Mood Stabilizers

Peter ForsterBipolar Treatment

There is nothing like a patient’s request to spur me on to tackle a long delayed project. Noting that a significant percent of the patients I see have bipolar, one of my patients wondered why I did not have any information on this website that addressed, in an organized way, the considerations that go into selecting a mood stabilizer. I …

Mania and Depression Sequence

Peter ForsterBest Practices, Bipolar Treatment

One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …

Lithium Prevents Suicide

Peter ForsterBipolar Treatment

This has been a year with lots of useful information highlighting the continued importance of some of the oldest treatments for bipolar disorder: lithium salts. A New York Times Magazine article (“I Don’t Believe in Good but I Believe in LIthium”) about bipolar focused on lithium, and another New York Times article a year before that asked the question “Should We …

Lithium and Genes

Peter ForsterBipolar Treatment, Psychobiology, Testing

Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …

Lithium and Kidney Damage

Peter ForsterBipolar Treatment, Physical Conditions and Health

Lithium may be effective as a mood stabilizer, but questions often come up about its safety, particularly with regard to kidney or renal effects. A recent very large study published in November 2015 in JAMA Psychiatry looked at a huge dataset from Denmark in order to provide the best information we have now about these risks. The study consisted of records …

Lithium Long Term Risks

Peter ForsterBipolar Treatment

Elsewhere we have talked about accumulating evidence that suggests that lithium may have significant long-term beneficial effects for brain function and health in people with bipolar. A recent article in the British journal the Lancet reminds us that lithium remains a medication that requires close monitoring and which has the potential to cause rare but significant adverse effects on kidney, …

Bipolar Depression Neurobiology – 2014 ISBD Update

Peter ForsterBipolar Treatment, Psychobiology

Bipolar depression neurobiology is an area that urgently needs more research. The treatment of a depression that follows an energized (hypomanic or manic) state remains one of the most difficult areas in psychiatry. Mark Frye, Chair of the Department of Psychiatry at the Mayo Clinic, gave a presentation on this topic at the 2014 International Society of Biological Society conference that was …

Lithium Benefits for Health – NYT Article

Peter ForsterBipolar Treatment

Does lithium have benefits for health when it is found at small doses in the water? This is the subject of a recent article in the New York Time (september 13th, 2014). The article captured the attention of many readers of this blog and the companion one I write about mood disorders (moodsurfing.com). It was tantalizingly entitled,”Should We All Take a Bit …

Early Lithium Treatment for Bipolar – Better Outcomes?

Peter ForsterBipolar Treatment

Does early lithium treatment for bipolar lead to better outcomes? This is the question that researchers sought to answer by looking at a Danish database of health information. The Danish registry is a set of nearly complete health information on the population of Denmark (hence, studies using this database are more representative of the general population than studies from many …