Recovery Issues in Bipolar Disorder

Written by HealthyPlace.com Staff Writer

Dr. Emanuel Severus, is a research fellow in psychiatry at Harvard Medical School where he works with the Bipolar and Psychotic Disorders Program. His research consists of new treatment options for bipolar disorder, schizophrenia, and other psychotic disorders.

David HealthyPlace.com moderator.

The people in blue are audience members.

online conference transcript

David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. Our topic tonight is "Recovery Issues in Bipolar Disorder." We have an excellent guest tonight. Dr. Emanuel Severus, M.D., is a research fellow in psychiatry at Harvard Medical School where he works with the Bipolar and Psychotic Disorders Program (New and Experimental Psychopharmacology Clinic/Lab). His research consists of new treatment options for bipolar, schizophrenia and other psychotic disorders. Dr. Severus won the 1999 Glaxo Wellcome Research Award.

Good evening, Dr. Severus and welcome to HealthyPlace.com. We appreciate you being our guest tonight. Before we get into the meat of the conference, can you tell us a bit more about your expertise in Bipolar Disorder?

Dr. Severus: Thank you for the invitation! Since 1995, I have been interested in new treatment options for bipolar disorder. In 1995, Dr. Stoll and I came up with the idea of using omega-3 fatty acids.

David: Can you expand on that a little more? Maybe explain what omega-3 fatty acids are and how they are used?

Dr. Severus: Omega-3 fatty acids are essential Polyunsaturated Fatty Acids (PUFAs). They are found in flaxseed oil and fish oil, and of course, fatty fish. Some examples include salmon, herring and mackerel.

Those fatty acids seem to share similar properties with the established mood stabilizers, with regard to signal transduction at the postsynaptic membrane.

David: In non-technical terms, what is the impact, then, of ingesting these fatty acids?

Dr. Severus: Down-regulating of post-synaptic pathways, resulting in improved membrane stability.

David: Since you are in the research field, what is the "best" treatment for bipolar disorder available today?

Dr. Severus: It really depends on the individual, and it also depends whether you are just focusing on pharmacological treatment options, or not.

David: Let's start with bipolar medications, or natural remedies for bipolar, and then we'll progress from there.

Dr. Severus: Okay. We can start with natural remedies for bipolar. Omega-3 fatty acids are definitely a good choice for patients with bipolar depression, however, they also seem to have mood-stabilizing properties.

Another benefit, is the beneficial side-effect profile. Apart from gastrointestinal distress, there are practically no adverse effects. In fact, omega-3 fatty acids seem to protect individuals with myocardial infarction from sudden cardiac death. And as you might know, patients with affective disorders are at an increased risk of developing Coronary Artery Disease and myocardial infarction.

David: I have not heard of many doctors recommending omega-3 fatty acids as a first line treatment. Usually, they start with medications like Lithium, etc. Would you suggest that some with bipolar disorder try omega-3 fatty acids first, before turning to some of these other medications?

Dr. Severus: It is true that Lithium is the most established mood-stabilizer. It seems to have potent anti-suicidal properties, apart from its mood-stabilizing properties. On the other hand, it seems to prevent manic episodes more effectively than depressive episodes. Some patients also complain about the side-effect profile, like increased thirst, cognitive dulling, weight gain, acne, tremor. I think it really depends on the individual.

KcallmeK: How does the use of omega-3 measure up in regard to anti-suicidal properties?

Dr. Severus: We don't know yet. There are some data from Finland which suggests that it also has anti-suicidal properties.

erycksmom: Can you try the omega-3 if you are currently on Lithium and still not stable?

Dr. Severus: Sure. I think adding omega-3s to Lithium or Valproate is a very good option. You also don't have to be concerned with drug interactions.