I recently spoke with Dr. Hirschfeld in connection with NARSAD’s Healthy Minds Across America forum highlighting the latest breakthroughs in mental health research.
Dr. Hirschfeld, a psychiatrist in Galveston TX and Professor and Chair of the Department of Psychiatry and Behavioral Sciences at the University of Texas Medical Branch (UTMB), has researched and authored hundreds of articles and abstracts on the topic of Bipolar Illness and Depression. Bipolar disorder is a dysfunction in the brain that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms are severe and include an overexcited state called a manic episode, and an extremely sad or hopeless state called a depressive episode. In addition to mania and depression, bipolar disorder can cause a range of moods, which can be considered as extending on a scale from severe depression on one side to hypomania and severe mania at the other end.
At this time, there is no cure for bipolar disorder; however, treatment can significantly decrease symptoms associated with the disorder. According to Dr. Hirschfeld, an exciting new direction in the research of bipolar depression is a re-examination of a class of anti-depressants called Monoamine Oxidase Inhibitors (MAOI’s). MAOI’s were used decades ago in the treatment of depression. Although useful, they are not considered the drug of first choice for depression because of their side effects, which require significant dietary restrictions and include serious interactions with common over-the-counter drugs. As new drugs were developed with less restrictive side effects, use of MAOI’s diminished.
Now, Dr. Hirschfeld describes new research on MAOI’s and bipolar depression that suggests this class of drugs could be highly effective in treating cases of bipolar depression that were previously unresponsive to other drugs. Not everyone responds to medications in the same way. In order to find the best course of treatment, several medications are generally tried. Mood stabilizing medications are usually the first choice, followed by atypical antispsychotics and antidepressant medications. Although the issues with side effects remain, the current evidence suggests MAOI’s as another treatment option.
National Institute of Mental Health http://www.nimh.nih.gov/health/publications/bipolar-disorder/complete-index.shtml