Guidance on the treatment of Bipolar Disorder

Bipolar disorder symptoms are often described as extreme mood swings. These mood swings range from extreme highs (or mania) to extreme lows (or depression).  Episodes of mania and depression can often last for several weeks or months.

Treatments for bipolar disorder aim to stop or reduce the number and severity of depression and mania episodes suffered. A successful treatment plan will mean a person can live life as normally as possible.

As part of a treatment plan for bipolar disorder, different types of medication are prescribed for episodes of mania and episodes of depression. Many people need to take medication on a regular basis, even between episodes when they are well, to help prevent a possible bipolar relapse. Medication prescribed for long-term treatment is called 'prophylactic' medication.

Trials have found that lithium not only prevents mood episodes and manic episodes but also prevents depressive episodes.

Recently published guidelines by the National Institute for Health and Care Excellence (The NICE) suggest offering lithium as a first line treatment of bipolar disorder as it is usually more effective than any other type of medication for long-term treatment of the bipolar disorder.

If you would like to discuss a possible treatment plan for Bipolar Disorder, please call 0207 299 0375 or fill in our enquiry form on our Contact page.

Starting lithium early in bipolar disorder

Kessing and colleagues have published details of an interesting study in the British Journal of Psychiatry (September 2014) which looks at when preventative treatment should be started in Bipolar Disorder. Their study suggests that starting lithium early is associated with increased probability of lithium response.

Dopamine and schizophrenia

An interesting article by Howes and colleagues in the British Journal of Psychiayry 2014 discusses the increasing evidence that dopamine may not be implicated in the pathogenesis in all forms of schizophrenia. This may explain why some anti-psychotic medications have poor efficacy in clients where other neurotransmitters such as glutamate may be of more importance than dopamine

Vitamin D Deficiency and Dementia

Can an extreme vitamin D deficiency increase the risk of developing dementia?

A recent study appearing in the journal Neurology supports the link between severe deficiency in vitamin D and an increased risk of developing dementia.

A team of researchers at the University of Exeter found that the higher the vitamin D deficiency, the higher the risk of developing dementia and Alzheimer's disease.

Study participants who were severely Vitamin D deficient were found to be more than twice as likely to develop Dementia and Alzheimer's disease.

Research revealed that those who were moderately deficient in vitamin D had a 53 per cent increased risk of developing dementia. This risk increased to 125 per cent in those who were severely Vitamin D deficient.

The research team was led by Dr Llewellyn who has said: “We expected to find an association between low Vitamin D levels and the risk of dementia and Alzheimer's disease, but the results were surprising - we actually found that the association was twice as strong as we anticipated.”

The exact mechanism is unknown, however vitamin D receptors are found in the brain and are thought to regulate neurotrophic factors which are involved in the maintenance of neurones.

The 3 Main Sources of Vitamin D are:

  • Exposure of skin to UV sunlight
  • Foods such as oily fish, egg yolks and cheese
  • Vitamin D Supplements

For older people, the skin can be less efficient at converting UV sunlight into Vitamin D. This making the elderly more likely to be deficient and reliant on other sources, such as food and supplements.

Dr Doug Brown, Director of Research and Development at Alzheimer's Society has said: "However, we're not quite ready to say that sunlight or vitamin D supplements will reduce your risk of dementia. Large scale clinical trials are needed to determine whether increasing vitamin D levels in those with deficiencies can help prevent the dementia from developing."

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