Mood disorder diseases

Endocrine or hormonal dysregulation (Addison s disease, Cushing s disease, hyper- or hypothyroidism, menstrual-related or pregnancy-related or perimenopausal mood disorders)... 

Lithium is the simplest therapeutic agent for the treatment of depression and has been used for over 100 years—lithium carbonate and citrate were described in the British Pharmacopoeia of 1885. Lithium therapy went through periods when it was in common use, and periods when it was discouraged. Finally, in 1949, J.J.F. Cade reported that lithium carbonate could reverse the symptoms of patients with bipolar disorder (manic-depression), a chronic disorder that affects between 1% and 2% of the population. The disease is characterized by episodic periods of elevated or depressed mood, severely reduces the patients quality of life and dramatically increases their likelihood of committing suicide. Today, it is the standard treatment, often combined with other drugs, for bipolar disorder and is prescribed in over 50% of bipolar disorder patients. It has clearly been shown to reduce the risk of suicide in mood disorder patients, and its socioeconomic impact is considerable—it is estimated to have saved around 9 billion in the USA alone in 1881. 

Mood Disorder Due to a General Medical Condition. Commonly called secondary manias, certain medical and neurological illnesses produce symptoms that mimic mania. Often, secondary manias occur when injury or disease interferes with right-sided brain function. As one might anticipate, this is in contrast to the predilection for left-sided brain injury to be associated with depressive symptoms. 

Escamilla et al. (86), in a study of bipolar mood disorder in an isolated population from Costa Rica, using micro satellite markers spaced 6cM intervals across chromosome 18, concluded that LD methods will be useful in this case in a larger sample. The Finnish and Costa Rican populations are considered ideal, since they are relatively homogeneous and show LD over a wider recombination distance than other populations. However, LD is routinely seen for closely linked loci and around disease genes in all populations. With sufficiently closely linked markers, including haplotype level analyses (61,62), association mapping should be a powerful and informative approach in many, and possibly most, populations (57). 

The Time Course of Recurrent Mood Disorders Periodic, Noisy and Chaotic Disease Patterns... 

Most theories about the origin of mood disorders refer to the subcellular or molecular level, mainly emphasizing an imbalance between different transmitter systems [17] as a possible cause for unipolar depression as well as bipolar disorders. No concrete concepts exist to explain how and in which way such molecular disturbances modify the neural dynamics and lead to an increased mental vulnerability with progressive occurrence of disease episodes. 

Pei, X., Neiman, A., and Moss, F. Noisy precursors of bifurcations in a neurody-namical model for disease states of mood disorders. Neurocomputing 2000, 32, 823— 831. 

Drags that act on the CNS include those used for the treatment of psychosis, affective (mood) disorders, such as depression and mania, anxieties and related disorders, seizure disorders (epilepsies), Parkinson s disease, Alzheimer s disease, pain (opioid analgesics) and brain tumors. Furthermore, the AIDS virus has a special affinity for the brain, where it attacks neurons and their structural supports (glial cells) causing memory loss, palsy, dementia and, finally, paralysis. 

Two elderly patients with Alzheimer s disease and a mood disorder were treated with donepezil 5 mg/day and paroxetine 20 mg/day. One of them became agitated, confused, and aggressive, and donepezil was withdrawn after 8 days. On reintroduction of donepezil she again became rapidly confused, irritable, and verbally aggressive. In the other case, while the patient was taking paroxetine, donepezil 5 mg/day resulted in severe diarrhea, flatulence, and insomnia. The dosage of donepezil was reduced to 5 mg on alternate days, but the diarrhea and flatulence persisted. The symptoms resolved when donepezil was stopped. 

Donepezil is metabolized in the liver by CYP2D6 and CYP3A4. Selective serotonin re-uptake inhibitors (SSRIs), such as paroxetine, are potent inhibitors of CYP2D6. Mood disorders are common in patients with Alzheimer s disease, and SSRIs are used in these patients and can increase the plasma concentration of donepezil, increasing the risk of severe adverse reactions. 

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