[Abstract]
![Cuadro de texto: Def.- El Trastorno Bipolar es una enfermedad mental, fruto de un desequilibrio químico en unas sustancias que tenemos en el cerebro llamadas neurotransmisores. El enfermo oscila entre la alegría y la tristeza, de una manera mucho más fuerte que las personas que no padecen esta patología. Así, el enfermo sufre de episodios o fases depresivas, o eufóricas (maníacas).El Trastorno Bipolar
Antes, esta enfermedad era conocida como maníaco-depresiva. Tiene tratamiento farmacológico, de ahí que el problema principal sea el que el enfermo esté correctamente diagnosticado: los manuales sitúan la media de espera de este diagnóstico en unos diez años.
Muchos enfermos depresivos en realidad tienen un trastorno bipolar, y no es hasta que se manifiesta un episodio en dirección contraria emocional que se hace patente la verdadera patología. Se calcula que la padece cerca de un 2% de la población, aunque no la haya manifestado. La enfermedad tiene una base genética y seguramente un detonante ambiental para manifestarse.
Effects of polyunsaturated fatty acids on psychiatric disorders Kuan-Pin Su, Winston W Shen and Shih-Yi Huang We are pleased to see the increased recognition of polyunsaturated fatty acids (PUFAs) in health promotion and medical treatment. However, a recent article in the Journal (1) covered many aspects of PUFAs but excluded many recent findings on psychiatric disorders, possibly because of the lag between the symposium and publication of the article. Empirical studies related to psychiatric disorders have focused on 1) assessment of PUFAs in the tissues (red blood cell membrane, platelet, fibroblast, and postmortem brain) of psychiatric patients, 2) therapeutic trials of PUFAs for the treatment of psychiatric disorders, and 3) evidence from the data of epidemiologic surveys. Studies in primates suggested that the PUFA concentrations of the red blood cell membrane can reflect the PUFA composition of frontal cortex (2). PUFAs are found to be depleted in the red blood cell membrane of patients with schizophrenia (3) and major depressive disorder (4). Horrobin et al (5) found decreased PUFAs in the frontal but not in the cerebellar cortex of postmortem brain tissue from schizophrenic patients. Tissue PUFA deficiency has provided the rationale for treating symptoms of psychiatric disorders with n-3 fatty acids. The results of one open trial suggested that eicosapentaenoic acid might improve residual symptoms in schizophrenic patients (6). Furthermore, n-3 fatty acids exhibited mood-stabilizing properties in bipolar disorder in a recent pilot study (7). Thus, n-3 fatty acids may play an important role in the psychoneuroendocrinology of various psychiatric disorders......American Journal of Clinical Nutrition, Vol. 72, No. 5, 1241, November 2000
Role of S-adenosyl-L-methionine in the treatment of depression: a review of the evidence1,2,3,4 American Journal of Clinical Nutrition, Vol. 76, No. 5, 1158S-1161S, November 2002
David Mischoulon and Maurizio Fava. Major depression remains difficult to treat, despite the wide array of registered antidepressants available. In recent years there has been a surge in the popularity of natural or alternative medications. Despite this growing popularity, there is limited evidence for the effectiveness of many of these natural treatments. S-adenosyl-L-methionine (SAMe) is one of the better studied of the natural remedies. SAMe is a methyl donor and is involved in the synthesis of various neurotransmitters in the brain. Derived from the amino acid L-methionine through a metabolic pathway called the one-carbon cycle, SAMe has been postulated to have antidepressant properties. A small number of clinical trials with parenteral or oral SAMe have shown that, at doses of 200–1600 mg/d, SAMe is superior to placebo and is as effective as tricyclic antidepressants in alleviating depression, although some individuals may require higher doses. SAMe may have a faster onset of action than do conventional antidepressants and may potentiate the effect of tricyclic antidepressants. SAMe may also protect against the deleterious effects of Alzheimer disease. SAMe is well tolerated and relatively free of adverse effects, although some cases of mania have been reported in bipolar patients. Overall, SAMe appears to be safe and effective in the treatment of depression, but more research is needed to determine optimal doses. Head-to-head comparisons with newer antidepressants should help to clarify SAMe’s place in the psychopharmacologic armamentarium.
FIGURE 1. Pathway of S-adenosyl-L-methionine (SAMe). SAMe is synthesized as part of a multistep pathway involving the vitamins folic acid and B-12. The end product then donates methyl groups in the reactions involved in the synthesis of the key neurotransmitters serotonin, norepinephrine, and dopamine. Deficiencies of these neurotransmitters are thought to be involved in the development of depression and other mood disorders. It has been postulated that exogenous addition of SAMe may result in increased synthesis of these neurotransmitters, which may account for its antidepressant effect. MTHFR, methylenetetrahydrofolate reductase (EC 1.7.99.5); MTHF, methyltetrahydrofolate; 1-Met, methionine; Mat, methionine adeonsyltransferase (EC 2.5.1.6); Met synthase, methionine synthase (EC 4.2.99.10); DA, dopamine; 5-HT, serotonin (5-hydroxytryptophan); NE, norepinephrine. Adapted from reference 11.
Cholesterol, depression and suicide K.-P. Su and S.-Y. Tsai Department of Psychiatry, Taipei Medical College-Affiliated Wan Fang Hospital, No. 111, Hsing-Lung Road Sec. 3, Taipei 116, Taiwan S.-Y. Huang Graduate Institute of Nutrition and Health Science, Taipei Medical College, Taipei, Taiwan We read with interest the excellent large-scale prospective study reported by Partonen et al (1999). They found that low serum total cholesterol appears to be associated with low mood and suicide. However, others have reported conflicting results (McCallum et al, 1994). Weidner et al (1992) found that patients on a cholesterol-lowering diet were associated with reductions in depression if they were instructed to increase fish consumption. This implied that differences in the composition of polyunsaturated fatty acids (PUFAs) might explain the conflicting finding. The PUFAs are classified into two main groups: omega-3 (or n-3) of which the parent essential fatty acid is alpha-linolenic acid (C18:3n-3), and n-6, of which the parent essential acid is linoleic acid (C18: 2n-6). Maes et al (1999) found that major depression is associated with: significantly decreased total n-3 fatty acids; increased monounsaturated fatty acids and C22: 5n3 proportions and increased C20:4n6/C20:5n3 and C22:5n6/C22:6n3 ratios; lower C22:4n6, C20:5n3 and C22:5n3 fractions in phospholipids; lower C18:3n3, C20:5n3 and total n3 fatty acids, and higher C20:4n6/C20:5n3 and n6/n3 ratios in cholesteryl esters; and lower serum concentrations of phospholipids and cholesteryl esters. These findings are consistent and have shown well-established positive correlation between depression and coronary artery disease. Many studies have documented evidence of hypothalamic-pituitary-adrenocortical axis hyperactivity within medication-free patients with major depression, including hypercortisolaemia (Raadsheer et al, 1994). Hypercortisolaemia can induce hypercholesterolaemia, hypertriglyceridaemia and hypertension. These are well known to be predisposing factors of cardiovascular disease. If low serum cholesterol concentrations were linked to increased depression, it would be difficult to interpret the correlation between depression and coronary
2.[Abstract]](bipolaridad_archivos/image006.gif)