Our results contribute to the idea that vitamin D deficiency and acute manic episode may have interactions with many pathways. Future trials may investigate this association with longer follow up. We recommend that serum vitamin D levels should be measured in patients with bipolar disorder especially in long term care.

Cabergoline is an orally administered synthetic dopamine agonist that is used for the treatment of hyperprolactinemia, Parkinson’s disease and antipsychotic-induced prolactin elevation. One of the main characteristics of cabergoline is its long duration of effect. It is highly effective in suppressing prolactin levels up to 21 days after a single 1 mg oral dose. The prolonged elimination half-life offers an advantage of once-daily dosing, but it might be a handicap in terms of washout of adverse effects such as psychosis. Cabergoline has been associated with adverse reactions consistent with other dopaminergic agonists including cardiovascular, gastrointestinal and neuropsychiatric effects. It is known that dopaminergic treatment is a remarkable risk factor for psychosis. A number of reports implicate dopamine agonists in the development of psychosis, but there is no knowledge in the literature of dopamine agonist-induced mania. In this case, we report the first manic episode occurring after cabergoline use for hyperprolactinemia treatment. In susceptible individuals, cabergoline can cause manic episodes and cabergoline should be used more carefully considering the risk–benefit ratio.

No abstract

Oxidative stress might play an important role in neurological and psychiatric diseases due to the central nervous system sensitivity to reactive oxygen species. Aim of this study is to contribute these data about oxidative stress in bipolar disorder, by detecting IMA levels of bipolar disorder patients in remission and also by comparing these results with healthy controls. Study population consisted of 35 outpatients with bipolar disorder, who being in remission. The patients meeting the Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition criteria for bipolar disorder I. 36 healthy subjects were included as control group. Serum ischemia modified albumin levels of all participants were determined and the results were compared between these two groups. The age, gender and ischemia modified albumin levels were not significantly different between bipolar disorder patients and healthy controls. Studies focusing on oxidative stress in bipolar disorder have reached controversial results up till now. The many different markers have been investigated to explain the effects of oxidative stress on bipolar disorders, and this might be reason why there are conflicting results. In addition, the past episodes of patients who were in remission during this study are unclear. Further investigations are needed to be carrying out to illustrate possible changes of oxidative balance in psychiatric disorders, including bipolar disorder.

To date, studies on oxidative stress in bipolar disorder have led to controversial results. In the present study, no statistically significant difference was detected between the oxidative parameters of bipolar disorder patients and HCs. In order to comprehensively evaluate oxidative stress in bipolar disorder, further studies are needed.