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The Switch Mechanism and the Bipolar/Unipolar Dichotomy

Published online by Cambridge University Press:  02 January 2018

M. W. P. Carney ,
T. K. N. Chary ,
T. Bottiglieri  and
E. H. Reynolds
M. W. P. Carney*
Affiliation:
Northwick Park Hospital and Clinical Research Centre
T. K. N. Chary
Affiliation:
Northwick Park Hospital and Clinical Research Centre
T. Bottiglieri
Affiliation:
Northwick Park Hospital and Clinical Research Centre
E. H. Reynolds
Affiliation:
Maudsley Hospital and Kings College Hospital, London
*
∗Northwick Park Hospital and Clinical Research Centre, Watford Road, Harrow, Middlesex HA1 3UJ
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Abstract

During open trials of intravenous and oral S-adenosyl methionine (SAM) and a placebo-controlled trial of intravenous SAM in 29 patients, 25 patients had SAM and four had placebo (27 courses of SAM, two of the patients receiving two trials apiece). Nine of 11 bipolar patients (all SAM-treated) switched into elevated mood state (hypomania, mania and euphoria) and two did not respond. Six endogenous unipolar patients improved and five did not. No non-endogenous patient or placebo patient responded for more than 14 days. No unipolar patient switched into elated mood. In eleven (38%) trials and nine (33%) patients there was a switch from depression to elation. Biochemical data from the cerebrospinal fluid of eight patients suggested that the role of the dopaminergic system should be further explored.

Type
Papers
Information
The British Journal of Psychiatry , Volume 154 , Issue 1 , January 1989 , pp. 48 - 51
Copyright
Copyright © The Royal College of Psychiatrists 

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