Bipolar%20Disorder

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Bipolar Disorder

• For BIO 443 Drugs and Disease
• Presented by Abby Normal

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Bipolar Disorder

• Also known as Manic Depression
• Results in pathological mood swings from mania to
  depression
• These mood swings occur spontaneously

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Manic Phase

• Characterized by
• Hyperactivity
• Over-involvement
• Inflated self-esteem
• Easily distracted
• Little need for sleep
• Hypomania
• Less severe
• Does not cause significant distress

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Depressive Phase

• Characterized by
• Sluggishness
• Loss of self-esteem
• Withdrawal
• Sadness
• Excess need for sleep
• Risk of suicide

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Epidemiology

• Overall affects men and women equally
• Affects about 1 of adults in the US
• Usually appears between 15-25 years
• No difference among racial groups

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Types of Bipolar Disorder

• Bipolar I
• More time in depressed state
• Long periods of normality
• Bipolar II
• Long episodes of depression, occasional hypomania
• Virtually no time of wellness

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Types of Bipolar Disorder

• Cyclothymia
• Many episodes of hypomania
• Occasional mild depression
• Mixed states
• Signs of depression and mania at same time
• Rapid cycling
• Many cycles of mania and depression each year
• Four or more episodes a year

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Childhood Onset Bipolar Disorder

• Affects those younger than age 15
• Often involves mixed episodes
• Extreme amounts of cycling many times a day
• Bipolar is more severe when present in children
  and harder to treat

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Genetics

• Environment can trigger it and affect the
  severity of the disorder
• No single genetic basis
• Most likely complex genetic disorder
• One possibility inherited variation in
  serotonin transporter gene may play a role

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Serotonin

• Low levels can set off impulsive and aggressive
  behaviors, depression
• Low levels can also lead to inability to handle
  powerful emotions

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Pet Scan for serotonin
Person in depressive episode
Healthy individual
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Treatments

• Older Mood Stabilizers
• Lithium
• Valproic Acid
• New Mood Stabilizers
• Lamictal
• Neurotonin
• Topamax

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Old Mood Stabilizers

• Have been shown to reduce mania and slow cycling
• Often require blood levels frequently for
  monitoring
• Many side effects
• Nausea, vomiting
• Weight gain or loss
• Acne problems
• Hair loss
• Affects balance

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Lithium and Valproic Acid

• Slow action suggest that they may regulate gene
  expression
• Thought to inhibit protein kinase C which
  regulates neurohormonal release
• Interferes with the reuptake of serotonin and
  norepinephrine

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New Mood Stabilizers

• Have been shown to be effective in adults
• Effects are not known in children yet
• Mechanisms are unknown
• Effects are quicker
• Side effects appear less
• May have long term side effects that are not
  known of yet

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Future?

• Researchers believe they are coming closer to
  finding a genetic link and mechanism of the
  disorder
• This could lead to better drugs that would act
  specifically for bipolar disorder

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Questions?