#Telomere length and #bipolar disorder

http://www.nature.com/npp/journal/vaop/ncurrent/full/npp2017125a.html

Variation in telomere length is heritable and is currently considered a promising biomarker of susceptibility for neuropsychiatric disorders, particularly because of its association with memory function and hippocampal morphology. Here, we investigate telomere length in connection to familial risk and disease expression in bipolar disorder (BD). Telomere length was shorter in psychiatrically well relatives (p=0.007) compared with unrelated healthy participants. Telomere length was also shorter in relatives (regardless of psychiatric status; p<0.01) and patients with BD not on lithium (p=0.02) compared with lithium-treated patients with BD. In the entire sample, telomere length was positively associated with left and right hippocampal volume and with delayed recall.

Adjunctive Bright #Light Therapy for #Bipolar #Depression: A Randomized Double-Blind Placebo-Controlled Trial
http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2017.16101200

Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% compared with 22.2%; adjusted odds ratio=12.6) at weeks 4–6 and significantly lower depression scores (9.2 SD=6.6 compared with 14.9 SD=9.2; adjusted β=–5.91) at the endpoint visit. No mood polarity switches were observed. Sleep quality improved in both groups and did not differ significantly between them.

Conclusions:
The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression

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#Tamoxifen for #bipolar disorder: Systematic review and meta-analysis

https://journals.sagepub.com/doi/full/10.1177/0269881118822167

Tamoxifen is an oral medication that has been proposed as a potential treatment for bipolar disorder. Tamoxifen acts to inhibit the intracellular action of protein kinase C, which is also an action of well-established treatments such as lithium and valproate.

Change in mania scale scores favoured tamoxifen over placebo: SMD −2.14 (95% CI −3.39 to −0.89; 4 trials), as did endpoint mania scale scores SMD 1.23 (95% CI 0.60–1.87; 5 trials). Response rates were also higher: RR 4.35 (1.99–9.50; 4 trials). Acceptability was similar to placebo: RR 1.03 (0.94–1.13; 5 trials).

Conclusions:
Tamoxifen appears to be a promising potential treatment for episodes of mania. Future studies could investigate its effects as an adjunct to dopamine antagonists for improved anti-manic efficacy, and establish its longer term effects on mood, particularly depression and relapse.

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#Bipolar disorder and risk of #Parkinson disease
A nationwide longitudinal study

https://n.neurology.org/content/early/2019/05/22/WNL.0000000000007649

Patients with BD had a higher incidence of PD (0.7% vs 0.1%, p < 0.001) during the follow-up period than the controls. A Cox regression analysis with adjustments for demographic data and medical comorbid conditions revealed that patients with BD were more likely to develop PD (hazard ratio HR 6.78, 95% confidence interval CI 5.74–8.02) than the control group. Sensitivity analyses after exclusion of the first year (HR 5.82, 95% CI 4.89–6.93) or first 3 years (HR 4.42; 95% CI 3.63–5.37) of observation showed consistent findings. Moreover, a high frequency of psychiatric admission for manic/mixed and depressive episodes was associated with an increased risk of developing PD.

Conclusion Patients with BD had a higher incidence of PD during the follow-up period than the control group. Manic/mixed and depressive episodes were associated with an elevated likelihood of developing PD. Further studies are necessary to investigate the underlying pathophysiology between BD and PD.

Risk of Developing #Parkinson Disease in #Bipolar Disorder
A Systematic Review and Meta-analysis


..Seven studies were eligible for inclusion and included 4 374 211 participants overall. A previous diagnosis of BD increased the likelihood of a subsequent diagnosis of idiopathic PD (odds ratio, 3.35; 95% CI, 2.00-5.60; I2 = 92%). A sensitivity analysis was performed by removing the studies that had a high risk of bias and also showed an increased risk of PD in people with BD (odds ratio, 3.21; 95% CI, 1.89-5.45; I2 = 94%). Preplanned subgroup analyses according to study design and diagnostic certainty failed to show a significant effect.

Conclusions and Relevance This review suggests that patients with BD have a significantly increased risk of developing PD compared with the general population. Subgroup analyses suggested a possible overestimation in the magnitude of the associations. These findings highlight the probability that BD may be associated with a later development of PD and the importance of the differential diagnosis of parkinsonism features in people with BD.

The impact of #caffeine consumption on clinical symptoms in patients with #bipolar disorder: A systematic review

https://2medical.news/2021/06/04/the-impact-of-caffeine-consumption-on-clinical-symptoms-in-patients-with-bipolar-disorder-a-systematic-review/

Adjunctive #dietary intervention for #bipolar disorder: a randomized, controlled, parallel-group, modified double-blinded trial of a high n-3 plus low n-6 diet

https://2medical.news/2021/10/10/adjunctive-dietary-intervention-for-bipolar-disorder-a-randomized-controlled-parallel-group-modified-double-blinded-trial-of-a-high-n-3-plus-low-n-6-diet/

Cause-specific excess #mortality after first diagnosis of #bipolar disorder: population-based cohort study

https://2medical.news/2023/08/11/cause-specific-excess-mortality-after-first-diagnosis-of-bipolar-disorder-population-based-cohort-study/