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The Switch Mechanism and the Bipolar/Unipolar Dichotomy

Published online by Cambridge University Press:  02 January 2018

M. W. P. Carney ,
T. K. N. Chary ,
T. Bottiglieri  and
E. H. Reynolds
M. W. P. Carney*
Affiliation:
Northwick Park Hospital and Clinical Research Centre
T. K. N. Chary
Affiliation:
Northwick Park Hospital and Clinical Research Centre
T. Bottiglieri
Affiliation:
Northwick Park Hospital and Clinical Research Centre
E. H. Reynolds
Affiliation:
Maudsley Hospital and Kings College Hospital, London
*
∗Northwick Park Hospital and Clinical Research Centre, Watford Road, Harrow, Middlesex HA1 3UJ
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Abstract

During open trials of intravenous and oral S-adenosyl methionine (SAM) and a placebo-controlled trial of intravenous SAM in 29 patients, 25 patients had SAM and four had placebo (27 courses of SAM, two of the patients receiving two trials apiece). Nine of 11 bipolar patients (all SAM-treated) switched into elevated mood state (hypomania, mania and euphoria) and two did not respond. Six endogenous unipolar patients improved and five did not. No non-endogenous patient or placebo patient responded for more than 14 days. No unipolar patient switched into elated mood. In eleven (38%) trials and nine (33%) patients there was a switch from depression to elation. Biochemical data from the cerebrospinal fluid of eight patients suggested that the role of the dopaminergic system should be further explored.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 1 , January 1989 , pp. 48 - 51
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Agnoli, A., Ruggieri, S., Gnone, G., et al (1977) The dopamine hypothesis of depression: results of treatment with dopaminergic drugs. In Depressive Disorders (ed. Sanattini, G.). Stuttgart: Schattauer-Verlag.Google Scholar
Angst, J. (1987) The switch from depression to mania and from mania to depression: the role of psychotic drugs. Psychotherapy Bulletin, 23, 66–67.Google Scholar
Botez, M. I., Botez, T., Leveille, J., et al (1979) Neuropsychological correlates of folic acid deficiency: facts and hypotheses. In Folic Acid in Neurology, Psychiatry and Internal Medicine (eds Botez, M. I. & Reynolds, E. H.). New York: Raven Press.Google Scholar
Bottiglieri, T., Laundy, M., Martin, R., Carney, M. W. P., Nissenbaum, H., toone, B. K., johnson, A. L. & reynolds, E. H. (1984a) S-adenosylmethionine influences monoamine metabolism. The Lancet, ii, 224.Google Scholar
Bottiglieri, T., Lim, C. K. & Peters, T. J. (1984b) Isocratic analysis of 3-methoxy 4-hydroxyphenylglycol, 5-hydroxyindole acetic acid and 4-hydroxy-3-methoxy phenylacetic acid in cerebrospinal fluid by high performance liquid chromatography with amperometric detection. Journal of Chromatography, 311, 354–360.CrossRefGoogle Scholar
Bunney, W. E. (1978) Psychopharmacology: a Generation of Progress (eds Lipton, M. A., di Manisco, A. & Killam, K. F.). New York: Raven Press.Google Scholar
Bunney, W. E., Murphy, D. L., Goodwin, F. K. & Borge, G. F. (1970) The switch mechanism process from depression to mania: relationship to drugs which alter brain amines. The Lancet, ii, 1022–1027.Google Scholar
Carney, M. W. P. (1986) Neuropharmacology of S-adenosylmethionine. Clinical Neuropharmacology, 9, 235–243.Google Scholar
Carney, M. W. P., Roth, M. & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–674.Google Scholar
Carney, M. W. P., Martin, R., Bottiglieri, T., Reynolds, E. H., Nissenbaum, H., Toone, B. K. & Sheffield, B. F. (1983) Switch mechanisms in affective illness and S-adenosylmethionine. The Lancet, i, 820–821.Google Scholar
Carney, M. W. P., Chary, T. K. N., Bottiglieri, T., et al (1987) Switch mechanism in affective illness and oral S-adenosylmethionine (SAM). British Journal of Psychiatry, 150, 724–725.Google Scholar
Lewis, J. L. & Winokur, G. (1982) The induction of mania. Archives of General Psychiatry, 39, 303–306.Google Scholar
Lipinski, J. F., Cohen, B. M., Frankenburg, F., et al (1984) Open trial of S-adenosylmethionine for treatment of depression. American Journal of Psychiatry, 141, 448–450.Google Scholar
Reynolds, E. H. (1981) Anticonvulsant drugs, folate metabolism and mental symptoms. In Advances in Epileptology: 12th Epilepsy International Symposium (eds Dam, M., Gram, L. & Perry, J. K.). New York: Raven Press.Google Scholar
Reynolds, E. H., Carney, M. W. P. & Toone, B. K. (1984) Methylation and mood. The Lancet, ii, 196–197.Google Scholar
Thomas, C. S., Bottiglieri, T., Edeh, J., Carney, M. W. P., Reynolds, E. H. & Toone, B. K. (1987) The influence of S-adenosylmethionine (SAM) on prolactin in depressed patients. International Clinical Psycho-Pharmacology, 2, 97–102.Google Scholar
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