Bipolar Medical Literature

The serotonin system genetically is apparently not involved, based on research on many genes involved with the serotonin system. (Institute of Psychiatry, London, UK, Neurosci Lett 1997 Mar, Arranz MJ) (Clarke Institute of Psychiatry, U of Toronto, Ontario, Canada, American Journal of Psychiatry Jan 1999, Vincent JB) (Universitat de Barcelona, Spain, Hum Genet Oct 1997, Gutierrez B)

Studies show that panic disorder is often associated with bipolar, and may indicate some genetic link. Sometimes genetics is involved, particularly chromosomes 18 and 21, although this is controversial. There is some genetic link of bipolar, particularly at marker D18S37. (Dept of Psychiatry, Johns Hopkins University School of Medicine, Biol Psychiatry Jul 1997, MacKinnon, DF), (Dept of Psychiatry, University of Ottawa, Ontario, Canada, Canadian Journal of Psychiatry May 1997, Alda M) (NIH, Genetic Studies Section, Genet Epidemiol 1997)

The concentration of calcium inside platelet cells and lymphocytes is higher in those with bipolar disorder than in normals or individuals without bipolar. Abnormal cellular function related to calcium may be a part of the underlying problem. (Clarke Institute of Psychiatry, Toronto, Ont, Canada, American Journal of Psychiatry, July 1997 - Emamghoreishi M)

High levels of "signal-transducing guanine-nucleotide-binding proteins" (G proteins) have been found in those with bipolar, and this chemical may be involved with lithium’s effectiveness. (NIMH, Am J Psychiatry Feb 1997, Mitchell PB)

There is a weak association of autoimmune thyroid problems (where the body attacks the thyroid gland as foreign) in bipolar where depression symptoms predominate. Thyroid dysfunction in general is more common in mixed bipolar rather than bipolar patients with predominately the manic type. (Department of Psychiatry, U of NC School of Medicine, Depress Anxiety 1997, Haggerty JJ Jr), (U of Cincinnati College of Medicine Dept of Psychiatry, Biol Psychiatry May 1998, Chang KD)

Some structural abnormalities exist in bipolar disorder based on MRI tests involving "hyperintense" white matter, ventricular enlargement and differences in temporal lobe and hippocampal structures. (Dept of Psychiatry, Duke University, Prog Neuropsychopharmacol Biol Psychiatry Nov 1997, Norris SD)

No X-chromosome linkage in bipolar disorder. No maternal effect on genetic transmission of bipolar disorder. (Dept of psychological Medicine, Institute of Psychiatry, London, UK, Psychiatr Genet 1998 Autumn, Vallada, HP) (Macquarie University, Sydney, NSW, Australia, Genet Epidemiol 1997, Donald JA)

Patients with bipolar II (hypomania without mania), have a severe deficit in self-awareness. It’s so impressive that it may constitute a distinguishing psychopathological characteristic of bipolar II disorder. (Neurosciences Institute, Florence, Italy, Am J Psychiatry Jul 1999, Pallanti S)

Suicide risk is now considered to be less than 15%, and is highest in young men in the early phases of the illness - particularly in those who have made a previous suicide attempt, those abusing alcohol, and those recently discharged from the hospital.  Lithium is the best medication for preventing suicide.  The risk is also increased in patients who are in the depressed phase of bipolar, those in mixed states, or who have psychotic mania. (Department of Psychiatry, The Johns Hopkins University School of Medicine, J Clin Psychiatry 1999 Simpson SG)

Borderline personality disorder was significantly more prevalent in bipolar disorder, as is obsessive compulsive, paranoid and histrionic personality disorders. (Department of Psychiatry, Istanbul, Turkey, Compr Psychiatry 1998, Ucok A)

Frontal lobe seizures can mimic bipolar (VA Puget Sound Health Care System, Mental Health Service, Seattle, WA J Geriatr Psychiatry Neurol Oct 1997, Pascualy M)

The "tryptophan hydroxylase gene" - which is the "rate limiting enzyme" in the production of serotonin, was found not to be involved in bipolar and major depression. (Am J Med Genet 1998 May - University of Cambridge, UK)

The genetics debate in bipolar is not resolved. There is a "modest" association for a bipolar risk on chromosome 18. Theses studies showed that bipolar disorder is not transmitted more through the mother through the "X" chromosome than the father. (Genet Epidemiol 1997 - Sydney, Australia), (Psychiatr Genet 1998 Autumn - London, UK)

Bipolar is a "relapsing and recurring condition." Effective management of bipolar is now recognized to need: 1) medications, 2) strong encouragement to comply with medication, and 3) a "holistic package of interventions." (Can J Psychiatry 1997 Aug, Suppl - Halifax, Canada)

Lithium is the best medication to prevent suicide. Those with a previous suicide attempt, abusing alcohol, are depressed, are in a "mixed state," or have psychotic mania are at higher risk. (J Clin Psychiatry 1990, Suppl - John's Hopkins, Baltimore, MD)

Alcohol abusers and depression prone bipolars are at higher risk of a "poor outcome" long term. (J Affect Disorder 1998 Sep - U of Iowa)

No association between the dopamine D3 receptor gene and bipolar disorder. (Am J Med Genet, 1997 Apr - U of Cagliari, Italy)