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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 Hyperactivity

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Bipolar disorder

Bipolar Disorder

For BIO 443: Drugs and Disease

Presented by: Abby Normal


Bipolar disorder1
Bipolar Disorder …

  • Also known as Manic Depression

  • Results in pathological mood swings from mania to depression

  • These mood swings occur spontaneously


Manic phase
Manic Phase

  • Characterized by

    • Hyperactivity

    • Over-involvement

    • Inflated self-esteem

    • Easily distracted

    • Little need for sleep

  • Hypomania

    • Less severe

    • Does not cause significant distress


Depressive phase
Depressive Phase

  • Characterized by

    • Sluggishness

    • Loss of self-esteem

    • Withdrawal

    • Sadness

    • Excess need for sleep

    • Risk of suicide


Epidemiology
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


Types of bipolar disorder
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 disorder1
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
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
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
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
Pet Scan for serotonin

Person in depressive episode Healthy individual


Treatments
Treatments

  • Older Mood Stabilizers

    • Lithium

    • Valproic Acid

  • New Mood Stabilizers

    • Lamictal

    • Neurotonin

    • Topamax


Old mood stabilizers
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


Lithium and valproic acid
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
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


Future
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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