Bipolar extreme fatigue
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Bipolar Disorder and Extreme Fatigue: Insights from Recent Research
Understanding Bipolar Disorder and Fatigue
Bipolar disorder is a severe mental illness characterized by extreme mood swings, including manic and depressive episodes. These episodes can lead to significant disruptions in daily life, with depressive episodes often marked by profound fatigue and low energy levels2 3. Fatigue in bipolar disorder is a multifaceted symptom that can be challenging to manage with standard treatments1.
Ketamine's Anti-Fatigue Effects in Bipolar Disorder
Recent studies have explored the potential of ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, to alleviate fatigue in individuals with treatment-resistant bipolar depression. In a double-blind, placebo-controlled, crossover study, ketamine was shown to significantly reduce fatigue scores compared to placebo from 40 minutes post-treatment to 14 days post-treatment, with the most notable improvement observed on day 21. This suggests that ketamine may offer rapid relief from fatigue symptoms in bipolar disorder, highlighting the importance of targeting glutamate pathways in developing new anti-fatigue treatments1.
Biological Mechanisms Behind Fatigue in Bipolar Disorder
The pathophysiology of bipolar disorder involves complex neurobiological changes, including mitochondrial dysfunction, oxidative stress, and altered glutamatergic systems, which can contribute to persistent fatigue5. Chronic stress and inflammation, common in contemporary Western lifestyles, further exacerbate these symptoms by desynchronizing the internal clock and disrupting sleep patterns4. These findings underscore the need for comprehensive treatment approaches that address both the biological and lifestyle factors contributing to fatigue in bipolar disorder4 5.
Clinical Implications and Future Directions
The high prevalence of fatigue and other mood symptoms in bipolar disorder necessitates ongoing research into effective treatments. The promising results of ketamine in reducing fatigue highlight the potential of targeting non-canonical pathways, such as glutamate receptors, for therapeutic interventions1 5. Additionally, lifestyle modifications aimed at reducing stress and inflammation may offer complementary benefits in managing fatigue and improving overall quality of life for individuals with bipolar disorder4.
Conclusion
Fatigue is a significant and challenging symptom of bipolar disorder, often resistant to standard treatments. Emerging research on ketamine and the underlying biological mechanisms of bipolar disorder provides new insights into potential therapeutic targets. By addressing both the neurobiological and lifestyle factors contributing to fatigue, more effective and comprehensive treatment strategies can be developed to improve the lives of those affected by bipolar disorder.
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Most relevant research papers on this topic
An assessment of the anti-fatigue effects of ketamine from a double-blind, placebo-controlled, crossover study in bipolar disorder.
Ketamine rapidly improves fatigue symptoms in individuals with treatment-resistant bipolar depression, suggesting it as a potential target for new anti-fatigue approaches in multiple disorders.
RCTSpecial issue on bipolar disorder.
Bipolar disorder is a serious mental illness with significant psychological contributions to understanding, assessment, and treatment, often including psychotherapy and medications.
[On bipolar disorder].
Bipolar disorder is characterized by dramatic "highs" and "lows" (manic and depressive episodes) that can last hours or weeks, with a greater risk of suicide than the general population.
Highly CitedBipolar disorder: An evolutionary psychoneuroimmunological approach
Bipolar disorder is linked to chronic stress and inflammation, driven by contemporary Western lifestyles, and reducing these factors through lifestyle changes is crucial for effective treatment.
Non-canonical pathways in the pathophysiology and therapeutics of bipolar disorder
Non-canonical pathways in bipolar disorder may offer opportunities for drug development and identify new, clinically relevant biological mechanisms, potentially improving treatment outcomes.
P-849 - Rhabdomyolisis With Renal Acute Failure Secondary to Extreme Psychomotor Agitation in a Female Patient Diagnosed With Bipolar i Disorder
A female patient with bipolar I disorder developed rhabdomyolisis with renal acute failure due to extreme psychomotor agitation, which was treated with intravenous fluids and dialysis.
Case Report
Rigorous JournalGenetics of bipolar disorder.
Bipolar disorder is a complex genetic disorder with a major genetic contribution to risk, and identifying susceptibility genes in the next few years will significantly improve treatment and patient care.
Highly CitedEvidence for bipolar mood states.
Bipolar mood states, composed, anxious, agreeable, energetic, elated, depressed, and clear-thinking, are present in psychiatric patients.
Observational StudyHighly CitedExtreme attributions predict transition from depression to mania or hypomania in bipolar disorder.
Extreme attributions predict a higher likelihood of transitioning from depression to mania or hypomania in bipolar disorder patients, suggesting cognitive flexibility treatments may benefit these individuals.
RCTPerceived fatigue and energy are independent unipolar states: Supporting evidence.
Energy and fatigue are distinct perceptual states, with different mechanisms and treatment needs for each, and measuring them using separate unipolar scales may improve understanding and therapeutic outcomes.
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