Texas Medical Center News


Vol. 21, No. 1		January 15, 1999

Researchers Studying New Treatment for Bipolar Disorder

by KRISTINA VAN ARSDEL
Texas Medical Center News

Treatment with medication is a lifelong reality for someone with bipolar disorder, or manic-depression, which affects about 1 percent of the population.

The illness is characterized by episodes of mania in which the person may exhibit reckless behavior and make risky decisions. This grandiose, very energetic behavior is countered with periods of depression, and with that depression comes a decreased self-esteem, feelings of guilt and worthlessness, changes in appetite and sleep patterns (either too much or too little). Symptoms usually surface during the teens and 20s.

"In between these episodes, people are often fine," says Dr. Lauren Marangell, director of clinical psychopharmacology and mood disorders research in the department of psychiatry and behavioral sciences at Baylor College of Medicine. "They are often high functioning and many are creative and very successful individuals."

Researchers believe that neurobiology plays a major role in bipolar disorder, and studies are ongoing as to the exact role neurotransmitters, neuropeptides, second messengers and genetics may play.

Lithium was the first medication used to treat bipolar disorder and is still effective for many people. Anticonvulsant medications are also now commonly used to treat the illness. Their effectiveness seems to lie in the way they affect intracellular signalling in the brain, says Dr. Marangell, who founded the Mood Disorders Center at Baylor.

Researchers at Baylor are now studying omega-3 fatty acids, also known as fish oil, as a possible treatment for bipolar disorder because the acids seem to react similarly in the brain. "We've been interested in studying the effects of this agent as a treatment for bipolar disorder," she says. "We have an initial study in press which appears to show efficacy, and we have further studies planned."

Pregnant women with bipolar disorder may one day benefit from such a treatment option. "One of the nice things about the omega-3 fatty acids is that they don't cause birth defects," says Dr. Marangell. "They may actually be good for the developing fetus."

Dr. Marangell and Dr. Lucy Puryear, director of The Women's Clinic in Baylor's department of psychiatry, are also studying the omega-3 fatty acids in postpartum depression.

While medication is needed to treat the neurobiology of bipolar disorder, psychotherapy may be recommended for the social effects of the illness.

"Psychotherapy will not treat bipolar disorder anymore than it will treat diabetes," she says. "It can be very helpful in dealing with the way the illness impacts a person's life."

To inquire about participating in one of the mood disorder studies, call 713-798-MOOD.

Unipolar Depression Affects More Women Than Men

While bipolar disorder affects men and women equally, women are twice as likely as men to experience unipolar depression. According to Dr. Marangell, one in four women are estimated to have at least one episode of depression in their lifetime.

"The common misconception is that it is the same thing as being sad," she says. "This goes beyond sadness. We know from our imaging data that there really is a physiology to depression that is different from sadness."

Symptoms include lack of energy, tearfulness, extreme feelings of guilt and disinterest in activities that used to be pleasurable. Treatment with medications or psychotherapy give many people suffering from unipolar depression the tools they need to cope.

In both bipolar disorder and unipolar depression, most medications take several weeks to produce results. Researchers are currently working to find medications that act within a shorter period of time.

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