back to circadian rhythms? treating bipolar depression with modafinil

August 7, 2007

Modafinil (more commonly known as Provigil), a drug approved for use in sleep apnea, narcolepsy, and shift work disorder, appears to be helpful with bipolar depression.

The article notes that the manufacturer supplied both the modafinil and the matching placebo.   I wonder how much placebo costs?  Are there places that manufacture brand-name placebo?  I mean, there must be, for researchers to run studies.

Bipolar disorder: Not just circadian rhythms but social rhythms too

July 18, 2007

(And probably other kinds of rhythms, too.)

A long time before I was diagnosed with bipolar disorder I figured out that I felt a whole hell of a lot better if had a regular schedule. Not just sleep schedule, but work schedule, and regular doses of socialness instead of nothingnothingnothing and then hoursandhours of seeing other people.

Circadian rhythms are important in bipolar disorder; lithium is involved in helping reset circadian rhythms. But we have other rhythms, too. Social rhythm disruption often shows up in bipolar disorder, when people swing between the gregariousness and over-gregariousness of hypo/mania, and the withdrawal of depression. And externally regulated social rhythms (being around and not around people on a regular schedule) can help regulate bipolar disorder. (Not all on their own, duh, nor for everyone, but they can be helpful.)

Around The Clock is a blog written by a circadian rhythm and photoperiodism researcher (in case you were wondering, as I was, photoperiodism is “the physiological reaction of organisms to the length of day or night“). He has an entry with several short pieces on circadian rhythms, social rhythms, and bipolar that I recommend. I do want to say that he overstates the effect of social rhythm disruption on people with bipolar; it is not true that any new relationship, job, etc., will necessarily result in wild cycling. But don’t let that detract from the general interestingness of the post.

insomnia predicts future anxiety but not future depression

July 9, 2007

Based on two surveys 11 years apart headed up by Dag Neckelmann of Haukeland University Hospital in Norway. Reuters article. Via Spikol. Insomnia at time 1 predicted anxiety disorder at time 2, but not depression, although depression and insomnia co-occurred.

I thought the fact that it wasn’t significantly predicting depression (despite predicting anxiety) was pretty interesting, since insomnia and depression are widely known to be related (and anxiety and depression can both co-occur and each cause the other). Maybe insomnia is a byproduct of early anxiety that isn’t yet diagnosable? Maybe it’s a version of the same phenomenon where lack of sleep can make bipolar people hypo/manic?

manic mice? and circadian rhythms

June 25, 2007

Manic mice

Mice engineered to lack a specific gene showed behaviors similar to human mania in a study funded in part by NIMH; they were hyperactive, slept less, appeared less depressed and anxious, and craved sugar, cocaine and pleasure stimulation. The rodents’ behavior was more normal after lithium treatment or restoration of a functioning CLOCK protein, which the knocked-out gene codes for.

The article says this is similar to human mania, and it sounds like it’s similar enough to tell us useful stuff, although the mice don’t sound bipolar, just, as they say, behaving similarly to some aspects of manic humans.

The CLOCK protein is involved in circadian rhythms. And so here is some interesting stuff on circadian rhythms in bipolar disorder, and on how lithium works, from one of my favorite bipolar disorder sites, Jim Phelps’ Psych Education. Lots of science, lots of high-level information that isn’t very widely spread, and an excellent site for info on bipolar II in general and on anxiety in bipolar.