Aspirin for Bipolar Patients?

April 29, 2010 · Posted in Potential Treatments · Comment 

Bipolar patients treated with acetylsalicylic acid (aspirin) in conjunction with lithium prophylaxis needed fewer other adjunctive treatments, compared to patients treated with lithium alone, reports Stanley Rapoport of the National Institutes of Health. These retrospective epidemiological data are of considerable interest in relationship to evidence of an inflammatory component in the affective disorders, as reviewed in Vol. 13(2), 2009 of the BNN, but because the data is preliminary, more study is required.

EDITOR’S NOTE: Several measures of inflammation are higher in children and adults with bipolar disorder compared with controls. These include the ratio of inflammatory to anti-inflammatory cytokines, higher levels of TNF-alpha, and the inflammatory marker c-reactive protein. These peripheral markers measured in blood have been confirmed with direct measurements in postmortem brain autopsy specimens of people who had a history of bipolar disorder.

It is unclear how this information about inflammation in bipolar disorder may eventually inform treatment.  In past BNNs, we have noted the positive effects of the anti-inflammatory antibiotic minocycline on schizophrenia, and stressed the need for studies of this compound in bipolar disorder. TNF-alpha inhibitors have also been associated with improvement in depression when used in the treatment of patients with rheumatoid arthritis and other autoimmune disorders.

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