Bipolar disorder is a serious mental disorder suffered by more than 2.3 million adult Americans. This means that at any given moment, 1% of the population is dealing with some form of bipolar disorder. Researchers believe that brain abnormalities and anomalies in neuro-circuitry cause the illness’ mood swings, energy changes and functionality changes. The symptoms of bipolar disorder are treatable with medications and psychotherapy.
Understanding Bipolar Disorder
There is constant research going on all over the world to understand bipolar disorder. Scientists are looking at neuroscience studies, scientific studies that deal with the brain and human behavior, the impact genetics have on the illness, epidemiological and clinical research. Researchers are also studying the best available and experimental treatments and combinations for dealing with bipolar disorder. They are seeking better treatment options in the short term and preventative measures that will lead to a cure in the long term.
Medicating Bipolar Depression – Antidepressants
Medication side effects are often troublesome and can lead to the patient avoiding their medications. Some regimens work well for years and then gradually lose their effectiveness. Researchers are working at multiple levels – molecular genetics, neuro-imaging, behavioral science, clinical trials – to learn what underlies these and other treatment related problems and to apply this knowledge towards the development of better treatments and enhanced treatment strategies.
Anti-depressant medications have long been used to treat the depressive phase of bipolar disorder. However, recent research has shown that antidepressants, when taken without a mood stabilizing medication, can increase the risk of switching into mania, hyper-mania, or developing rapid cycling in people with bipolar disorder. Therefore, mood stabilizing medications are generally required, alone or in combination with antidepressants, to protect patients from this switch. Lithium is perhaps the most commonly used mood stabilizing drug, however, research studies are evaluating the potential mood stabilizing properties of newer medications.
Medicating Bipolar Depression – Anticonvulsants
Some patients do not respond to lithium or they may be unable to handle the side effects associated with the medication (weight gain, tremor and excessive urination) so they can be administered some anticonvulsant medications that work as mood stabilizers. Valporate and carbamazepine are two medications primarily used as alternatives to lithium. They have been used for more than 20 years to treat acute mania and prevent cycling. There are some promising alternative anticonvulsant drugs (lamotrigine and gabapentin) that may work as mood stabilizers.
Medicating Bipolar Depression – Antipsychotics
Research has evaluated the efficacy of atypical antipsychotic medications in the treatment of bipolar disorder. One study demonstrated the mood stabilizing and anti-manic effects of clozapine in patients with treatment resistant bipolar disorder. Another study found olanzapine to help relieve psychotic depression in patients with a diagnosis of major depression or bipolar-1 disorder. Other research has supported the efficacy of olanzapine for acute mania.
Medicating Bipolar Depression – Homeopathy
A homeopathic approach under investigation for maintenance treatment of bipolar disorder involves Omega-3 fatty acids found in fish oil. Preliminary research has found a combination of the two main Omega-3 fatty acids to be better than placebo (when added to ongoing conventional medications) in avoiding an acute episode and in improving a variety of symptoms over a period of four months.
Psychotherapy for Bipolar Depression
Interest in using psychotherapy in combination with medication for bipolar disorder has grown with the recognition of the continuing high rate of relapse, some of which appears to be preventable, during solely pharmacological maintenance treatment. Researchers are conducting studies to evaluate the benefits of specific types of adjunctive psychotherapy in the long term management of bipolar disorder. These psychotherapies include psycho-education, cognitive behavioral therapy, family focused therapy, and interpersonal and social rhythm therapy.
In recent years, there has been an increasing emphasis on extending clinical research (research that examines how well treatments work in patients) from tightly controlled inpatient hospital settings to real world settings. However, in order to improve the standards of treatment for bipolar disorder, all current research work revolves around the following:
Establish treatment effectiveness in the short and long term.
Develop guidelines for treating patients who do not respond to standard single therapies.
Evaluate combinations of pharmacological and psycho-social treatments.
Define a core set of outcome measures to make findings across studies comparable.
Translate research findings more quickly into routine clinical practice.
