Posted by JudeS on March 30, 2006, at 23:02:48
In reply to Re: Never thought I'd hear this..... » linkadge, posted by SLS on March 17, 2006, at 7:38:46
Here's a trial in which S-adenosyl methionine induced an "elevated mood state" in most bipolar patients but in none of the uniplar patients:
> > That is exactly my point. If mood stabalizers serve as antidotes to manic episodes (of any origin), then there is no way to determine what exactly caused the manic episode.
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> My point is this: The cluster of behaviors that we see with the administration of amphetamine, and that you have listed, is not a sufficient criterion for true mania such that these investigators needed to find other models to use. They judged the validity of their models based upon the capacity of mood stabilizers to reverse them. The hyperlocomotive and hyperlibidinal effects produced by psychostimulants are thus not equivalent to mania, and the presence of these behaviors is not sufficient to presume a valid animal model. Otherwise, I imagine they would have used cocaine. So far, I don't believe that they have been able to reproduce mania in rodents using SSRIs. Hopefully, they will develop a strain of rodent that exhibits such a reaction so as to serve as a model for mania. Of course, this would only go to reinforce the notion that there must be a genetic bipolar diathesis present to display a manic reaction to antidepressants.
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> My mania lasted for weeks after the antidepressants were discontinued, despite lithium treatment. I think this is one factor that leads me to believe that a manic reaction to antidepressants is fundamentally different from the acute behavioral states produced by psychostimulants. Mania involves a self-perpetuating process, most likely effected by kindling and probably facilitated through second messenger events. My guess is that antidepressant-induced mania gains inertia the longer it is allowed to continue. The sooner it is recognized and the offending drugs discontinued, the more quickly the mania will dissipate.
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> I wish Depakote were around when I became manic the first time. I believe that it would have been best if I were allowed to continue taking the antidepressants and just have added Depakote. My current treatment resistance probably developed because Nardil was given and withdrawn multiple times within a short period of time and the precipitation of severe mania followed by severe depression on each occassion. Again, Depakote would have prevented this as my mania are very responsive to it. It is also responsive to Zyprexa, but not to the older APs. I should think that combining Nardil and Zyprexa would be a great combination for bipolar depression.
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> I'm not saying that it is impossible for an SSRI to produce a manic reaction in someone who is not bipolar. Prednisone seems to be sufficient to do that. However, I think the odds are that for someone who has an affective disorder, the precipitation of mania by the administration of an antidepressant is reflective of bipolar disorder.
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> - Scott
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poster:JudeS
thread:620137
URL: http://www.dr-bob.org/babble/20060329/msgs/626928.html