RESUMEN
BACKGROUND: Inositol monophosphatase (IMPase) activity was reported to be low in lymphocyte-derived cell lines of bipolar patients. METHODS: IMPase activity was measured spectrophotometrically as inorganic phosphate liberated from inositol-1-phosphate. RESULTS: The previously reported reduction was replicated in a new, small group of bipolar patients. The reduction is not present in cell lines of unipolar or schizophrenic patients. IMPase activity in postmortem frontal and occipital cortical samples of unipolar, bipolar and schizophrenic patients was not different from controls. CONCLUSIONS: A reduction in lymphocyte-derived IMPase activity without a parallel reduction in cortical IMPase activity could be due to the fact that most leukocyte IMPase activity is the product of the IMPA-2 gene.
Asunto(s)
Trastorno Bipolar/enzimología , Trastorno Bipolar/patología , Encéfalo/enzimología , Encéfalo/patología , Linfocitos/patología , Monoéster Fosfórico Hidrolasas/metabolismo , Adulto , Anciano , Técnicas de Cultivo de Célula , Ensayo de Inmunoadsorción Enzimática , Femenino , Lóbulo Frontal/enzimología , Lóbulo Frontal/patología , Humanos , Masculino , Persona de Mediana Edad , Lóbulo Occipital/enzimología , Lóbulo Occipital/patología , EspectrofotometríaRESUMEN
OBJECTIVE: Phenytoin, a classical anticonvulsant, shares with antimanic anticonvulsants the property of blockade of voltage-activated sodium channels. The authors therefore planned a trial of phenytoin for mania. METHOD: Patients with either bipolar I disorder, manic type, or schizoaffective disorder, manic type, entered a 5-week, double-blind controlled trial of haloperidol plus phenytoin versus haloperidol plus placebo. Of 39 patients, 30 completed at least 3 weeks and 25 completed 5 weeks. RESULTS: Significantly more improvement was observed in the patients receiving phenytoin. Added improvement with phenytoin in scores on the Brief Psychiatric Rating Scale and Clinical Global Impression was seen in the patients with bipolar mania but not those with schizoaffective mania. CONCLUSIONS: Blockade of voltage-activated sodium channels may be a common therapeutic mechanism of many anticonvulsants given for mania, and phenytoin may be a therapeutic option for some manic patients.
Asunto(s)
Anticonvulsivantes/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Fenitoína/uso terapéutico , Anticonvulsivantes/farmacología , Antimaníacos/farmacología , Antimaníacos/uso terapéutico , Trastorno Bipolar/psicología , Escalas de Valoración Psiquiátrica Breve/estadística & datos numéricos , Método Doble Ciego , Esquema de Medicación , Femenino , Haloperidol/uso terapéutico , Humanos , Masculino , Fenitoína/farmacología , Placebos , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Trastornos Psicóticos/tratamiento farmacológico , Trastornos Psicóticos/psicología , Canales de Sodio/efectos de los fármacos , Resultado del TratamientoRESUMEN
Studies in European and American populations have suggested that the course of bipolar illness is most often characterised by a predominance of depressions over manias. The current chart review study suggests that among manic-depressive patients in Southern Israel, a predominately manic course of illness is more common. Unlike some previous studies, no sex differences were noted in type of illness course. Possible explanations for the main finding, including climate-related factors, are discussed.
Asunto(s)
Trastorno Bipolar/epidemiología , Adulto , Trastorno Bipolar/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Índice de Severidad de la EnfermedadAsunto(s)
Trastorno Bipolar/terapia , Depresión/terapia , Magnetismo/uso terapéutico , Adulto , Trastorno Bipolar/psicología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estimulación Física , Escalas de Valoración Psiquiátrica , Método Simple Ciego , Resultado del TratamientoRESUMEN
OBJECTIVE: Left prefrontal transcranial magnetic stimulation has been reported to have ECT-like effects in depression; therefore, the authors planned a study of transcranial magnetic stimulation in mania. METHOD: Sixteen patients completed a 14-day double-blind, controlled trial of right versus left prefrontal transcranial magnetic stimulation at 20 Hz (2-second duration per train, 20 trains/day for 10 treatment days). Mania was evaluated with the Mania Scale, the Brief Psychiatric Rating Scale, and the Clinical Global Impression. RESULTS: Significantly more improvement was observed in patients treated with right than with left prefrontal transcranial magnetic stimulation. CONCLUSIONS: The therapeutic effect of transcranial magnetic stimulation in mania may show laterality opposite to its effect in depression.
