Is Lithium really the best treatment for bipolar disorder?

Bipolar disorder is a major medical disorder that affects almost 14 million people in our U.S. today.  This disorder might not be seen as a major medical issue to the general public as many people have never been exposed to a person suffering from BD, but it drastically affects individuals’ lives both mentally and socially.  Bipolar disorder is characterized by rapid changes in mood, consisting of cycles between mania and depression.  After analyzing the scientific paper titled, “Bipolar disorder and mechanisms of action of mood stabilizers” in class throughout last week and discussing with classmates, many interesting issues were cultivated.
The paper explained BD and outlined different hypothesis that described how the common drugs, including, lithium, valproic acid, and carbamezapine work in treating BD.  The two main issues that stuck out to me after reading this paper was the fact that the cause of BD is somewhat of a mystery to scientists as well as the drugs used for treatment.  Even though scientists have a few different drugs or drug combinations to subscribe to patients suffering from BD, these drugs could be dangerous to patients with long-term use.
The first very interesting topic that was brought up in classroom discussion was dealing with the current treatments of BD and their long-term effects on patients.  BD is a very serious disorder that can cost patients a significant amount of money through treatment with drugs in order for them to live a normal life.  Although there are drugs out there that treat BD fairly well, there are some very negative side-effects that come with taking these drugs for extended periods of time, and unfortunately, life-long drug use is necessary for most BD patients to live normal lives.  Lithium is drug of choice for doctors as of right now even thought it has some negative effects on patients.  With long-term use of Li, a patient can gain a very significant amount of weight and is also susceptible to the development of diabetes.  Both of these can decrease the life span of BD patients.  Although treating patients with Li can decrease life span, can they function without treatment?
Another interesting issue that stuck out in my head while reading through this paper was the unknown cause of BD.  Although scientists have developed drugs to treat BD, they haven’t been able to identify a definitive cause to the life-changing disorder.  Before reading the paper I thought that the cause of BD was primarily a genetic disorder.  However, there are many different things that come into play when looking at what causes an individual to develop BD.  The paper stated a very interesting statistic showing that only 40% of monozygotic twins both develop BD and less than 10% of dizygotic twins both develop the disorder.  This emphasizes the fact that there must be another reason for an individual to develop the disorder.
The paper also talked about a recent genome-wide associated study that revealed 88 different alleles that increase the risk of an individual to develop BD.  They also stated that a person with a combination of 15 or more of these different alleles has a significantly higher risk of developing the disorder.  This doesn’t mean that someone with 15 of these alleles will definitely develop BD but it makes it easier for environmental factors to trigger the onset of the disorder.  It seems as if the environmental aspect of triggering this specific disorder plays a very significant role in development of BD.  Repeated findings have shown that half of the adults studied with BD reported having a traumatic/abusive experience as a child.  This highlights the fact that environmental factors can really play a part in developing BD.
Throughout classroom conversation someone brought up the interesting topic about testing children’s genomes to determine their risk of developing BD.  Would knowing your child had a greater risk of developing BD change how parents raised their children? This was just an interesting question that is very controversial, as many other medical genetic topics are.
The topic of BD is a very mysterious topic that is being researched extensively by scientists in an attempt to both; determine the overall cause of the disorder, as well as developing a safer treatment for BD.  It will be very interesting to see the progression of research and whether or not we can find a way to allow people living their lives struggling through manic and depressive mood swings to live a normal life without having to take combinations of drugs that could affect their future.

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