Alterations in Motor Activity, Sleep, and Biochemistry in a Cycling Manic-Depressive Patient

Post, Robert M.

doi:10.1001/archpsyc.1977.01770160104009

Cited by 106 publications

(22 citation statements)

References 9 publications

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“…The data summarized here generally refer to drug-free patients, with few exceptions35, 61. Higher urinary cyclic adenosine 3’5’monophosphate (cAMP)59, 62, urinary norepinephrine35, 63, 64, and dopamine35, 63 have all been associated with mania and, more relevant to the present discussion, the switch to mania. Increased urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) has also been described in this context60, 65.…”

Section: Antidepressants and Switchmentioning

confidence: 98%

“…Even considering these caveats, it appears that drugs that “perturbate” more than one monoaminergic system, such as TCAs and, possibly, venlafaxine, confer a higher risk for TEAS than SSRIs or other second-generation antidepressants. A putative role for the monoaminergic system in the switch process has been suggested by clinical35, 64 and preclinical studies140, but needs further systematic investigation. Increased catecholamine levels lead to upregulation of factors involved in neuroplasticity cascades and to increased post-synaptic receptor sensitivity, which might ultimately increase the liability to switch (see Figure 1).…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

“…Marked alterations in body temperature, sleep patterns, cortisol secretion, thyroid-stimulating hormone (TSH) secretion, and motor activity have been described during episodes of BPD (reviewed in 7). Increased motor activity and decreased REM sleep, in particular, were found to strongly predict an imminent manic switch35, 59, 64. According to some researchers123, sleep loss might be the final common pathway triggering switches into mania.…”

Section: Other Neurobiological Factors Implicated In the Switch Prmentioning

confidence: 99%

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The Neurobiology of the Switch Process in Bipolar Disorder

Salvadore

Quiróz²,

Machado‐Vieira³

et al. 2010

J. Clin. Psychiatry

193

117

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Objective The singular phenomenon of switching from depression to its opposite state of mania or hypomania, and vice versa, distinguishes bipolar disorder (BPD) from all other psychiatric disorders. Despite the fact that it is a core aspect of the clinical presentation of BPD, the neurobiology of the switch process is still poorly understood. In this review we summarize the clinical evidence regarding somatic interventions associated with switching, with a particular focus on the biological underpinnings presumably involved in the switch process. Data Sources Literature for this review was obtained through a search of the MEDLINE database (1966–2008). Study Selection All English-written, peer-reviewed, published literature, including randomized controlled studies, naturalistic and open-label studies, and case-reports were eligible for inclusion. Data Synthesis Converging evidence suggests that certain pharmacological and non-pharmacological interventions with very different mechanisms of action, such as sleep deprivation, exogenous corticosteroids, and dopaminergic agonists, can trigger mood episode switches in patients with BPD. The switch-inducing potential of antidepressants is unclear, although tricyclic antidepressants (TCAs), which confer higher risk of switching than other classes of antidepressants, are a possible exception. Several neurobiological factors appear to be associated with both spontaneous and treatment-emergent mood episode switches; these include abnormalities in catecholamine levels, upregulation of neurotrophic and neuroplastic factors, HPA-axis hyperactivity, and circadian rhythms. Conclusions There is a clear need to improve our understanding of the neurobiology of the switch process; research in this field would benefit from the systematic and integrated assessment of variables associated with switching.

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Section: Antidepressants and Switchmentioning

confidence: 98%

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Section: Other Neurobiological Factors Implicated In the Switch Prmentioning

confidence: 99%

See 1 more Smart Citation

The Neurobiology of the Switch Process in Bipolar Disorder

Salvadore

Quiróz²,

Machado‐Vieira³

et al. 2010

J. Clin. Psychiatry

193

117

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“…1972;Jones et al. 1973;Post et al. 1977], Significant increase in urinary MHPG is also reported to be associated with the recovery from depressive episodes in selected groups of patients [Greenspan et al.…”

Section: Introductionmentioning

confidence: 99%

Urinary MHPG, Stress Response, Personality Factors and Somatosensory Evoked Potentials in Normal Subjects and Patients with Major Affective Disorders

Buchsbaum¹,

Muscettola²,

Goodwin³

1981

Neuropsychobiology

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Stressful procedures are reported to increase urinary MHPG in both noraml and depressed patients. Bipolar depressed patients are alos shown to be especially pain tolerant in comparison to normals. In the present study, 12 depressed patiens (6 bipolar and 6 unipolar patients) and 10 normal volunteers had average evokded potentials recorded for visual and painful electrical stumuli. MHPG urinary excretion was measured during this session and during an unstimulated resting session on the home ward. Male normal volunteers showed a significant increase in urinary MHPG under stress, while no MHPG increment was noted for the depressed patient group. Depth of depression, assessed by the Zung and Beck scales, was found to be correlated with the reduced urinary MHPG response to stress. Possible interpretations of the results are discussed.

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“…Several neurobiological investigations in patients with 48-hour cycles dealt with the question which biochemical, endocrine or neurophysiological variables correlate with the mood cycles Kupfer and Heninger, 1972;Gillin et al, 1977;Post et al, 1977;Doerr et al, 1979;Gann et al, 1993;Juckel et al, 2000]. Several authors reported higher cortisol levels on depressed days compared to manic days Dirlich et al, 1981;Gann et al, 1993].…”

mentioning

confidence: 99%

Neurobiological Findings before and during Successful Lithium Therapy of a Patient with 48-Hour Rapid-Cycling Bipolar Disorder

Voderholzer¹,

Weske²,

Ecker³

et al. 2002

Neuropsychobiology

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48-hour rapid cycling is a very rare form of bipolar disorder, characterized by regular periodic changes of mood from one day to the other. We report on a patient who suffered from a 48-hour rapid cycling without a history of bipolar disorder before the abrupt onset of his rapid mood cycles. We present polysomnographic and neuroendocrine findings and the clinical course based on daily self-ratings of mood. Treatment with lithium carbonate effectively reduced the amplitude of the mood cycles. With plasma levels between 0.8 and 1.0 mmol, almost complete remission occurred. An overview on previous reports on the therapeutic effect of mood stabilizers in this rare form of bipolar disorder is presented.

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Alterations in Motor Activity, Sleep, and Biochemistry in a Cycling Manic-Depressive Patient

Cited by 106 publications

References 9 publications

The Neurobiology of the Switch Process in Bipolar Disorder

The Neurobiology of the Switch Process in Bipolar Disorder

Urinary MHPG, Stress Response, Personality Factors and Somatosensory Evoked Potentials in Normal Subjects and Patients with Major Affective Disorders

Neurobiological Findings before and during Successful Lithium Therapy of a Patient with 48-Hour Rapid-Cycling Bipolar Disorder

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