we think is important in bipolar disorder ... However, the researchers did not find altered ratios of omega-3 to omega-6 fatty acids in bipolar subjects ... Although the researchers did find lower levels of omega-3s in patients with bipolar disorder that correlated with symptoms" - See fish oil supplements at Amazon.com.
  • Saying No to Cannabis Improves Bipolar Outcomes - Medscape, 1/19/15 - "quitting cannabis during acute treatment for manic/mixed bipolar episodes and refraining from use during a maintenance treatment period significantly improved function and lowered the risk for recurrence ... Our results also showed that patients who continued to use cannabis had worse outcomes than those who either stopped using cannabis or had never used it ... patients that continued using cannabis had more suicide attempts than those that quit or those who never used cannabis"
  • Omega-3 Fatty Acids Plus Inositol Promising in Pediatric BPD - Medscape, 6/26/14 - "The effects that we saw with these products, particularly the combination of high EPA omega-3 fatty acids plus inositol, were comparable to the effects that we are accustomed to seeing with more toxic drugs. It was quite surprising and quite impressive ... The small study included 24 children aged 6 to 12 years ... randomly assigned to receive either monotherapy with EPA/DHA (docosahexaenoic acid) omega-3 fatty acids (3000 mg) plus placebo (n = 7), inositol (2000 mg for children weighing 25 kg or more; 80 mg/kg for children weighing less than 25 kg) plus placebo (n = 7), or the combined active treatment of omega-3 fatty acids and inositol ... At the end of 12 weeks, the children who received the combined treatment of omega-3 fatty acids and inositol showed significantly greater improvement on the Young Mania Rating Scale (YMRS) than those treated with inositol (P = .021) and omega-3 fatty acids (P = .046) alone" - See fish oil supplements at Amazon.com and inositol at Amazon.com.
  • The protective effect of melatonin against brain oxidative stress and hyperlocomotion in a rat model of mania induced by ouabain - Behav Brain Res. 2014 Jun 21 - "Our study showed that Melatonin, similarly to lithium, protected against OUA-induced brain oxidative stress and hyperlocomotion in rats. Thus, our findings reinforce the notion that oxidative stress may play an important role in the manic-like behavioural. Therefore, we indicate that Melatonin has antimanic-like action, suggesting a potential role for this substance in the pharmacological management of Bipolar disorder" - See melatonin at Amazon.com.
  • Amino acid offers potential therapeutic alternative in psychiatric disorders - Science Daily, 10/8/13 - "drug discovery is at a near standstill for treating psychiatric disorders such as schizophrenia, bipolar disorder, depression and common forms of autism ... According to Professor Berk, there is now an incontrovertible evidence base that these disorders share inflammation and oxidative stress as part of their disease physiology ... The amino acid, NAC, seems to have multiple effects on all these pathways: it boosts glutathione, which is the body’s major antioxidant defence; has anti-inflammatory properties; enhances levels of nerve cell growth proteins and the growth of new neurons; and reduces cell death pathways. It also appears to reduce dysfunction of mitochondria ... NAC reduces the core symptoms of schizophrenia including negative symptoms such as improved apathy, social interaction and motivation. It also appears to reduce depression in people with bipolar disorder and at this meeting ... there is intriguing evidence that it reduces cravings in a number of addictions including cocaine, cannabis and cigarette smoking" - See n-acetyl cysteine at Amazon.com.
  • Neuron loss in schizophrenia and depression could be prevented, study suggests - Science Daily, 3/13/13 - "It now appears that parvalbumin neurons are particularly vulnerable to oxidative stress, a factor that may emerge commonly in development, particularly in the context of psychiatric disorders like schizophrenia or bipolar disorder, where compromised mitochondrial function plays a role. Parvalbumin neurons may be protected from this effect by N-acetylcysteine, also known as Mucomyst, a medication commonly prescribed to protect the liver against the toxic effects of acetaminophen (Tylenol) overdose ... This study raises the possibility that GABA neuronal deficits in psychiatric disorder may be preventable using a drug, N-acetylcysteine, which is quite safe to administer to humans" - See n-acetyl cysteine at Amazon.com.
  • N-Acetyl Cysteine Effective for Bipolar Depression - Medscape, 6/10/11 - "oxidative stress and inflammation play a role in the pathophysiology of bipolar disorder ... NAC is a cysteine analogue shown to effectively raise plasma levels of the primary antioxidant, glutathione. NAC also modulates cytokines, glutamates neurotransmission, and enhances neurogenesis ... significant differences (P < .001) were found between baseline and week 8 for all study measures. Minimal side effects occurred" - Note:  That seems like a high dose but I would think most would take a lower lower dose over a longer period of time which may be as effective.  See n-acetyl cysteine at Amazon.com.
  • Fish oil may have positive effects on mood, alcohol craving, new study shows - Science Daily, 5/26/11 - "Researchers at the Indiana University School of Medicine have found at a molecular level a potential therapeutic benefit from these dietary supplements for treating alcohol abuse and psychiatric disorders ... In a multi-year study, researchers showed conclusive behavioral and molecular benefits for omega 3 fatty acid given to mice models of bipolar disorder. The fatty acid DHA, which is one of the main active ingredients in fish oil, "normalized their behavior," ... The mice that were given DHA normalized their behavior, they are not depressed and when subjected to stress, they do not become manic ... When we looked into their brains, using comprehensive gene expression studies, we were surprised to see that genes that are known targets of psychiatric medications were modulated and normalized by DHA ... These bipolar mice, like some bipolar patients, love alcohol. The mice on DHA drank much less; it curtailed their alcohol abusive behavior ... There is now substantial evidence at the molecular level that omega-3 fatty acids work on the brain in ways similar to psychiatric drug ... Omega 3 fatty acids are known to be good for one's health, good for one's brain, and lack major side-effects, as opposed to some psychiatric medications" - See Jarrow Max DHA at Amazon.com.
  • N-acetylcysteine in psychiatry: current therapeutic evidence and potential mechanisms of action - J Psychiatry Neurosci. 2010 Nov 1;35(6):100057 - "This review outlines the current literature regarding the use of NAC in disorders including addiction, compulsive and grooming disorders, schizophrenia and bipolar disorder. N-acetylcysteine has shown promising results in populations with these disorders, including those in whom treatment efficacy has previously been limited. The therapeutic potential of this acetylated amino acid is beginning to emerge in the field of psychiatric research" - See n-acetyl cysteine at Amazon.com.
  • New study links DHA type of omega-3 to better nervous-system function - Science Daily, 12/16/09 - "The omega-3 essential fatty acids commonly found in fatty fish and algae help animals avoid sensory overload ... The finding connects low omega-3s to the information-processing problems found in people with schizophrenia; bipolar, obsessive-compulsive, and attention-deficit hyperactivity disorders; Huntington's disease; and other afflictions of the nervous system" - See Jarrow Max DHA at Amazon.com.
  • Add-On Therapy Improves Depressive Symptoms In Bipolar Disorder - Science Daily, 9/2/08 - "sought to evaluate whether N-acetyl cysteine (NAC), an over-the-counter supplement that increases brain glutathione, might help alleviate depressive symptoms ... Glutathione is the brain’s primary antioxidant defense, and there is evidence of increased oxidative stress in bipolar disorder. Therefore, we studied the potential benefit of NAC treatment in bipolar disorder and found that it impressively remedied residual depressive symptoms" - See n-acetyl cysteine at Amazon.com.
  • Bright Light Therapy Eases Bipolar Depression For Some - Science Daily, 1/3/08
  • Omega-3 fatty acid monotherapy for pediatric bipolar disorder: a prospective open-label trial - Eur Neuropsychopharmacol. 2007 May-Jun;17(6-7):440-7 - "omega-3 fatty acids 1290 mg-4300 mg combined EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) ... Subjects experienced a statistically significant but modest 8.9+/-2.9 point reduction in the YMRS scores (baseline YMRS=28.9+/-10.1; endpoint YMRS=19.1+/-2.6, p<0.001). Adverse events were few and mild. Red blood cell membrane levels of EPA and DHA increased in treated subjects" - See Mega Twin EPA at Amazon.com.
  • Daily Routine May Help Bipolar Disorder - WebMD, 9/8/05
  • Fish Oil Soothes Personality Disorder - WebMD, 1/17/03 - "a new study shows daily fish oil supplementation can significantly reduce their symptoms without the negative side effects associated with other treatments" - See TwinLab Mega Twin EPA at Amazon.com.
  • Omega-3 May Cut Bipolar Symptoms in Pregnancy - Clinical Psychiatry News, 8/02 - "From studies on animals, scientists now know that omega-3 fatty acids provide for normal brain and central nervous system development. Depriving animals of these compounds is associated with abnormalities in offspring ... Omega-3 fatty acids are thought to dampen signal transduction pathways associated with the pathophysiologic characteristics of bipolar disorder, similar to medications such as lithium and valproate. Omega-3 fatty acids also boost the brain's levels of serotonin ... fish oil supplement capsules carry no danger for pregnant women, according to an FDA spokesperson" - See TwinLab Mega Twin EPA at Amazon.com.
  • Omega 3: Implications in human health and disease - PowerPak (39 page CME course for Registered Dietitians), exp. 8/1/03 - "In 1999, Stoll, in a placebo controlled, double blinded study in 30 patients with bipolar depression, reported that 9.6 g/day of omega 3 as EPA (6.2 g) and DHA (3.4 g) resulted in significant improvements in remission and outcome compared to placebo (olive oil). The reductions in depressive and mania-related events in the omega 3 treatment group were so significant that the study was stopped after 4 months and a larger multicenter study is in progress" - See Twinlab Mega Twin EPA at Amazon.com.  Note that the omega-3 in a supplement is the total of the eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acids (DHA), not the total fish oil that it says on the label.  That's a confusing area the the FDA should be cracking down on.
  • Supplement Mix Eases Bipolar Symptoms - WebMD, 12/20/01 - "In the six-month trial, 14 patients, aged 19-46, continued on their regular medications, but also took the specially-formulated, 36-ingredient supplement mixture of vitamins, minerals, amino acids, and antioxidants. Prior to the study, the patients had used an average of 10 different drugs to help control their symptoms, and each had been hospitalized at least once ... At regular intervals during the trial, patients took several standardized tests to measure their depression and mania symptoms. Within two weeks, most of the patients showed 50%-66% improvements in all symptoms. "In some cases," the researchers write, "the supplement replaced psychotropic medications and the patients remained well.""
  • Polyunsaturated Fats and Neurological Disorders - Nutrition Science News, 9/00
  • Researchers Look To Omega-3 Fatty Acid For Manic Depression Treatment - Doctor's Guide, 5/13/99
  • Omega 3 fatty acids in bipolar disorder: a preliminary double-blind, placebo-controlled trial - Arch Gen Psychiatry. 1999 May;56(5):407-12 - "A Kaplan-Meier survival analysis of the cohort found that the omega3 fatty acid patient group had a significantly longer period of remission than the placebo group (P = .002; Mantel-Cox). In addition, for nearly every other outcome measure, the omega3 fatty acid group performed better than the placebo group."
  • Thiamine's Mood-Mending Qualities - Nutrition Science News, 1/99

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