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Tamoxifen relieved the symptoms of mania in a small clinical trial.
NIH
Tamoxifen, a drug commonly used to prevent breast cancer recurrence, is also effective against the manic phase of bipolar disorder, new research suggests
bipolar disorder -. formerly known as manic depression - affects about 1% of the population. As its nickname indicates exceeded, patients experience periods of deep depression and mania, extremely hyperactive condition that can lead to wild spending, risk taking, and extreme sexual activity. When mixed with depression, mania also leads to suicide.
Lithium has been the mainstay of bipolar treatment for over 50 years, but about 40% of patients do not respond to it, said Husseini Manji psychiatrist National Institute of Mental Health (NIMH) in Bethesda, Maryland . In recent years, both anticonvulsant and antipsychotic drugs have proven effective for mania, but can take weeks for the shot. Now it seems that an alternative may be to fast action horizon.
Tamoxifen protects against breast cancer by blocking the receptors for the hormone estrogen, which some tumors depend on. But the drug has another function: It inhibits an enzyme called protein kinase C (PKC) that regulates the excitability of brain cells. Studies have shown increased PKC activity in the brains of people with bipolar disease, and a recent study of the whole genome found that the gene with the strongest association with the disease is that governing PKC. It is found that tamoxifen is the only PKC-inhibiting compound approved for direct human use which can pass from the bloodstream into the brain.
So over several years, a NIMH group led by psychiatrist Carlos Zarate conducted a controlled study with 16 patients hospitalized for mania. Over a period of 3 weeks, each person was given either tamoxifen or placebo. In a paper appearing online today in the journal Bipolar Disorders , the team reports that the tamoxifen treated patients began to improve by the 5th day, and five of the eight showed a reduction of 50% or more symptom reduction on a rating scale-mania -. compared to only one of eight in the placebo group
"This is potentially a major development if replicated," says psychiatrist Paul Keck of the University of Cincinnati in Ohio. "It potentially opens a whole new avenue for targeted treatments."
Manji, a co-author of the study, said doctors have provided a lot of anecdotal evidence that patients with bipolar breast cancer on tamoxifen did not have that much trouble with mania. He said that there were no gender differences in response to drugs in the NIMH trial shows the effect is not related to estrogen receptors. Now, he notes, the work is to test potential drugs that do not mess with estrogen and are "pure PKC inhibitors."
Related Sites
- More about bipolar disorder
- study on the use of lithium to treat mania
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