I came across an impressive poem through an interpretation of the poem in the British Journal of General Practice.
Lithium
After the arc of ECT
and the blunt concussion of pills,
they gave him lithium to cling to—
the psychiatrist’s stone.
A metal that floats on water,
must be kept in kerosene,
can be drawn into wire.
(He who had jumped in the harbor,
burnt his hair off,
been caught hanging from the light.)
He’d heard it was once used
to make hydrogen bombs,
but now was a coolant for nuclear reactors,
so he broke out of hospital barefoot
and walked ten miles to meet me in the snow.
An excellent slideshow with an overview about Bipolar Disorder. The site is sponsored but the information on bipolar disorder is correct, useful and very readable. RxList.com Bipolar Disorder Overview Slideshow
A short but adequate summary of bipolar disorder. To the point on BBC Health.
Our moods are rarely completely stable and the world would be a very boring place if they were, but in bipolar disorder, mood swings aren’t like normal highs and lows, they’re much more intense.
A Cochrane systematic review investigated the efficacy of omega-3 fatty acids for bipolar disorder. Only one trial out of 5 provided data that could be analysed, investigating ethyl-EPA(=eicosapentaenoic acid) as an adjunctive treatment in a mixed outpatient population. Some positive benefits were found for depressive symptoms but not for mania, and no adverse events were reported.
There is currently insufficient evidence on which to base any clear recommendations concerning omega-3 fatty acids for bipolar disorder. However, given the general health benefits and safety of omega-3, the preliminary evidence from this review provides a strong case for well-powered, high-quality trials in specific index populations.
the essential fatty acids omega-3 and omega-6 are taken in through diet and compete with each other for the same elongation enzymes. Omega-6 eventually leads to arachidonic acid and eicosanoids, which promote inflammation, platelet clotting, and the production of prostaglandins. Omega-3 also leads to the production of eicosanoids, but the eicosanoids that are derived from omega-3 — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — actually possess anti-inflammatory properties and decrease platelet stickiness.
These two main omega-3 fatty acids in fish oil have important biological functions in the brain. DHA is a component of neuronal membranes, and changing the fatty acid composition of neuronal membranes leads to functional changes in the activity of receptors and other proteins embedded in the neuronal membranes. This is why researchers got interested in the use of omega-3 fatty acids in all kinds of psychiatric disorders, also in bipolar disorder. Stabilizing the membrane could possibly mean also stabilizing mood.
The only study used in this review was a 12 week, double-blind, randomised trial with 3 conditions. Active treatment, receiving a total of 1g/day of EPA, active treatment, receiving a total of 2g/day of EPA, or control treatment, receiving a total of 2g/day of a placebo (liquid paraffin). There was no significant difference between 1 or 2 grams of EPA a day, the groups were combined for analysis.All participants were allowed to continue all associated psychotropic medication during the trial. Participants were recruited on the referral of their treating physicians or through advertisements in patient groups’ newsletters. 75 Patients participated which is a small group.
My opinion is that it is to early to speak of an additional effect, on the other hand no adverse effects were found.
A new candidate drug for bipolar disorder is being designed by researchers in Chicago and New York. It works as well in mice as do the currently prescribed drugs. They hope that it will ultimately provide relief without the side-effects of present treatments. Bipolar disorder, which afflicts about 1% of adults, is typically treated with drugs called mood stabilizers, especially lithium is used. Lithium is thought to act by blocking the function of an enzyme called glycogen synthase kinase-3beta (GSK-3beta) in the brain. Kozikowski and colleagues did two things. First, they looked for a way to improve binding to the enzyme. They also altered the enzyme so that it could get from the blood into the brain, which involves passing through a water-resistant membrane. They made a whole family of molecules, and tested how well each of these blocked the enzyme’s chemical behavior. They identified the best of them and looked at whether it would work in animals. In a mouse model of ‘mania’, hyperactive mice were calmed and moved around much less when given the new candidate drug. The new compound looks promising, but a lot of work remains to be done before it will be ready for human trials. References
1. Kozikowski, A. P. et al. J. Am. Chem. Soc. 129 , 8328-8332 (2007).
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