bipolar disorder

A Glimpse Into Hypomania

→ September 2, 2010 - Comments off

Blur of Hypomania, ManiaI do stream-of-conscious bipolar writing here sometimes. I like it. And actually, other bipolars generally respond quite well to stream-of-conscious writing as well. I have found, though, that those without mental illness are left somewhat dumbfounded. Or, at least, that’s the impression I get from the lack of feedback. Stream-of-consciousness writing is tough to get if you’ve never been in that type of consciousness. Hypomania. Crazy.

I Do Stream-of-Conscious Bipolar, Hypomanic Writing Anyway

Nevertheless, I insist on doing streamed bipolar writing anyway. I’m obstinate that way.

And I really think hypomanic stream-of-conscious is illuminating, particularly for those with no experience in it. It really helps to give a glimpse into a moment of life in my brain. So for HealthyPlace I wrote, Hypomania Means Never Having to Make Sense.

Take a gander. Let me know what you think.

Hypomanic Morning Means A Devastating Afternoon

→ August 25, 2010 - 9 Comments

This is not of the quality you typically find here. Sorry.

I knew I was hypomanic because yesterday I couldn’t sleep.

Not sleeping. Waking multiple times during the night. That’s hypomania.

I’m sleeping too little, eating too little, producing too much and feeling too OK; that’s hypomania. It makes you brilliant and insightful and creative and magical. It also makes me completely fucked up.

The hypomania is probably from being on Pristiq and Welbutrin together. That’s a long story.

Being a Writer, My Wordiness is Hampered

I know these words aren’t coming out right but that’s because I’ve had 6 mg of Lunesta, now 9 mg with clonazapam to boot. Sleep is critical to calming the mood swings, hypomania, depression so I try to make sure I get sleep, but at the moment my attempts aren’t looking terribly successful.[push]This is higher hypomania than I’ve been in quite a while.[/push]

So that’s right, I’m smashed on meds, typing incoherently, and I know, that in very short order this hypomania go to end with a devastating mess of epic proportions.

Hypomanic SymtpomsSigns of Hypomania

Signs of hypomania have probably been going back to a week ago, which is far for a gal like me. Usually with bipolar rapid cycling you’re up, you’re down, you’re hypomanic, you’re depressed, with almost no warning signs. But not at the moment. I’ve become so terribly obsessive over – everything. And song are getting stuck in my head for days. Over and over and over I hear the same pop tune endlessly playing.[pull] “I Would Die For You” by Prince was yesterday’s favorite, who knows what today’s will be.[/pull]

Yup, hypomania. Work production goes up, creativity goes up, randomness goes up, follow-through goes down. Chattiness goes up. Irritation goes up. Impatience goes up. Fragmentation goes up. Food intake goes down. Sleep down down. Oh, and you might have noticed, comprehensibility goes down.

Fear of a Devastating Afternoon

And extra-specially devastation is coming as the pendulum swign soars. Nothing that goes up, doesn’t come down. Depression crater.

Bipolar Disorder and Remission

→ July 25, 2010 - 3 Comments

Depression RemissionI’m not sure that remission is something we will all get to enjoy, as bipolars. And the remission from depression, the remission from hypomania, the remission from bipolar we do experience seems to be a very watered-down version of the lives we want, the lives we deserve and certainly the lives we’re promised by doctors and treatments. So if remission isn’t all it’s cracked up to be, what is remission in bipolar disorder?

Are You Bipolar? Do You Have Bipolar Disorder?

→ July 12, 2010 - 2 Comments

Natasha Tracy is BipolarWhen you think of mental illness, bipolar disorder, do you consider yourself to be bipolar or do you think of yourself as someone who has bipolar disorder? Just like: Bipolars have mood swings vs. people who suffer from bipolar disorder have mood swings. (I also think I’m crazy, and no, I don’t think “crazy” is derogatory necessarily.)

HealthyPlace Writing Clears Up Bipolar Confusion – I Am Bipolar

Personally, I say I’m bipolar all the time. I don’t have a problem with “being bipolar.” I know some people do dislike this concept for psychological reasons though, so on Breaking Bipolar there’s Are You Bipolar, Or Do You Have Bipolar Disorder?

Do Others Want You to Deny You Are Bipolar?

→ July 9, 2010 - 8 Comments

Deny Bipolar DisorderIt’s pretty common to deny you have bipolar disorder, before, and even during diagnosis of bipolar disorder. None of us wants to be sick, and none of us wants to be crazy-sick (sick-crazy, crazy and sick?). And it can take us a long time to come to terms with living with a mental illness like bipolar disorder.

Deny You Have Bipolar Disorder?

But sometimes, worse is the fact that those around us want to deny, or want us to deny, our bipolar disorder. They want us not to talk about bipolar, or to “control the symptoms of bipolar” or they just don’t believe in mental illness or treat it like a disease at all.

So earlier this week I wrote a piece at Breaking Bipolar about Bipolar and Denial. (Hint, I’m not for it.)

It’s Scary to Show People Bipolar, and Not Just Tell Them

→ June 28, 2010 - 6 Comments

Show People Bipolar DisorderThere are two types of writing I do about bipolar. The first type talks about being bipolar, what it’s like, information around it and so on. It’s generally not overly emotional. The second type is written from the point of view of my bipolar, period. It’s not therapied or controlled or softened.

And that second type really bothers people.

Showing People Bipolar Disorder

It has happened many times over the years that people have come onto my blog and gotten upset at my very “real” writing. Often bipolars tell me it expresses exactly how they were feeling and they are grateful. Others though, complain that I’m illogical, need help, and am just generally crazy. They want to yell at me, for expressing the sickness. Yell at me for showing bipolar disorder as it is.

So today on HealthyPlace I write some more about showing someone the bipolar versus just telling them about it.

How To Get Off Pristiq or Reduce Pristiq

→ June 26, 2010 - 25 Comments

Now I’m not a doctor, in fact, I don’t even play one on TV, but I wanted to share a little about me and how I’m handling getting off of, or at least reducing, Pristiq.

Please also read: When to Get Off Antidepressants with Bipolar Disorder

and: How to Get Off Antidepressants Effexor/Pristiq (Venlafaxine/Desvenlafaxine)

Read more

Are bipolars crazy? I am. It’s OK to be Crazy.

→ June 10, 2010 - 4 Comments

CrazyI am crazy. I tell this to people in my personal life. It’s not a secret. I figure there’s no point in trying to cover it up; it’ll come out eventually. I’m crazy. The approximately 20 scars on my forearms rather give away that something is amiss.

But people really don’t like the word “crazy”. In fact, most often, what people say to me is, “no, you’re not!”. Well, actually, I am. I have a mental illness, I’m bipolar and I’m crazy.

more at Breaking Bipolar: Are bipolars crazy. I am.

Bipolar Natasha Tracy’s Interview with HealthyPlace

→ June 9, 2010 - Comments off

Breaking Bipolar at HealthyPlaceHere is today’s interview with me, Natasha Tracy, complete with call-in questions. I think it went well. We discussed some of the negative impact bipolar has had on my life.

I talked about bipolar disorder, depression, suicide, coping and how my writings at HealthyPlace have been controversial.

 

Watch live streaming video from healthyplace at livestream.com

 

See more video and audio at Breaking Bipolar at HealthyPlace.com.

Psychiatric Disorders in Children – Diagnosed and Medicated

→ April 20, 2010 - 13 Comments

I have bipolar-disorder-type-II-ultradian-cycling. I diagnosed myself when I was 20 years old, and once I finally agreed to see a doctor, he agreed sometime thereafter. My diagnosis was fairly easy for me. I’m very self-aware and I could pick out discrete moods and swings. But as a 20-year-old, in university, using research, and having a fairly high IQ, this is not terribly surprising. If I were five-years-old, the picture would have been a little different.

Epidemic of Children Diagnosed with Mental Illness

There is an epidemic of children, as young as two, being diagnosed with psychiatric disorders in North American right now. It’s made the cover of Time magazine and countless articles have been written on the phenomenon.

So, Antipsychotics are Now Approved for Children

It was once thought that disorders like bipolar did not occur before adulthood, but thoughts on this seem to be changing as diagnoses go up and more drugs are approved for treatment of children.

Antipsychotics FDA-approved for use in children (under 18) is:

And so on. And of course, doctors are free to prescribe any medication off label to children just like adults.

Antipsychotics Can Fuck You Up

I have been on all three of those antipsychotics and all three have fucked me up. Specifically seen has been weight gain, blood pressure changes, twitching, extreme fatigue, incurable hunger, and in the case of Geodon, psychosis. Among other things.

What Do Antipsychotics Do?

Antipsychotics turn down the dopamine in your brain. That’s what’s the do. They also turn down serotonin. These are two of the “feel good” chemicals in your brain, and you are turning these down. This seems to help with certain disorders like schizophrenia, but dopamine in integral for motivation, reinforcement, learning, and memory. If, for example, your five-year-old eats his peas, and you praise him, he feels good because a shot of dopamine is released. This then reinforces the pea-eating behavior, so that next time, he will again eat his peas. If you take away dopamine, he may not be able to make this link. And if you take away dopamine from a child’s (naturally developing) brain for a long period of time, no one has any idea what would happen.

I cannot, in any world, imagine giving these drugs to a child.

We Don’t Know How to Diagnose Bipolar In a Child

The truth is, no one knows what bipolar looks like in a child, or if it even exists. There is no diagnostic criteria in the DSM. Psychiatrists are using relaxed versions of symptoms seen in adults for diagnoses. This is patently ridiculous.

Children are Naturally Crazy

Kids blur the line between fantasy and reality. Kids act out. Kids throw tantrums. Kids ignore you. Kids break rules. Kids often don’t show a great regard for their safety or the safety of others. Kids throw broccoli across the kitchen table. Kids do, the darndest things. They’re kids. It’s what they do. None of this makes them crazy.

Recently a friend of mine was talking about a girl who hallucinated a dead robot baby. Moreover, this same girl spent her recent birthday having an elaborate funeral for a bird found dead in her back yard. Sound crazy? Not for a seven-year-old. It might be a bit unusual, but to me this speaks of intelligence creativity and compassion, not a mental disorder.

And let’s face it, some kids are very challenging to handle. Some are overly aggressive, or sad, or obstinate. They hit their sister, break a vase, or refuse to stay in their room for a time-out. This still doesn’t make them crazy, this just makes them challenging. Parents don’t get a pass just because their job is harder than they thought it was going to be.

Kids Can Be Crazy and Still Perfectly Normal

Basically, kids can have almost any pattern of behavior and still be pretty darn normal. And that doesn’t take into account all of the environment factors that are effecting kid’s behaviors. I’ve never seen great parents with a kid with huge behavioral problems. Yes, I’m sure it happens, but generally, kids are a reflection of their home lives. And kids with bad home lives don’t need or deserve drugs. They deserve better home lives.

And on top of all of this, if a child really is having behavioral problems there are specialists who can help with that, they’re called child psychologists. They help children and parents all day long. And they don’t cause weight gain and high blood pressure.

And don’t get me started on how idiotic it is to diagnose a two-year-old with a mental disorder. Two? Really? It can take an adult two years for an adult to get a diagnosis of bipolar. That sounds like a parent disorder if ever I heard of it.

Children on Antipsychotics and Other Psych Medication Seem Like Lab Rats

It feels to me like these children are being treated as lab subjects, and not real people. I am highly suspicious of any doctor that would medicate a child. Could it possibly be a reasonable thing to do? Well, maybe. But you’d be hard pressed to convince me.

Mental Illness as Self-Fullfillment

And in addition to whatever drugs are being fed to these children, they are also being saddled with a diagnosis – for the rest of their lives. As an adult it can be extremely detrimental to be labeled “crazy”, but as a child I can only imagine it would be infinitely worse. These children don’t even have a chance to find an identity before they’re told they’re crazy. How can that label not result in self-fulfillment?

Victims of Fad Diagnoses

When the movie Cybil based on a woman with “multiple personality disorder,” came out, the diagnosis of this disorder exploded across the US. A disorder that had virtually never been seen was suddenly everywhere. But over the decades that followed, medical professionals were able to determine that these were not genuine cases. In fact, some doctors feel that there has never been a documented case of “multiple personality disorder” as featured in the film. There are other disorders with similar features, but the giant outbreak seen after the film, just didn’t exist.

Is Childhood Bipolar a Fad Diagnosis?

And one has to wonder if we’re seeing something similar here. If more adults are being diagnosed as bipolar, then naturally, we are looking for markers of it at younger ages, and in their genes. We want this information to help people, to help treat the disease, but it can just as easily be used to further label people before we even know how to do it properly. Multiple personality disorder looked like a correct diagnosis until we figured out it wasn’t.

And if someone as young as a toddler gets diagnosed with some behavioral disorder, don’t these children deserve time to correct this issue via safer methods than drugs? It seems that out of an eight year life, it’s impossible that enough other treatments have been tried to warrant drugs.

Now, it’s true, I’m not a doctor, or a parent. And I do have a strongly held belief that doctors and their patients should be able to choose treatments without judgment from the outside world. But I also think any doctor worth seeing is going to try the least harmful treatment first, especially in a population that has been radically understudied. True, behavioral therapy might not work, but it’s unlikely to cause debilitating side-effects. And what about waiting for a child to grow out of behavioral issues? I hear that was a thing that used to happen. Before we got all diagnos-y.

I’m not suggesting that no one under 18 is sick, or that no one under 18 should be treated with medication. What I am suggesting is that diagnosis and treatment of children needs to be handled with extreme care and caution. I’m an adult and I give informed consent to fuck with my brain; children do not have that ability, and yet, they will be the ones that have to live with the results. They deserve every possible solution that avoids nasty, unknown side effects. Parents need to be held to a higher standard of decision-making and not pick what is easiest for them, but what is best for their child. Doctors need to be held to a higher standard to care with children, ideally with third party monitoring of underage drug-treatment. This is not something to be taken lightly on any front.

Someone needs to sanity-check the parents. Kids need to be able to act crazy, without getting labeled crazy.

Free Gift with Depression – A Tale of Anxiety

→ March 29, 2010 - 4 Comments

Anxious and DepressedAnxiolytic Isn’t Even in the Dictionary

I grit my jaw. I bite the skin around my nails. I pull at my hair. I bunch my fists. My breaths are shallow. I twitch and clench erratically.

I tell myself not to grit, bite, pull, bunch, twitch and clench. I tell myself to intake more air. Those instructions are followed. For moments. And then they’re not. While I wasn’t looking I started gritting, biting, pulling, bunching, twitching, and clenching all over again.

Anxious. Anxiety.

These are tiny, little words. The barely seem to warrant entries in dictionaries bloated with words like crunk (a type of hip-hop or rap music) and yogilates (a combination of Pilates and yoga), and yet somehow they have achieved great significance in my life.

Anxiety and Depression, Like Peas and Carrots

Anxiety and depression always come in pairs. The each cover half a sphere. How much you feel of each of them depends on your point of view of the sphere.

I was never an anxious person before. Or at least, I was never inordinately anxious, I think. But then came the psych meds and so the anxiety. Anxiety – the side effect that’s it’s own mental illness.

And now I worry. And I’m overwhelmed. Frozen with the fear of things not getting done . . . leading to the very obvious result of things not getting done.

Anxiety. A self-replicating organism.

Anticonvulsants as Calcium Antagonists in Mood Stabilization

→ March 20, 2010 - 2 Comments

This is a paper I wrote for a psychology course I am taking so the level of discourse is quite high, sorry about that. I promise though, it is comprehensible. What I’m basically talking about is calcium-channel blockers and other calcium antagonists (they turn calcium down). This refers to calcium in your brain and not calcium in your blood.

Mood Stabilizers and Bipolar Disorder

Because inadequate response, poor compliance, chronic recurring symptoms, and functional disability are constant challenges is the treatment of bipolar disorder, (Gitlin, 2006) efforts have been made to search out new mood stabilizing medication and determine new methods of action. There has been an effort to treat bipolar disorder with a class of medication termed “mood stabilizers”, most notably consisting of some anticonvulsants (also known as antiepileptics) in addition to the traditional lithium.[1] [push]I will show that these anticonvulsants, stabilize mood in bipolar disorder, at least partially, through their ability to act as calcium antagonists.[/push]

While anticonvulsants are widely used in the treatment of mood disorders, their method of action in mood stabilization is mostly unknown.[2] Recent research has indicated that disrupted calcium homeostasis is present in bipolar disorder, and that anticonvulsants and lithium effect calcium channels and concentration in the brain (Amann, 2005). The mood-stabilizing effects of calcium channel blockers like Nimodipine (Levy, 2000) further add to the evidence that calcium antagonism is useful in the treatment of bipolar disorder. I will show that these “mood stabilizers”, anticonvulsants, stabilize mood in bipolar disorder, at least partially, through their ability to act as calcium antagonists.

Bipolar Disorder and Calcium Levels

A review of hypercalcemia and hypocalcemia shows links from calcium blood levels to depression, irritability, delirium, and psychosis – symptoms that are similar to a bipolar disorder. Additional to calcium’s powerful abilities in the blood, it also plays a vital role both as primary and secondary messengers in the brain and according to Gargus (2009), is known to regulate “physiological systems at every level from membrane potential and ion transporters to kinases and transcription factors”. Calcium also plays a role in long-term changes to the architecture of a neuron (Amann, 2005). Disruption of intracellular calcium homeostasis is now thought to underlie many diseases such as Autism, Migraine, Seizures, and psychological disorders like bipolar (Gargus, 2009). Additionally, atrophy and glial death now found in mood disorders may be avoided by increasing cellular plasticity, accomplished through reducing intracellular calcium concentrations (Landmark, 2008).[pull]Atrophy and glial death now found in mood disorders may be avoided by increasing cellular plasticity, accomplished through reducing intracellular calcium concentrations.[/pull]

In some studies, the bipolar population has been found to have abnormally elevated intracellular calcium, elevated basal platelet and lymphocyte calcium concentrations, and elevated B-lymphoblast calcium (Silverstone, 2005). Found more consistently the bipolar population, both in the manic and depressed phase, is an enhanced calcium response to agonist stimulation (Silverstone, 2005). This may partially be explained by the enhanced platelet intracellular calcium mobilization found after stimulation by serotonin in bipolar disorder (Suzuki, 2003). This research suggests that not only are calcium levels elevated, and calcium activities dysregulated, but this may become worse if the patient is treated with a selective serotonin reuptake inhibitor (SSRI), which is often the case.

Lithium and Calcium

Lithium has long been the standard therapy for bipolar disorder both for acute and maintenance treatment due to its quality and quantity of supporting evidence (Gitlin, 2006), (Levy, 2000). Part of lithium’s biological effects is to both inhibit the entry of calcium intracellularly acting as a calcium antagonist, and to block calcium channels directly. This, in turn, inhibits other cellular responses of subtypes adrenergic, serotonergic, and cholinergic (Levy, 2000). Moreover, adding Verapamil, a calcium channel blocker, to unresponsive lithium treatment, improves outcomes, (Mallinger, 2008) suggesting that both calcium itself and calcium channels benefit from antagonists.[3]

Calcium Channel Blockers as Mood Stabilizers

A number of calcium channel antagonists have been studied with varied results likely resulting from their specific affinities to different calcium channel subtypes and their individual ability to cross the blood-brain barrier. Verapamil, one of the most studied calcium channel blockers, is not the most lipophilic and is likely not as effective as other calcium channel blockers like nimodipine (Gitlin, 2006), although Verapamil has been shown effective in some studies and does work on calcium ions in a way similar to lithium (Levy, 2000).[pull]Nimodipine is not only a calcium channel blocker but has also been shown to have anticonvulsant properties and has shown great potential as a mood-stabilizer particularly for cycling forms of bipolar disorder.[/pull]

Nimodipine is not only a calcium channel blocker but has also been shown to have anticonvulsant properties and has shown great potential as a mood-stabilizer particularly for cycling forms of bipolar disorder (Goodnick, 2000). While its efficacy needs further study, there have been positive results shown for bipolars in manic, depressed, and rapid cycling states.

Anticonvulsants spawn a broad range of medication and methods of action. Useful actions for treatment of psychiatric disorders are thought to be: increases in GABAurgic transmissions, decreases in glutamate, inhibition of voltage-gates sodium and calcium channels, and interference with intracellular modulators (Landmark, 2008). For the treatment of bipolar disorder, specifically mood stabilization, carbamazepine and Lamotrigine, have been identified, and accepted as treatments through their inhibition of voltage-gated sodium and calcium channels (Landmark, 2008).[push]Anticonvulsants that work on calcium channel blockers are also known to be helpful in the treatment of neuropathic pain, which some researchers believe is closely tied to psychological pain, here in the form of bipolar disorder.[/push]

Carbamezapine and Lamotrigine have also been seen to positively affect mood while GABAurgic transmitting anticonvulsants have not. The general decreased excitability found with Carbamezapine and Lamotrigine may also be responsible for their role in preventing affective episodes (Landmark, 2008). Valproate is also considered an accepted treatment although likely functions more from the combined actions mentioned above, making it an anti-mania treatment as well as possibly useful for mood stabilization (Landmark, 2008). The effects of anticonvulsants are compared to the therapeutic effects of lithium on calcium, calcium channel blockers, and inositol concentrations, another secondary messenger indirectly acting on calcium signals (Berridge, 1993). Anticonvulsants that work on calcium channel blockers are also known to be helpful in the treatment of neuropathic pain (Landmark, 2008), which some researchers believe is closely tied to psychological pain, here in the form of bipolar disorder.

Lithium acts in the body as a complex agent, making it difficult for scientists to specify exactly how it stabilizes mood in the bipolar population, in spite of its being used for decades. It is clear; however, that part of its biological action is to antagonize calcium concentrations as well as calcium channels. This action is shown to have positive mood stabilizing effects as proven by successful treatments with calcium blocking agents like Verapamil and Nimodipine. These same mood stabilizing effects are seen with some anticonvulsants which also act as calcium antagonists. Therefore, it is reasonable to assume that part of the reason why some anticonvulsants stabilize mood is because of their ability to work on calcium, calcium channel blockers, and inositol, as seen in Lithium and calcium channel blockers.

_________________________

[1] There are several antipsychotics also in this list but are outside the scope of this paper.
[2] Treatment of bipolar disorder and mood stabilization in this paper will refer to non-acute treatment, although some of the drugs mentioned can be used in acute treatment also. No distinction will be made between types of bipolar.
[3] It should be noted that Mallinger (2009) posited that the positive effects of combining Lithium and Verapamil may also be due to the inhibition of protein kinase C (PKC) activity provided by the Verapamil.

References

(I apologize for the departure from APA style, blog formatting issues.)

Amann, B., & Grunze, H. (2005). Neurochemical Underpinnings in Bipolar Disorder and Epilepsy. Epilepsia (Series 4), 4626-30.
doi:10.1111/j.1528-1167.2005.463006.x.
Retrieved from EbscoHost Mar. 14, 2010 AN = 17118993

Berridge, M. J. (1993). Inositol Trisphosphate and Calcium Signaling. Nature 361, 315-325.
doi:10.1038/361315a0
Available online: http://www.ncbi.nlm.nih.gov/pubmed/8381210

Farooq, M., Moore, P., Bhatt, A., Aburashed, R., & Kassab, M. (2008). Therapeutic Role of Zonisamide in Neuropsychiatric Disorders. Mini Reviews in Medicinal Chemistry, 8(10), 968-975.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost Mar. 15, 2010 AN = 34436130

Gargus, J. (2009). Genetic Calcium Signaling Abnormalities in the Central Nervous System: Seizures, Migraine, and Autism. Annals of the New York Academy of Sciences, 1151133-156.
doi:10.1111/j.1749-6632.2008.03572.x.
Retrieved from EbscoHost Mar. 14, 2010 AN = 35830926

Gitlin, M. (2006). Treatment-resistant bipolar disorder. Molecular Psychiatry, 11(3), 227-240.
doi:10.1038/sj.mp.4001793.
Retrieved from EbscoHost Mar. 14, 2010 AN = 19892243

Goodnick, P. (2000). The use of nimodipine in the treatment of mood disorders. Bipolar Disorders, 2(3), 165.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost Mar. 15, 2010 AN = 6500123

Landmark, C. (2008). Antiepileptic Drugs in Non-Epilepsy Disorders. CNS Drugs, 22(1), 27-47.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost Mar. 15, 2010 AN = 28088990

Levy, N., & Janicak, P. (2000). Calcium channel antagonists for the treatment of bipolar disorder. Bipolar Disorders, 2(2), 108-119.
Retrieved from Academic Search Complete database.
Retrieved from EbscoHost Mar. 14, 2010 AN = 5788405

Mallinger, A., Thase, M., Haskett, R., Buttenfield, J., Luckenbaugh, D., Frank, E., et al. (2008). Verapamil augmentation of lithium treatment improves outcome in mania unresponsive to lithium alone: preliminary findings and a discussion of therapeutic mechanisms. Bipolar Disorders, 10(8), 856-866.
doi:10.1111/j.1399-5618.2008.00636.x.
Retrieved from EbscoHost Mar. 14, 2010 AN = 35323933

Silverstone, P., McGrath, B., Wessels, P., Bell, E., & Ulrich, M. (2005). Current Pathophysiological Findings in Bipolar Disorder and in its Subtypes. Current Psychiatry Reviews, 1(1), 75-101.
doi:10.2174/1573400052953574.
Retrieved from EbscoHost Mar. 14, 2010 AN = 18882320

Suzuki, K., Kusumi, I., Akimoto, T., Sasaki, Y., & Koyama, T. (2003). Altered 5-HT-Induced Calcium Response in the Presence of Staurosporine in Blood Platelets from Bipolar Disorder Patients. Neuropsychopharmacology, 28(6), 1210-1214.
doi:10.1038/sj.npp.1300159.
Retrieved from EbscoHost Mar. 15, 2010 AN = 22436847

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