Combination Therapy Better Than Leading Drug for Bipolar Disorder, Study Suggests

People with bipolar disorder are less likely to suffer a relapse if they are taking both lithium and sodium valproate rather than the drug valproate alone, an Oxford University study has shown.

Sodium valproate (available as Depakote) has been increasingly prescribed over lithium (Priadel) as a long-term therapy for bipolar disorder, particularly in North America. But the findings of the randomised trial, published in the medical journal The Lancet, suggest that those who have been prescribed valproate would fare better if lithium was added to their therapy, or if they changed to lithium alone.
'Our study indicates that a combination therapy of lithium plus valproate may be preferable for people with bipolar disorder over valproate alone, as there were significantly fewer relapses among those on both drugs over the two year period of the trial,' says Professor John Geddes of the Department of Psychiatry at the University of Oxford, who led the research.
About 1 in 100 people are diagnosed as having bipolar disorder (also known as manic depression), a mood disorder characterised by swings in a person's mood, including depression and mania. During a severe depressive episode, people may have feelings of hopelessness and despair, and have difficulty in carrying on with daily activities and work. In the manic phase, people may be overactive, lose judgement, become sexually uninhibited, and have grandiose ideas or delusions.

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Ziprasidone Okayed for Bipolar Disorder

The FDA has cleared ziprasidone (Geodon) for maintenance treatment of bipolar I disorder as an adjunct to lithium or valproate.

It joins several other antipsychotic drugs -- including quetiapine (Seroquel), aripiprazole (Abilify), and olanzapine (Zyprexa) -- approved for this indication.

Ziprasidone is also approved for acute manic and mixed episodes associated with bipolar disorder, with or without psychotic features, and for schizophrenia.

The approval as bipolar maintenance therapy follows a a six-month, double-blind, randomized, placebo-controlled trial in adult patients with bipolar I disorder, according to the drug's manufacturer, Pfizer.

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The Growing Evidence for Antidepressants as Anticancer Agents

Prostaglandins are infinitesimal, ephemeral lipid signalers in every cell in the body, and regulating every activity that takes place within a cell. As regulators of cellular activity, prostaglandins influence how cells are formed and what part of the body the cell will become. lithium are vital for cellular growth, health, and replication. Prostaglandins regulate the normal life cycle of a cell, knowing when each cell must be repaired and when each one is beyond repair and has reached the end of its cycle.

Laboratory animal experiments in the 1960s demonstrated a powerful influence of prostaglandins on the brains of the animals and birds. Subsequent experiments showed that lithium and every antidepressant tested inhibit prostaglandins. Excessive synthesis of prostaglandins activates a number of mechanisms that result in cancer. Cancer cells grow too fast and multiply too rapidly. They aren’t repaired and don’t die at the end of their cycle. Excessive synthesis of prostaglandins disrupts the signaling mechanisms in which cells communicate with each other. It hinders optimum performance of the immune system, weakening it and turning it against itself. The weakened immune system allows cancer cells to thrive. About 20% of cancers are caused by pathogenic, or disease-causing, microbes. By inhibiting prostaglandins, lithium and antidepressants stimulate immune function and defeat microbes.

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Stimulating Immune Function With Lithium and Antidepressants

Stimulating immune function would transform the prevention, treatment, research and economics of infectious disorders, among them the acquired immunodeficiency syndrome (AIDS), hospital-acquired infections, antibiotic-resistant bacterial infections, resistant tuberculosis, a possible avian influenza pandemic and acts of bioterrorism. Immune stimulation is widely held to be beyond our reach, an unfortunate misconception, for as early as nineteen eighty-one published evidence showed that lithium (1) and antidepressants (2) have immune stimulating and antimicrobial properties (3).

In the early 1950’s physicians observed that patients treated for tuberculosis with the monoamine oxidase inhibitors isoniazid and iproniazid became animated and energized, the observation the first that drugs are capable of acting as antidepressants. That monoamine oxidase inhibitors have dual antimicrobial and antidepressant properties curiously failed to impact the pharmacology of infectious disorders. Remission of such manifestations of viral infections as sinusitis, bronchitis, frequent colds, sore throats, cold sores and genital herpes in patients taking lithium carbonate has been reported. In various studies chronic lithium therapy reduced the rate of recurrent labial herpes infections, while lithium and antidepressants reduced the rates of common, “flu-like” colds, and lithium reduced the frequency and duration of recurrences of genital herpes.

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