Medication for Breast Cancer Shortens Time for Treatment of Manic State

Depending on the strictness of definition, up to 3 or 5% of americans may suffer from bipolar illness, with varying degrees of tending towards depression of mania. Mania is much what it sounds like, and people in the less than complete manic state are often very creative (perhaps why the gene was selected). If mania is full blown, it can be a very destructive state to the patient, the family and to society, often requiring hospitalization. Patients with mania are expansive, often hypersexual, foolish in financial and other choices, and are very irritable. They often have impaired sleep. They are happy but those around them are miserable.

There is a state called hypomania which is a muted version of full blown mania. After a while the patient becomes depressed; hence the term "bipolar disease". It has a strong family disposition, especially in some groups such as the amish. There is no cure but with careful psychiatric care, the proper medications and family support, the bipolar patient can live a useful and productive life. As an aside, in the depressed state, suicide, up to 20% is common and suicidal thoughts should be carefully monitored with hospitalization if necessary. psychotherapy may also be useful.

There are many standard drugs used to treat the manic phase of bipolar disease but other than the antipsychotics which knock the patient out, the standard drugs take over a week ur typically longer to work. An amazing finding by nimh scientists based on basic science and the main subject of this article is that the breast anticancer drug, tamoxifen may be useful in treating the manic state. The advantages of tamoxifen are that it easily crosses the blood brain barrier and induces remission faster than other drugs used such as lithium, tegretol (carbemazepine), valproic acid (the latter two are anticonvulsants) and the family of antipsychotics, which still may be necessary for immediate control. And it directly inhibits protein kinase c thought to be associated with the manic state. The researchers - see references - speculated that because tamoxifen acted directly on this brain protein kinase associated with the manic state(see references) it would act quicker and indeed it did. Within a week a majority of the patients were symptom free, faster than conventional medications. Other antimanic drugs also affect pkc (protein kinase c) but indirectly. PKC seems to be essential to the development of manic-depressive illness. The drug was well tolerated, other than weight loss but may not be useful in women with uteri, as it is associated with (a highly curable) endometrial cancer. The researchers could not rule out some effect from the estrogen like activity of tamoxifen.

So the world of psychiatry has discovered a new drug in an unexpected place, and further medications based on this may be expected with all of the speed of development and fda approval.