Dr. Michael Berk gave a paper at the recent ECNP conference arguing for a possible link between inflammation and bipolar disorder. He argued that reducing inflammation might prevent some of the damage done to the brain during manic episodes. Bipolar disorder, especially type I, is degenerative, and each manic episode causes damage that can lead to a larger number of and more severe episodes in the future. By preventing inflammation, Dr. Berk believes it would be possible to slow this rate of progression. The full presentation is discussed on Clinical Psychiatry News here
Commentary
These findings are very important, to say the least. Dr. Berk suggests that randomized trials should be started to see the effect of
aspirin on bipolar patients. Aspirin is known to prevent inflammation, so he believes that it can protect bipolar patients from brain damage during manic and hypomanic episodes. It is worth noting that he doesn’t think anti-inflammatories can replace mood stabilizers or antipsychotics. Their role would be completely prophylactic for preventing brain damage. However, his findings provide hope that the degenerative effects of bipolar disorder can be slowed, perhaps even with medication as simple as aspirin. Currently, there is no way to prevent the brain damage from manic episodes without preventing the episode itself. While preventing the episodes is of course better, this would provide another option for those times the episode cannot be prevented.
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