Metabolic Problems in Mental Illness

Unfortunately there are iatrogenic problems in mental illness. These are problems caused by the treatments.

"Having a mental illness has been and remains even now, a strong barrier to effective medical care. Most mental illness, such as schizophrenia, bipolar disorder, and depression are associated with undue medical morbidity and mortality. It represents a major health problem, with a 15 to 30 year shorter lifetime compared with the general population."

Saravane D, Feve B, Frances Y, Corruble E, Lancon C, Chanson P, Maison P, Terra JL, Azorin JM; avec le soutien institutionnel du laboratoire Lilly.

Service des spécialités, l'Association nationale pour la promotion des soins somatiques en santé mentale, EPS Ville-Evrard, 202, avenue Jean-Jaurès, 93332 Neuilly-sur-Marne cedex, France.

This quote is from Ref. 1. "Encephale" is French for "brain". The quote refers to problems associated with atypical antipsychotics, which can cause severe metabolic problems. However, schizophrenics have metabolic problems to begin with. Sorting these out from the drug-induced metabolic problems is an important and difficult task.

Side Effects

Unfortunately these drug side effects have been a horror story.

"Adverse effects including extrapyramidal symptoms (EPS), akathisia, sedation, headache, nausea were significant in clinical trials in children and adolescents. The possibility of aripiprazole causing tardive dyskinesia cannot be excluded."

Greenaway M, Elbe D.

Department of Child and Adolescent Psychiatry, BC Children's Hospital, Vancouver, BC.

This quote is from Ref. 2. Unfortunately some atypical "antipsychotics" can cause diabetes (3), which is a terrible disease that can be fatal.

The Mitochondria in Mental Disorders

"Several investigators have proposed that mitochondrial dysfunction is related to the pathophysiology of bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia (SZ)."

Jou SH, Chiu NY, Liu CS.

Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.

This quote is from Ref. 4, which is an outstanding article. It is available free full text at the journal website, and fortunately for me is in English. The mitochondria are organelles that produce cellular energy. In the brain this energy is produced primarily from glucose, although the brain can burn amino acids in an emergency. The brain depends very heavily on glucose, and as a result certain metabolic conditions such as hypoxia and hypoglycemia can cause psychosis. This is discussed in the book "The Harvard Guide to Psychiatry", Third Edition, edited by Armand Nicholi, Jr. I read the 1999 edition.

There has been a major surge of research in this area in the Far East (5, 6, 7). Although most of the articles have been from Japan, Ref. 8 is from Israel. Ref. 8 reports similar results.

Reduced Brain Energy Metabolism

Refs. 9 & 10 report reduced brain energy metabolism in schizophrenia. Unfortunately many of these academic references are highly technical. One needs a college degree in science to come close to understanding them.

Bipolar Disorder

Similar findings have been reported in bipolar disorder (11, 12, 13). This implies that bipoloar disorder is similar to schizophrenia in the biochemical etiology.

Depression

In fact, Refs. 14 & 15 report similar findings in depression. This suggests that schizophrenia, bipolar disorder, and depression may be points on a continuum. Psychiatric diagnoses may be much like ladies fashions! All three diseases are diabetes of the brain!

Advocacy

The greater Boston NAMI consumer council can be reached at the following e-mail address:

info@namigbcan.org

Their office address is as follows:

NAMI GB-CAN, SCFMHC Room 515, 85 East Newton Street, Boston MA, 02118

If people are interested in more information on this outstanding advocacy group, let me know and I will provide more information. SCFMHC means Solomon-Carter-Fuller Mental Health Center.

Conclusions

My own theory is that tryptophan is flooding the brain cells in mental illness causing problems in the mitochondria and other organelles. Branched chain amino acids compete with tryptophan for transport into the brain and might make good treatments. However, too much of them would also lower brain dopamine. If you lower brain dopamine too much you might get acute dystonia. Therefore they need to be taken in moderation.

More information is presented in Refs. 16-20.

References

1. [Drawing up guidelines for the attendance of physical health of patients with severe mental illness.] Saravane D, Feve B, Frances Y, Corruble E, Lancon C, Chanson P, Maison P, Terra JL, Azorin JM; avec le soutien institutionnel du laboratoire Lilly. Encephale. 2009 Sep;35(4):330-9. Epub 2009 Jul 9. French.

2. Focus on Aripiprazole: A Review of its use in Child and Adolescent Psychiatry. Greenaway M, Elbe D. J Can Acad Child Adolesc Psychiatry. 2009 Aug;18(3):250-60.

3. [Diabetes and second-generation (atypical) antipsychotics.] Chabroux S, Haffen E, Penfornis A. Ann Endocrinol (Paris). 2009 Sep;70(4):202-10. Epub 2009 Aug 22. French.

4. Mitochondrial dysfunction and psychiatric disorders. Jou SH, Chiu NY, Liu CS. Chang Gung Med J. 2009 Jul-Aug;32(4):370-9.

5. Drug News Perspect. 2006 Dec;19(10):597-602. The role of mitochondrial dysfunction in bipolar disorder. Kato T.

6. CNS Drugs. 2007;21(1):1-11. Mitochondrial dysfunction as the molecular basis of bipolar disorder: therapeutic implications. Kato T.

7. Bipolar Disord. 2000 Sep;2(3 Pt 1):180-90. Comment in: Bipolar Disord. 2000 Sep;2(3 Pt 1):145-7. Mitochondrial dysfunction in bipolar disorder. Kato T, Kato N.

8. PLoS One. 2008;3(11):e3676. Epub 2008 Nov 7. Neuroanatomical pattern of mitochondrial complex I pathology varies between schizophrenia, bipolar disorder and major depression. Ben-Shachar D, Karry R.

9. Volz HR, Riehemann S, Maurer I, Smesny S, Sommer M, et al. Reduced phosphodiesters and high-energy phosphates in the frontal lobe of schizophrenic patients: a 31P chemical shift spectroscopic-imaging study. Biol Psychiatry. 2000;47:954-961.

10. Fukuzako H, Fukuzako T, Hashiguchi T, Kodama S, Takigawa M, et al. Changes in levels of phosphorus metabolites in temporal lobes of drug-naive schizophrenic patients. Am J Psychiatry. 1999;156:1205-1208.

11. Kato T. Mitochondrial dysfunction in bipolar disorder: from 31P-magnetic resonance spectroscopic findings to their molecular mechanisms. Int Rev Neurobiol. 2005;63:21-40.

12. Bertolino A, Frye M, Callicott JH, Mattay VS, Rakow R, et al. Neuronal pathology in the hippocampal area of patients with bipolar disorder: a study with proton magnetic resonance spectroscopic imaging. Biol Psychiatry. 2003;53:906-913.

13. Stork C, Renshaw PF. Mitochondrial dysfunction in bipolar disorder: evidence from magnetic resonance spectroscopy research. Mol Psychiatry. 2005;10:900-919.

14. Coupland NJ, Ogilvie CJ, Hegadoren KM, Seres P, Hanstock CC, et al. Decreased prefrontal Myo-inositol in major depressive disorder. Biol Psychiatry. 2005;57:1526-1534.

15. Yildiz-Yesiloglu A, Ankerst DP. Review of 1H magnetic resonance spectroscopy findings in major depressive disorder: a meta-analysis. Psychiatry Res. 2006;147:1-25.

16. www.associatedcontent.com/article/2176981/abnormal_tryptophan_metabolism_in_psychiatric.html

17. www.associatedcontent.com/article/2160239/brilliant_discoveries_in_neuropsychiatry.html

18. www.associatedcontent.com/article/2163849/the_psychiatric_side_effects_of_drugs.html

19. www.associatedcontent.com/article/2128781/the_biochemical_explanation_for_schizophrenia.html

20. www.CraigOlson.bizhosting.com.