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Tuesday, December 20, 2011

7 Novel Bipolar Treatment Medications

This post is a brief overview of seven emerging or novel drugs for treating bipolar disorder.  This should not be considered a thorough analysis of the state-of-the-art in psychotropic medications. Most of these products have not finished being tested.

Your psychiatrist has probably not even heard of them.  So don't get too excited about seeing if they will work for you anytime soon.  I am posting this out of curiosity and hope for the future.  I think it is encouraging to know science is making headway towards more effective drugs with less side effects.

Current treatments for bipolar depression have a considerable lag of onset of action.  An alternative product with rapid antidepressant effects (hours or days versus days or weeks) is needed.  Ongoing research is promising with newer, faster acting drugs in the testing or approval stage.

1. Ketamine is a drug that has some clinical testing and appears to work well for treatment resistant bipolar depression.  It is fast acting and generally well tolerated.  An IV is used for administering the drug so you better like getting poked.  

It seems product development on this drug has stalled since it can cause hallucination and significantly interupts normal brain function.  Because of the ability to experience abnormal states ketamine is popular at underground parties and raves.

2. Oxycarbezepine is a derivative of the mood stabilizer carbamazepine (Tegretol).  It is being studied for acute mania, hypomania, mixed episodes, and rapid-cycling.  For now a lack of sufficient quality trials precludes us from knowing its effectiveness and tolerability. 

3. Riluzole is a novel chemical that is being studied for treatment of bipolar depression.  It is already an FDA approved prescription drug used to treat Lou Gehrig's disease.  Studies show it effective in treating acute bipolar depression alone or in combinations with other antidepressants.  The first large controlled trial of Riluzole is being conducted at the Yale Depression Research Program.

4. Tamoxifen has been evaluated for acute mania treatment.  Results from several trials demonstrate that it is both effective and well tolerated.  One researcher said that Tamoxifen isn't perfect but it fits the bill.  Is that an endorsement?  It is a promising antimanic drug but larger studies are needed before it can be sent to the FDA for approval.  Interestingly, the drug has been in use for two decades to treat breast cancer under the brand name Nolvadex.

5. Tiagabine is an anticonvulsant being studied for maintenance treatment of bipolar disorder.  It is already FDA approved for treatment of partial seizures under the brand name Gabitril and it is already being used off label for controlling anxiety.  As with most of these emerging treatments tiagabine needs better studies before a determination can be made as to its therapeutic potential for bipolar disorder.   

6. Saredutant is a promising neuropeptide being studied for treatment of major depression disorder.  Neuropeptides work on different neurotransmitter systems than conventional antidepressants.  Saredutant produced favorable results and is in clinical trials for long-term efficacy and safety.

7. Scopolamine.  Scopolamine showed rapid, robust antidepressant properties in clinical testing.  It is being tested for relief from both depression and bipolar depression.  It is interesting to note that this drug is already in use for motion sickness relief.  If it ends up working then you can go boating without puking or being sad.  

Research for drugs that can effectively treat bipolar disorder continues.  It is exciting to note they are finding chemicals that work much faster than what we are used to, showing effects in hours instead of days or weeks.  It is also promising that some of these medications are already approved and in use for other treatment purposes. 

The understanding of bipolar mood mechanisms is increasing. While promising solutions are being discovered it can be disappointing at how long it takes for them to get studied and approved for use.  However, we should be grateful for what we already have and hopeful that science will make enhanced meds that work even better.

Do you know of other medications being studied for bipolar treatment? 

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