Transcript Bipolar Disorder

Bipolar Disorder
For BIO 443: Drugs and Disease
Presented by: Abby Normal
Bipolar Disorder …
• Also known as Manic Depression
• Results in pathological mood swings from
mania to depression
• These mood swings occur spontaneously
Manic Phase
• Characterized by
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Hyperactivity
Over-involvement
Inflated self-esteem
Easily distracted
Little need for sleep
• Hypomania
– Less severe
– Does not cause
significant distress
Depressive Phase
• Characterized by
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Sluggishness
Loss of self-esteem
Withdrawal
Sadness
Excess need for sleep
Risk of suicide
Epidemiology
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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
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
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
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
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
Serotonin
• Low levels can set off impulsive and
aggressive behaviors, depression
• Low levels can also lead to inability to
handle powerful emotions
Pet Scan for serotonin
Person in depressive episode
Healthy individual
Treatments
• Older Mood
Stabilizers
– Lithium
– Valproic Acid
• New Mood Stabilizers
– Lamictal
– Neurotonin
– Topamax
Old Mood Stabilizers
• Have been shown to reduce mania and slow
cycling
• Often require blood levels frequently for
monitoring
• Many side effects
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Nausea, vomiting
Weight gain or loss
Acne problems
Hair loss
Affects balance
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
New Mood Stabilizers
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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
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
Questions?