N-Acetyl Cysteine for Bipolar Depression: Novel Approach, Limited Data.

Always looking for novel ways to treat bipolar disorder, researchers have turned to an old standby for Tylenol overdose: n-acetyl cysteine (NAC). Among other causes, mood disorders may be a result of oxidative or metabolic imbalances in the brain caused by low levels of the biochemical glutathoine. NAC works to restore these imbalances, which are possibly at the root bipolar depression, by working as an antioxidant.

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Atypical Antipsychotics and Sudden Cardiac Death: More Trouble in the Promised Land.

The Background

The second generation of antipsychotic medications was launched by the arrival of clozapine in1990. Subsequent pharmacologic development produced a handful of similar follow-ups including risperidone, olanzapine, zispradone, aripiprazole and quetiapine. Their novel mechanism of action (increased antagonism at certain dopamine and serotonin receptors) combined with their reduction of certain side effects (movement disorders, especially tardive dyskinesia and hyperprolactinemia) gave these new agents a sense of promise and potential advantage. Later findings that several of these new atypicals might be specifically effective in mood disorders, particularly bipolar states, made their glow even stronger.

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Modafinil in Bipolar Depression: Treatment Advance or Back to the Future?

The search for effective treatments for bipolar depression is fully underway. Driven by epidemiologic prevalence, clinical need and financial profit, academic researchers and Pharma are both developing anda testing new compounds at a furious pace. Modafinil (Provigil) is a recent entrant into this mad race. Approved by the FDA for use in Excessive Daytime Sleepiness (EDS) associated with Narcolepsy, Sleep Apnea and Shift Work Sleep disorder, studies over the past five years have assessed the potential of this new drug in treating conditions that range from ADHD, Cocaine Dependence and Mood Disorders.

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Atypical Antipsychotics in Bipolar Depression Circa 2007: Ready For Prime Time?

The use of antipsychotic medications in the treatment of bipolar disorder is hardly new.

The effectiveness of the original, first generation antipsychotic agents was obvious from the start. They reduced the excitement, agitation, psychosis and other symptoms of the manic syndrome. And this made sense. Drugs defined as neuroleptics should produce an acute calming action. Recent pharmaceutical developments and new research has complicated this early, simple state of affairs and forced a reevaluation of the role of this class of medications in the treatment of manic-depressive illness.

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Omega-3 Fatty Acids

Epidemiological and observational studies have suggested that consumption of fish and omega-3 fatty acids has a protective role against several illnesses, including depression. Some clinical data support the hypothesis that omega-3 fatty acids are a potential treatment option for mood disorders. Cold-water fish, including cod, salmon, and mackerel, contain the essential omega-3 fatty acids Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA). Flaxseed, canola oil, and walnuts are also potential dietary sources of these omega-3 fatty acids. Dietary supplements containing fish oil are also widely available. Omega-3 fatty acids help regulate everyday cellular functions in the body that are necessary for good health. DHA is important as a major structural component of cell membranes, while EPA is thought to play an important role in neuronal signal transduction. DHA and EPA are not produced in the body and people can only get these fatty acids through their diet or from nutritional supplements.

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GSK-3 Inhibitor – A New Buzz in Town

A press release in January 2007 generated excitement among Chicago researchers and clinicians studying and treating bipolar disorder.

Dr. Alan Kozikowski and his group in the Department of Medicinal Chemistry and Pharmacognosy at the University of Illinois in Chicago were awarded a three-year, $2.1 million grant from the National Institute of Mental Health (NIMH). The grant was awarded for research toward the development a new drug, a safe and selective glycogen synthase kinase-3 (GSK-3) inhibitor, to treat bipolar disorder.

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