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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by bipolarspectrum on May 19, 2006, at 16:11:09
Hi,
My father, like me, suffers from bipolar disorder... he just recently saw a new pdoc who said he may also have ADHD (ADD)... what type of triats would someone who has bipolar exhibit if they have had ADD too??I'm a little confused... (wonder if thats a ADD trait?)
bps
Posted by linkadge on May 19, 2006, at 16:56:57
In reply to Can you have ADHD with BIPOLAR?, posted by bipolarspectrum on May 19, 2006, at 16:11:09
Yes, there is definate overlap.
Quite a few studies seem to indicate that bipolar individuals have less dense prefrontal corticies. This can translate to increased impulsivity in bipolar, or inattention of ADD.
Stimulants will work to increase the activity of
the frontal cortex.I would recomend omega-3's to anyone exhibiting both symptoms, since they have shown to have some significant efficacy in both disorders,
although mood stabilizers and stimulants may also be needed.I would recomend depakote over lithium in this regard. Depakote can increase dopamine output in the frontal cortex.
Linkadge
Posted by Caedmon on May 20, 2006, at 11:22:02
In reply to Re: Can you have ADHD with BIPOLAR?, posted by linkadge on May 19, 2006, at 16:56:57
> I would recomend depakote over lithium in this regard. Depakote can increase dopamine output in the frontal cortex.
>
>
> Linkadge
Really? Interesting!- Chris
Posted by bipolarspectrum on May 20, 2006, at 14:44:18
In reply to Re: Can you have ADHD with BIPOLAR?, posted by linkadge on May 19, 2006, at 16:56:57
Hey,
Thanx for the replies... it seems ur a big fan of omega-3 fatty acids link! They seem to only make me manic, weird i know... yeah, I dont understand much about adult ADD, but my dad seems to have symptoms and I've read that its genetically linked... so i might have it as well! I'm going to ask my pdoc about the add medications, like ritalin and adderall (i think?)... is there anything I should know about ehese ADD meds going into the meeting? ie. is one better than another?
bps
Posted by linkadge on May 20, 2006, at 16:51:07
In reply to Re: Can you have ADHD with BIPOLAR? » linkadge, posted by Caedmon on May 20, 2006, at 11:22:02
It can, but I don't know how long lived the effect is. I remember reading a comparison between some of the effects of lithium and depakote.
Depakote caused a release of dopamine in the frontal cortex wherase lithium was devoid of effect. Lithium decreased dopamine release in the neucleus accumbens, ie pleasure centres.
I will try to find the study so you can make of it what you will.
Linkadge
Posted by linkadge on May 20, 2006, at 16:55:58
In reply to Re: Can you have ADHD with BIPOLAR?, posted by bipolarspectrum on May 20, 2006, at 14:44:18
If fish oil made you manic, then you will probably want to be careful about adding a stimulant medication.
Both fish oil and stimulants can effect dopamine in different ways, though stimulants probably have a higher propensity to induce mania.
Stimulants will have risks, but hopefully a benifit supercedes it.
My mother is bipolar, and I got benifit from ritalin (even more so than lithium)
I just can't get over the study I read linking ritalin to chromosomal dammage. Which is why I stopped taking it. Hopefully further studies can better clarify the risk.
But, don't let me freak you out, please :)
Linkadge
Posted by bipolarspectrum on May 21, 2006, at 23:57:56
In reply to Re: Can you have ADHD with BIPOLAR? » bipolarspectrum, posted by linkadge on May 20, 2006, at 16:55:58
Hey Link,
I remember from earlier posts that ur an advocate of fish oils... my main problem has always been medications sending me into mania.. I'd love to try stimulants with a mood stabilizer but I think even thats too risky.. have u ever heard of being on more than 2 mood stabilizers? for example, im on lithium and depakote right now... and would love to add another mood stabilzier because i dont think im getting proper relief... Im even on seroquel as well!
bps> If fish oil made you manic, then you will probably want to be careful about adding a stimulant medication.
>
> Both fish oil and stimulants can effect dopamine in different ways, though stimulants probably have a higher propensity to induce mania.
>
> Stimulants will have risks, but hopefully a benifit supercedes it.
>
> My mother is bipolar, and I got benifit from ritalin (even more so than lithium)
>
> I just can't get over the study I read linking ritalin to chromosomal dammage. Which is why I stopped taking it. Hopefully further studies can better clarify the risk.
>
> But, don't let me freak you out, please :)
>
> Linkadge
>
>
>
>
Posted by B2chica on May 22, 2006, at 9:16:04
In reply to Re: Can you have ADHD with BIPOLAR? » bipolarspectrum, posted by linkadge on May 20, 2006, at 16:55:58
what kind of chromosomal damage??
do you remember the link to this study?b2c.
Posted by linkadge on May 23, 2006, at 16:26:45
In reply to Re: Can you have ADHD with BIPOLAR?, posted by bipolarspectrum on May 21, 2006, at 23:57:56
Adding additional mood stabilizers can probably help with manic episodes, but I don't know of how well it works for depressive episodes.
There is also the risk of creating further cognitive problems.
Seroquel is a dopamine antagonist. It may exaserbate cognitive problems. Antipsychotics are kind of like the opposite to stimulants.
You may be able to try a stimulant. Sometimes they have paradoxical effects even in bipolars.
I remember having what doctors thought was a manic episode, only to find that ritalin ended the mind noise and impulsivity.
Linkadge
Posted by bipolarspectrum on May 23, 2006, at 23:43:50
In reply to Re: Can you have ADHD with BIPOLAR? » bipolarspectrum, posted by linkadge on May 23, 2006, at 16:26:45
Hey Link,
Thanx for the message... my pdoc and i decided to add another mood stabilizer to the mix to help quell the hypomania... its interesting u talk about ritalin kuz my pdoc says that certain bipolar get mood stabilizing effects from stimulants, he seems to have specialist skill in ADHD... thanx for ur help, hows ur quest going for mental sanity?
bps> Adding additional mood stabilizers can probably help with manic episodes, but I don't know of how well it works for depressive episodes.
>
> There is also the risk of creating further cognitive problems.
>
> Seroquel is a dopamine antagonist. It may exaserbate cognitive problems. Antipsychotics are kind of like the opposite to stimulants.
>
> You may be able to try a stimulant. Sometimes they have paradoxical effects even in bipolars.
>
> I remember having what doctors thought was a manic episode, only to find that ritalin ended the mind noise and impulsivity.
>
> Linkadge
>
>
>
>
>
Posted by detroitpistons on May 24, 2006, at 15:29:15
In reply to Re: Can you have ADHD with BIPOLAR?, posted by linkadge on May 19, 2006, at 16:56:57
> Quite a few studies seem to indicate that bipolar individuals have less dense prefrontal corticies. This can translate to increased impulsivity in bipolar, or inattention of ADD.
>Link,
Wanna hear something funny? I mentioned the whole prefrontal cortex density thing to my pdoc and he had no idea what the h*ll I was talking about!! I thought that was a pretty well known theory. It's a good thing I didn't mention anything about decreased dopamine volume in the basal ganglia!!
Posted by linkadge on May 26, 2006, at 16:58:18
In reply to Re: Can you have ADHD with BIPOLAR? » linkadge, posted by detroitpistons on May 24, 2006, at 15:29:15
Intersting. I think Dr. Manji (who does a lot of research into bipolar and some in ADD) was the one who reported finding abnormalities in the frontal corticies of bipolars (and those with family history of unipolar). He said there was a significant reduction in glia (I believe) in SG-25.
Anyhow, it seems to suggest that the problem is perhaps more structural and less biochemical. I suppose stimulants and such can work to boost the activity in whatever circutry exists.
His findings also seemed to show that treatment with lithium or valporate (but not other mood stablizers or antidepressants) seemed to reverse atrophy in this area.
Both lithium and valproate (but not other drugs) increased BDNF and BCL-2 in this region.
Linkadge
This is the end of the thread.
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