Alternative Treatments in Pediatric Bipolar Disorder

Potter, Mona P.; Moses, Alana; Wozniak, Janet

doi:10.1016/j.chc.2008.11.001

Cited by 15 publications

(5 citation statements)

References 148 publications

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“…Although several previous MRS studies have implicated inositol in the pathophysiology of BD [see Potter et al. (42) for review], it is not yet clear whether early exposure to lithium or other medications would confer neuroprotection from progression to mania in children who may be at familial risk for developing BD. Future studies with larger sample sizes are needed to clarify the impact of medication exposure on in vivo neurochemistry.…”

Section: Discussionmentioning

confidence: 99%

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

et al. 2011

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Objectives We aimed to compare concentrations of N-acetyl aspartate, myo-inositol, and other neurometabolites in the cerebellar vermis of offspring at risk for bipolar disorder (BD) and healthy controls to examine whether changes in these neuronal metabolite concentrations occur in at-risk offspring prior to the onset of mania. Methods A total of 22 children and adolescents aged 9–17 years with a familial risk for bipolar I or II disorder [at-risk offspring with non-bipolar I disorder mood symptoms (AR)], and 25 healthy controls (HC) were examined using proton magnetic resonance spectroscopy at 3T to study metabolite concentrations in an 8-cc voxel in the cerebellar vermis. Results Decreased myo-inositol and choline concentrations in the vermis were seen in the AR group compared to HC (p < 0.01). Conclusions Decreased cellular metabolism and interference with second messenger pathways may be present in the cerebellar vermis in youth at risk for BD as evident by decreased myo-inositol and choline concentrations in this region. These results may be limited by a cross-sectional design, co-occurring diagnoses, and medication exposure. Longitudinal studies are necessary to determine whether early neurochemical changes can predict the development of mania. Improved methods for identifying children with certain neurochemical vulnerabilities may inform preventive and early intervention strategies prior to the onset of mania.

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Section: Discussionmentioning

confidence: 99%

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

et al. 2011

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“…144 Other options, such inositol, Hypericum perforatum, melatonin or acupunture, have been tested for the treatment of BD with controversial results. 145 More double-blind, placebo-controlled trials are needed to determine the possible role of alternative treatments in youth with BD.…”

Section: Alternative Treatmentsmentioning

confidence: 99%

Bipolar Disorder in 10–17 Year Old Patients: Treatment Options and Cautions

Alvaro¹,

Romero

2011

Clinical Medicine Reviews in Therapeutics

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In recent years, bipolar disorder (BD) has been diagnosed with increasing frequency in the pediatric population. BD requires a multimodal treatment plan to address complex symptoms and the associated comorbidities. Pharmacological intervention assists the core symptoms of the illness and psychotherapeutic intervention may be beneficial as an adjunctive treatment. Controlled studies corroborate the comparable short-term efficacy of several second generation antipsychotics and mood stabilizers for treating mania, but major dissimilarities exist with respect to the kind and severity of side effects. The selected treatment option is determined by the tolerance and safety. In addition, data suggests that youth may be more vulnerable to the adverse effects of psychotropic medications than adults. More clinical trials, that focus on risk-benefit ratios of these medications and that clarify assessment and management of their comorbidities are needed to find safer and more effective treatment options for long-term treatment.

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“…C30:1 PC, a lecithin, was also lower both under normal conditions and in the presence of dexamethasone. This is of some interest since lecithins have also been explored as putative treatment agents in bipolar disorder [77,78]. …”

Section: Discussionmentioning

confidence: 99%

Perturbational Profiling of Metabolites in Patient Fibroblasts Implicates α-Aminoadipate as a Potential Biomarker for Bipolar Disorder

et al. 2016

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Many studies suggest the presence of aberrations in cellular metabolism in bipolar disorder. We studied the metabolome in bipolar disorder to gain insight into cellular pathways that may be dysregulated in bipolar disorder and to discover evidence of novel biomarkers. We measured polar and nonpolar metabolites in fibroblasts from subjects with bipolar I disorder and matched healthy control subjects, under normal conditions and with two physiologic perturbations: low-glucose media and exposure to the stress-mediating hormone dexamethasone. Metabolites that were significantly different between bipolar and control subjects showed distinct separation by principal components analysis methods. The most statistically significant findings were observed in the perturbation experiments. The metabolite with the lowest p value in both the low-glucose and dexamethasone experiments was α-aminoadipate, whose intracellular level was consistently lower in bipolar subjects. Our study implicates α-aminoadipate as a possible biomarker in bipolar disorder that manifests under cellular stress. This is an intriguing finding given the known role of α-aminoadipate in the modulation of kynurenic acid in the brain, especially as abnormal kynurenic acid levels have been implicated in bipolar disorder.

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Alternative Treatments in Pediatric Bipolar Disorder

Cited by 15 publications

References 148 publications

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

Bipolar Disorder in 10–17 Year Old Patients: Treatment Options and Cautions

Perturbational Profiling of Metabolites in Patient Fibroblasts Implicates α-Aminoadipate as a Potential Biomarker for Bipolar Disorder

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Alternative Treatments in Pediatric Bipolar Disorder

Cited by 15 publications

References 148 publications

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

Neurochemical deficits in the cerebellar vermis in child offspring of parents with bipolar disorder

Bipolar Disorder in 10&ndash;17 Year Old Patients: Treatment Options and Cautions

Perturbational Profiling of Metabolites in Patient Fibroblasts Implicates α-Aminoadipate as a Potential Biomarker for Bipolar Disorder

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Bipolar Disorder in 10–17 Year Old Patients: Treatment Options and Cautions