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October 25, 2006

FDA approves Seroquel for bipolar depression

Seroquel, (manufactured by AstraZeneca) which is already used to treat the manic phases of bipolar disorder, has recently been approved by the FDA for treatment of bipolar depression, making it the only drug approved for both indications.

In an Astra Zeneca press release it quoted Patterson, executive director of development as saying "Treating acute bipolar disorder with a single medication may help patients adhere to their medication regimen,"

The FDA approval was based on results from studies where patients taking Seroquel showed an improvement in depressive symptoms starting at week one compared to those taking placebo, and this improvement continued throughout the study. In addition, patients treated with Seroquel showed significant improvement on overall quality of life and satisfaction related to functioning.

"For many patients with bipolar disorder, the depressive symptoms are significantly more debilitating and frequent than the manic symptoms, and having a medication that effectively treats both acute phases of the illness can be crucial to the overall treatment process," said Michael Thase, professor of psychiatry, University of Pittsburgh School of Medicine.

A recent news story by DataMonitor in the UK stated that AstraZeneca is currently defending the patent on its Seroquel drug, as Teva Pharmaceuticals is planning to market a generic version of the anti-psychotic drug.

Posted by szadmin at 12:47 PM | Comments (8)

Creative people or creative brains?

A review of the book "The Creating Brain: the Neuroscience of Genius" by the well-known psychiatry researcher Nancy Andreason was recently published in the UK medical journal "The Lancet".

In the review Steven Rose notes that Dr. Andreason is "one of the developers of the US psychiatrists' bible, the Diagnostic and Statistical Manual of Mental Disorders, and the author of some accessible books on the neuroscience of mental illness. Now, in keeping with the neurosciences' onward march into territory previously regarded as outside their terrain of competence, Andreasen has turned her attention from the mentally distressed to the mentally super-productive. What constitutes creativity, and what can neuroscience say about it?"

"Andreasen reviews the early anecdotal and more systematic studies, before turning to her own surveys of the psychiatric status of members of an Iowa writers' workshop. Here she found mood disorders (such as bipolar disorder) were fairly common but there was no sign of schizophrenia. This finding, and the other studies she cites, satisfactorily refutes the attempts by Tim Crow, Daniel Nettle, and others in recent years to claim schizophrenia as the genetic downside of an evolutionary drive towards creativity."

The review concludes with the statement "for those interested in this subject or for parents who aspire for the best for their offspring and want some encouragement in how to achieve it, The Creating Brain makes an enjoyable read."

The book can be purchased at Amazon and other book stores: The Creating Brain: the Neuroscience of Genius

Posted by szadmin at 12:36 PM | Comments (1)

Selective serotonin reuptake inhibitors (SSRIs) act as mood stabilizers for bipolar II disorder

According to a report published in the Journal of Affective Disorders, "We have previously observed that prescription of some antidepressant class drugs (particularly the SSRIs) is associated with attenuation of the number, duration and severity of both high and low mood states in those with bipolar II disorder. We examined whether SSRIs are a mood stabilizer for bipolar II disorder. We report a randomized, double-blind, placebo-controlled cross-over study lasting nine months in a sample of 10 patients who had not had previous treatment with any antidepressant, antipsychotic, or mood stabilizer drug."

"Treatment with the SSRI led to a significant reduction in depression severity, percentage of days depressed or high, and percentage of days impaired, when compared with placebo," said Gordon Parker and colleagues at the University of New South Wales. "There was no indication that the SSRI led to a worsening of illness course. Given the small sample size and a weighting to those with a rapid cycling condition, replication with a larger and more heterogeneous sample of those with bipolar disorder is required."

"This proof of concept study finds preliminary support for the potential utility of SSRIs in managing bipolar II disorder, with clear improvements in depression and impairment and some suggested benefit for hypomania," concluded the researchers.

Parker and associates published their study in the Journal of Affective Disorders (SSRIs as mood stabilizers for bipolar II disorder? A proof of concept study J Affect Disord, 2006;92(2-3):205-214).

Posted by szadmin at 12:31 PM | Comments (0)

October 24, 2006

Psychiatric Advance Directives - Information Center

With bipolar disorder, and other mental illnesses there are frequently periods during which the person is thinking clearly and capably, and other times when they are not.

During the periods when the person who suffers from bipolar disorder is thinking clearly it may be valuable to work out a plan that should be enacted for those times when the person is not as healthy. These plans can be made legal documents in the US using what is called a Psychiatric Advanced Directive. This document might also be valuable for people who are at high risk of bipolar disorder - but who do not have it (so the family can easily get help for the person should they ever develop the disorder).

You can learn more about Advanced Directives at the Bazelon Center for Mental Health Law web site link below:

National Resource Center on Psychiatric Advanced Directives

Posted by szadmin at 1:01 PM | Comments (1)

October 21, 2006

Bipolar Disorder and Sleep

The following is an excerpt from the book Bipolar II
by Ronald R. Fieve, M.D.

Published by Rodale; October 2006; $22.95US/$29.95CAN; ISBN 1-59486-224-9

Bipolar Disorder and Sleep

"How many hours do you sleep on average at night, and what is the quality of your sleep?" are two of the first questions I ask every patient on the initial interview and all subsequent follow-up visits. While the hypomanic usually gloats over how little sleep he needs, getting by on 3 to 4 hours a night, the lack of quality sleep can wreak havoc on his mood and decision-making abilities. Sleep deprivation results in feelings of malaise, poor concentration, and moodiness, and even accidental deaths.

In a revealing sleep study published in the September 2005 issue of the Journal of the American Medical Association, Judith Owens, MD, and her team of researchers from Hasbro Children's Hospital in Providence, Rhode Island, followed 34 pediatric residents from Brown University over the course of 2 years to compare post-call performance to performance after drinking alcohol. During this time, the residents were tested under light call (1 month of daytime duty with no overnight shift, or about 44 hours of work per week) and heavy call (overnight duty every fourth night with an average of 90 hours of work a week). The residents performed computer tasks to gauge their attention and judgment after their light call (after consuming alcohol) and heavy call shifts (with placebo). The residents who were on heavy call and had not ingested alcohol performed worse on the computer tests than those doctors who had taken alcohol and were on light call. Dr. Owens concluded that the residents were so sleep-deprived that they didn't recognize that their own judgment was impaired.

Drugs, stressful situations, and even excessive noise can affect daily body rhythms and moods. Once a Bipolar II mood disorder with disturbed rhythms has begun, it tends to be self-perpetuating, since depression and anxiety are likely to disrupt 24-hour rhythms further. An irregular living schedule can aggravate mood disorders. The old-fashioned sanitarium rest cure was effective with the "nervous" because it put the patient on a regular schedule of sleep, activity, and meals.


How is your sleep? Do you have difficulty falling asleep? Or do you toss and turn most of the night until you fall into a deep sleep just hours before the alarm goes off? A person suffering from insomnia has difficulty initiating or maintaining normal sleep, which can result in non-restorative sleep and impairment of daytime functioning. Insomnia includes sleeping too little, difficulty falling asleep, awakening frequently during the night, or waking up early and being unable to get back to sleep. It is characteristic of many mental and physical disorders. Those with depression, for example, may experience overwhelming feelings of sadness, hopelessness, worthlessness, or guilt, all of which can interrupt sleep. Hypomanics, on the other hand, can be so aroused that getting quality sleep is virtually impossible without medication. In a study at the University of Oxford in the United Kingdom, Allison G. Harvey, PhD, and colleagues in the department of experimental psychology determined that even between acute episodes of bipolar disorder, sleep problems were still documented in 70 percent of those who were experiencing a normal (euthymic) mood at the time. These normal-mood patients with bipolar disorder expressed dysfunctional beliefs and behaviors regarding sleep that were similar to those suffering from insomnia, such as high levels of anxiety, fear about poor sleep, low daytime activity level, and a tendency to misperceive sleep. Dr. Harvey concluded that even when the bipolar patients were not in a depressive, hypomanic, or manic mood state, they still had difficulty maintaining good sleep.

Delayed Sleep Phase Syndrome

This is the most common circadian-rhythm sleep disorder that results in insomnia and daytime sleepiness, or somnolence. A short circuit between a person's biological clock and the 24-hour day causes this sleep disorder. It is commonly found in those with mild or major depression. In addition, certain medications used to treat bipolar disorder may disrupt the sleep-wake cycle. I often recommend chronotherapy to patients. This therapy -- an attempt to move bedtime and rising time later and later each day until both times reach the desired goal -- is often used to adjust delayed sleep phase syndrome. To adjust the delayed sleep phase problem, sleep specialists might also use bright light therapy or the natural hormone melatonin, particularly in depressed patients.

REM Sleep Abnormalities

REM sleep abnormalities have been implicated by doctors in a variety of psychiatric disorders, including depression, posttraumatic stress disorder, some forms of schizophrenia, and other disorders in which psychosis occurs. Special tests, called sleep electroencephalograms, record the electrical activity of the brain and the quality of sleep. From these tests, we know that in people who are depressed, NREM sleep is reduced and REM sleep is increased. Most antidepressant medications suppress REM sleep, leading some researchers to believe that REM sleep deprivation relates to an improvement in depressive symptoms. Yet Wellbutrin XL, a common antidepressant, and some older medications used to treat depression do not suppress REM sleep. Researchers are therefore still trying to determine the connection between the REM sleep mechanism and depression.

Irregular Sleep-Wake Schedule

This sleep disorder is yet another problem that many with Bipolar II experience and in large part results from a lack of lifestyle scheduling. The reverse sleep-wake cycle is usually experienced by bipolar drug abusers and/or alcoholics who stay awake all night searching for similar addicts and engaging in drug-seeking behavior, which results in sleeping the next day. This sleep disruption and irregularity make it much more difficult for the bipolar patient's physician to treat him or her with conventional medications and adjunctive cognitive therapy. In most cases, the patient needs to acknowledge the drug-seeking behavior and get involved in a recovery program such as Alcoholics Anonymous, Cocaine Anonymous, or other group. Talk therapy with a psychologist is beneficial to many patients as they seek to change destructive lifestyle habits and learn new behaviors that will help them adhere to a more normal sleep-wake schedule.

Reprinted from: Bipolar II: Enhance Your Highs, Boost Your Creativity, and Escape the Cycles of Recurrent Depression -- The Essential Guide to Recognize and Treat the Mood Swings of This Increasingly Common Disorder by Ronald R. Fieve, M.D. © 2006 Ronald R. Fieve, M.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling at (800) 848-4735.

Ronald R. Fieve, MD, has published more than 300 scientific papers in the field of bipolar and depression research. His work has been published in such prestigious publications as The Lancet, Nature, The American Journal of Psychiatry, Archives of General Psychiatry, The Journal of the American Medical Association, L'Encephale, and Lithium. Dr. Fieve has also written two widely acclaimed books on mental health, Moodswing and Prozac (translated into five languages). He is professor of clinical psychiatry at Columbia Presbyterian Medical Center and Columbia College of Physicians and Surgeons, Columbia University, and principal investigator, Fieve Clinical Services, Inc. He maintains a private practice in New York City.

Copyright © 2006 Ronald R. Fieve, M.D.

Posted by daedalus at 5:22 AM | Comments (6)

October 12, 2006

An Excellent Bipolar Genetics Blog

There is an excellent new blog (written by psychiatric genetics researcher Ben Pickard) that is focused on bipolar disorder genetics.

In the blog Ben (and other writers) review many recent journal articles on the genetics of bipolar, and other brain disorders - in a way that for many people should be understandable (or at least most of it will be).

If you want to learn more about bipolar disorder genetics then this blog is a good place to visit. The blog is rather technical -- so perhaps its most appropriate for college students interested in learning more about the area.

Visit the Blog: Schizophrenia and Bipolar Disorder Genetics Blog

Posted by szadmin at 12:49 PM | Comments (4)

New Drug Being Tested For Treating Mania in Bipolar Patients

Memory Pharmaceuticals and The Stanley Medical Research Institute (SMRI) began phase 2a of testing their new drug MEM 1003. The drug is a calcium channel blocker and will be used to treat acute mania in those suffering from bipolar disorder.

“MEM 1003 is a neuronal L-type calcium channel modulator that Memory Pharmaceuticals is developing for the treatment of Alzheimer disease and bipolar disorder. By blocking L-type calcium channels, MEM 1003 may regulate the flow of calcium and re-establish normal levels of calcium, which may correct or prevent the severe mood swings that characterize bipolar disorder.”

This study will be a double-blind, randomized, placebo-controlled trail, in hopes of evaluating not only the safety, but the effectiveness of the new drug. The study consists of about 60 participants from the US. Each subject will either receive escalating doses of MEM 1003 or a placebo for 21 days. After the 21 day treatment, manic symptoms will then be determined using the Young Mania Rating Scale (YMRS).

This clinical trial is the first large-scale controlled study of a calcium channel blocker in bipolar disorder and is also an important milestone for Memory Pharmaceuticals, as we expand our clinical experience with MEM 1003 and explore the potential of this promising compound in this indication," said Stephen R. Murray, M.D., Ph.D., Vice President of Clinical Development. "In clinical practice, other calcium channel modulators have shown promise in the treatment of bipolar disorder, but the blood pressure lowering effects of these drugs have limited further development. We believe that MEM 1003 has been optimized for central nervous system activity and has the potential to improve the mood swings characterized by this disorder at doses below those that will lower blood pressure. We look forward to completing this trial in the first half of 2007."

Read Full Press Release:

"Memory Pharmaceuticals Initiates Phase 2a Trial of MEM 1003 in Bipolar Disorder" Memory Pharmaceuticals Sept 5 2006

Posted by Michelle Roberts at 9:57 AM | Comments (3)

October 11, 2006

Bipolar Awareness Campaign: Mania vs. Depression

October 5th 2006 was this years Bipolar Awareness Day, as part of the National Alliance on Mental Illness's (NAMI) annual Mental Illness Awareness Week. This included; events, movie viewings, donations, free mental health screenings, as well as posters promoting awareness of mental illnesses, all in hopes of educating and reducing stigma.

"The public's understanding of bipolar disorder remains unacceptably low, yet with proper diagnosis and treatment, people with bipolar disorder can and do reclaim their lives," said Suzanne Vogel-Scibilia, MD, President, NAMI National Board of Directors. "Given the fact that the consequences of lack of treatment are very serious, it is very important for everyone to know that treatment is available and it works."
This year encourages the understanding of mania vs. depression, “Bipolar Opposites: Understanding the Balance Between Mania and Depression”. Because depression is one of the most common mental illnesses, many can related to the damaging effects it can have on those affected. But mania is much less understood, and many people believe it isn’t as destructive as the depressive states.
"If left untreated, people experiencing either 'pole' of bipolar disorder are at great risk for suicide, relational stress, incarceration, substance abuse, job loss, or other harmful consequences," said Dr. Ken Duckworth, NAMI medical director and assistant professor of psychiatry at Harvard Medical School. "During an episode of mania, a person may have increased mental and physical energy and exaggerated feelings of optimism or self-confidence; however, they may also exhibit reckless behavior such as embarking on spending sprees, sexual indiscretions or alcohol abuse."

Although the specified time for Mental Illness Awareness week has passed, NAMI still provides information and resources on their site. You can find downloadable posters, fact sheets, and stickers, disorder information and resources in your area by clicking HERE. NAMI also provides information on future conferences HERE

Read Full Article:

"2006 Bipolar Disorder Awareness Campaign Encourages Public to Understand the Balance Between Mania and Depression" Drug News Wire Oct 9th 2006

For More Info:

NAMI's Mental Illness Awareness Week

"Bipolar Awareness Day" Psych Central

Posted by Michelle Roberts at 8:48 AM | Comments (6)

October 9, 2006

Book Review: Shifting Ground

In her recent autobiography, "Shifting Ground," Ruth McVeigh, documents the joy and the heartbreak of being married to an undiagnosed, unmedicated bipolar for 22 years.

The 22 years weren’t all bad. Ruth and Derry truly loved - and probably still love - each other despite the turmoil. Their life together was a whirlwind of adventure as they traveled to Guyana for Derry’s job as a forester, or to Ireland on vacation. They always managed to find wonderful places to live - Ruth describes the breathtakingly beautiful Canadian scenery so well, you’ll feel that you’ve been there.

But the beauty was often overshadowed by Derry’s depressions and manias. Ruth tells of the irratic behavior and careless decisions that estranged first her children from a previous marriage and then Derry’s own children. Knock wood, none of their children have inherited the illness.

The book is fascinating to me for a number of reasons, including the fact that the author founded a popular Canadian folk festival. She even got to meet Phil Ochs, a famous folk musician who happened to be bipolar! The list of musicians she mentions meeting at various points in the book is a veritable who’s who in folk music.

All-in-all, “Shifting Ground” was an excellent look into the lives and relationships in a family affected by one member’s bipolar disorder. I recommend that every spouse of a bipolar read this book. You’ll see your family there, and hopefully avoid some of the mistakes Ruth and Derry made. I hope that any bipolar who reads the book “gets” the cautionary tale contained in it; namely, that bipolar disorder is not a get-out-of-jail-free card. If we misbehave, if we are abusive or irresponsible, the people who love us *will* be hurt, and quite possibly driven away.

I hope you enjoy this book as much as I did.

Posted by daedalus at 12:28 PM | Comments (1)

Celebrities with Depression and Bipolar Disorder

The Independent of London (UK) reported this week that the following UK and US celebrities have talked openly about their mental illnesses:

1. Dame Kelly Holmes: Athlete "I became depressed and I cut my self with scissors and stuff."

2. Sinead O'Connor: Musician "I had developed manic depression [bipolar disorder] ... and the main symptoms the constant voice in the head telling you to kill yourself."

3. Hugh Laurie: Actor "It gets on top of me and I get frustrated."

4. Caroline Aherne: Actress "I try to piece together what I did and why I did it, but it's just a big blackout."

5. Robbie Williams: Singer "I've really been grappling with depression. It's all linked with my cocaine and ecstasy abuse."

6. Stephen Fry: Actor and director "I may have looked happy but inside Iwas hopelessly depressed."

7. Tony Slattery: Comedian "There's psychomotor agitation, where you're endlessly pacing, and you can't sleep and you're short-tempered."

8. Gail Porter: TV presenter "It's horrible, horrible, horrible. It took a year and a half until I found out that I had post-natal depression."

9. Brooke Shields: Actress "I just felt as though I would never be happy again, and as if I had fallen into a big black hole."

10. Adam Ant (Stuart Goddard):Musician "When I was sectioned for six months, that was one of the worst experiences of my life, not being able to go out and have freedom. Having experienced it, it's almost inexplicably awful."

11. Ruby Wax: TV presenter "Depressions are very cyclical, they happen once every five years. When I was on TV, yes I was effervescent, you can't fake it. It [depression] comes like the pox."

12. Richard Dreyfuss: Actor "I said to my doctor, 'You gotta testme, there's something wrong with me that I would be behaving this way.'"

13. Sarah Lancashire: Actress "My twenties were a writeoff. It's a cruel illness, because you can't see it and you can hide it so well."

14. Graeme Obree: Cyclist "When you're depressed, everything becomes distorted."

15.Winona Ryder: Actress "You have good days and bad days, and depression's something that, you know, is always with you."

16. Sophie Anderton: Model "I think it backfired. It wasn't what I expected, it was difficult. I didn't expect them to throw somany mind games into it. I didn't expect to be so emotional, but I asked for it really. I'ma glutton for punishment."

17. Denise Welch: Actress "I lost all sense of reality. I basically had what was a nervous break down."

18. Lenny Henry: Comedian "That' swhere depression hits you most - your home life. It doesn't affect your work. I can't do this zany, wacky, funny thing any more. I haven't been like that for a long time."

19.Mel C: Former Spice Girl "At the back of my mind there is always a fear the depression could return but I do all the right things. I try to get the right amount of sleep because I know that I need sleep to function and I need to eat properly and to do some exercising."

20.Melinda Messenger: Model and TV presenter "I felt suicidal. I couldn't stop crying. I remember thinking, 'wouldn't it be great if the car crashed and I died?'"

21. Bill Oddie: TV presenter "Chemicals will help you and medication will help you perhaps overcome it initially, but it won't work permanently if you don't follow it up with quite intense psychoanalysis of some sort."

22. Linda Hamilton: Hollywood actress "The lows were absolutely horrible. It was like falling into a manhole and not being able to lift the lid and climb out."

23. Trisha Goddard: TV presenter "I was in danger of having my children taken away from me when I needed five weeks in psychiatric care ... There is the smiling depressive which is the biggest time bomb and when they go they usually go with a bang, which was me ..."

24. James Dean Bradfield: Manic Street Preachers "I became a completely dysfunctional, miserable person, completely uncommunicative and aggressive."

25. Jim Carrey: Actor "I was on Prozac for a long time. It may have helped me out of a jam for a little bit, but people stay on it forever."

26. Ben Moody: Musician "I was horribly depressed, and I felt like I had failed as a band leader, a professional, as a person."

27. Keisha Buchanan: Singer, Sugababes "With depression, you can go in and out of it and not really know whether it's still there or not. Sometimes I'd find myself bursting into tears for no reason."

28. Carrie Fisher: Actress "Mania starts off fun, not sleeping for days, keeping company with your brain, which has become a wonderful computer, showing 24 TV channels all about you. That goes horribly wrong after awhile."

29. Neil Lennon: Footballer "It's a bit like walking down a long, dark corridor never knowing when the light will go on."

30. Lord Bragg: Broadcaster, author and president of Mind "Occasionally now I feel a wang that goes in my head - once you've got it you've got it. The [illness] was quite severe, leaving me deeply unhappy and frightened."

31.Meg Mathews: Noel Gallagher's ex-wife On the recent news of her going into rehab: "I can confirm Meg is receiving treatment. She is suffering from depression and needs time out."

32. Ben Stiller: Actor "I have not been an easygoing guy. I think it's called bipolar manic depression. I've got a rich history of that in my family."

33. Frank Bruno: Ex-boxer "It's like a kettle. If it's a kettle, you turn the kettle off, you know what I mean? I wish I could put a hole in my head and let the steam come out. The pressure was just getting a little bit much for me."

34. Russell Grant: TV presenter "It is amaze of total confusion can get to the point where you don't care if you live or die."

35. Katie Price/Jordan: Model "I was a psycho woman. It felt like something in me that I had no control over."

36. Paul Gascoigne: Footballer "Everywhere I looked life seemed to be full of problems and they were just going to go on and on. It was never going to get any better."

37. Kylie Minogue: Singer "You get such a kick and then it's all over. That's good ground for uncertainty and depression. I usually burst into tears."

38. Jack Dee: Comedian "Depression is something that has always figured in my life but now I'm dealing with it. I wish I'd done this years ago because it's been really helpful."

39. Uma Thurman: Actress "Nobody seemed to have any perspective any longer. Those were low points. But we got through it."

40. George Michael: Singer "It was like I had a curse on me. I couldn't believe how much God was piling on. There was so much death around me."

Posted by szadmin at 11:00 AM | Comments (54)

October 6, 2006

Bipolar Disorder May Be Indicated in Some Youth with Short Episodes Of Mania

Not all children with bipolar disorder may be getting properly identified because they fall just short of meeting diagnostic criteria for the disorder--criteria that is based on adult experiences--finds a study that examines the characteristics of children and adolescents who have symptoms of mania. The findings, from the first study of its kind to delineate the types of symptoms seen in children with bipolar spectrum disorders, were published today by researchers from the University of Pittsburgh School of Medicine in the Archives of General Psychiatry.

The researchers found that a significant number of children who presented with symptoms of bipolar disorder were just below the threshold of meeting the two primary classifications of bipolar disorder, mostly due to the fact that their manic episodes did not last long enough. However, these youth with "subthreshold" mania were similar in most ways to children and adolescents who met the full diagnostic criteria for bipolar disorder.

"Some children with bipolar disorder have distinct episodes of manic symptoms that last for many days or weeks at a time, just like it classically presents in adults with bipolar disorder. However, we do not know very much about children who have very clear periods of manic symptoms that do not last for several days. The results from this study suggest that some of these kids likely have bipolar disorder," said David Axelson, M.D., assistant professor of psychiatry, University of Pittsburgh School of Medicine and lead author of the study. "We need more research to figure out which kids go on to become bipolar adults, so it is too early to say that every child with brief periods of manic symptoms is bipolar. However, it is reasonable for clinicians to consider the possibility of bipolar disorder in youth who present with mania that does not reach the duration criteria for adult bipolar disorder."

The study assessed the symptoms of 438 children and adolescents between the ages of 7 and 17 years who were diagnosed with bipolar spectrum disorders; participants were enrolled at three centers: Brown University, University of California at Los Angeles and the University of Pittsburgh.

Bipolar disorder, commonly called manic-depressive illness, is characterized by swings between depression and mania and periods with mixed symptoms. As defined in adults by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV), bipolar disorder consists of two primary subtypes. Bipolar I (BP-I) is characterized by episodes of full-blown mania with or without major depression; Bipolar II (BP-II) involves episodes of less severe mania, called hypomania, and major depression. Significant manic symptoms that do meet the criteria for BP-I or BP-II is often called Bipolar Disorder Not Otherwise Specified (BP-NOS), which also is listed in the DSM-IV but does not have well-defined criteria. BP-NOS was defined for the purposes of this study as having a hypomanic episode without a history of major depressive episodes, having periods of mania that met the DSM-IV duration criteria for a manic episode but fell just short of the symptom criteria, or periods of mania that met the symptom criteria but were of short duration.

Participants and their caregivers were interviewed to assess symptoms, family history and socio-economic status using a host of well-accepted clinical evaluation tools. Data were evaluated to determine differences among the subtypes of bipolar disorder in intensity of symptoms, functional impairment, comorbid diagnoses, family history and manic symptoms.

A diagnosis of BP-I was most common among participants, with 255 (58.2 percent) having symptoms that qualified. A substantial number, 153 (34.9 percent) had a diagnosis of BP-NOS, and a small number, 30 (6.8 percent) had a diagnosis of BP-II.

There were many similarities between BP-NOS and BP-I, including age of onset, duration of illness, rates of comorbid diagnoses, rates of prior major depressive episodes, family history and types of manic symptoms. However, those with BP-I, on average, displayed one more manic symptom than those with BP-NOS and had more intense symptoms and more severe functional impairment. The BP-I subjects also had higher rates of psychosis and psychiatric hospitalization and were more likely to attempt suicide.

The researchers found that most participants with BP-NOS met the symptom criteria for BP-I or BP-II during the time they had experienced their most severe episode, but had not been diagnosed as having either classification because their manic symptoms did not last long enough. As such, the researchers say the duration criteria for BP-I and --II as defined for adults in the DSM-IV may not be adequate for assessing bipolar disorder in children. They hope outcomes from this study, which will follow the participants for five to ten years, will address whether changes should be made to the diagnostic criteria.

The results represent the second in a series of publications from the Course and Outcome of Bipolar Illness in Youths (COBY) study which is a multicenter National Institute of Mental Health-funded study led by Boris Birmaher, M.D., of the University of Pittsburgh, Martin Keller, M.D., of Brown University and Michael Strober, Ph.D., of the University of California at Los Angeles. The study is the largest study to date of pediatric bipolar disorder and the first prospective naturalistic study of children and adolescents with bipolar spectrum disorders. The first published results established the characteristics and short-term outcomes of the disease.

Posted by szadmin at 9:31 AM | Comments (0)

October 3, 2006

Bipolar drug Lamictal tied to birth defects

The FDA is notifying health care professionals and patients of new preliminary information suggesting that exposure to Lamictal (lamotrigine) during the first 3 months of pregnancy may lead to an increased risk of cleft lip or cleft palate in newborns.

New research suggests that babies exposed to Lamictal during the first three months of pregnancy may have a higher chance of being born with a cleft lip or cleft palate. Babies born with cleft lip or cleft palate have a gap in the upper lip or roof of the mouth.

If you take Lamictal and are pregnant or are thinking of becoming pregnant, talk with your doctor. Lamictal is used for seizures or bipolar disorder, serious conditions that need treatment even during pregnancy. Do not start or stop using Lamictal without talking to your doctor.

More Information: FDA says Glaxo drug may be linked to birth defect (Scientific American)

FDA Web Site Warning on Lamictal

Posted by szadmin at 11:30 AM | Comments (2)

New Bipolar Disorder Risk Gene Identified (Slynar)

University College London (UK) has announced that they believe that they've discovered a new gene that increases the risk for both depression and bipolar disorder.

The collaboration, led by Professor Hugh Gurling at University College London (UCL) and Professor Ole Mors at the University of Aarhus, first looked at bipolar cases in families living in the UK and in Denmark, and then at large numbers of unrelated people with bipolar disorder. The results of the genetic searches, published in the October issue of the American Journal of Psychiatry, identified the gene - known as Slynar - which is found on chromosome 12.

Bipolar disorder is known to run strongly in families, but the Slynar gene is one of just three genes now known to be implicated in susceptibility to the disorder. This gene appears to be present in around 10 per cent of bipolar disorder cases. Previous studies of families have already shown that there are multiple genetic subtypes of the disorder, but progress in identifying the exact genes responsible has been slow because groups of families inherit different susceptibility genes.

The Slynar gene is normally found in the brain, but in bipolar disorder has an abnormal effect due to mutations in the gene. However, researchers do not yet know what the gene's normal function is or how these mutations might be contributing to the disorder.

Professor Hugh Gurling, UCL Department of Mental Health Sciences, says: "The next step is to determine the role of the Slynar gene in the brain and how abnormalities in this gene may cause bipolar disorder. Using techniques such as animal models will help us to fully understand the mechanisms behind this gene and explore how we might be able to intervene in these mechanisms, to help people with the disorder.

"We hope our discovery will eventually lead to new treatments for depression and bipolar disorder, including possible preventive strategies, for example with drugs or even through nutritional intervention."

Around one in every 200 people in the UK develops bipolar and other related mood disorders. Signs of depression include losing weight, feeling totally negative about oneself, feel hopeless about the future and sometimes ending up in a depressive stupor in bed, unable to move, eat, drink or talk. People with bipolar disorder may also experience extreme mood highs, overactivity, increased libido, sleeplessness and grandiose delusions.

Posted by szadmin at 11:26 AM | Comments (12)