Bipolar disorder is a mental illness characterized by extreme mood and behavior changes. Many people with bipolar disorder cycle through extreme highs, called mania, and lows, called depression, and sometimes manic and depressive symptoms occur simultaneously. Each individual responds differently to medications, so treatment can be frustrating and complicated.

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Because a shortage of serotonin may contribute to bipolar disorder, antidepressant drugs such as selective serotonin reuptake inhibitors, which increase serotonin activity in the brain, are prescribed in conjunction with lithium, a mood-stabilizing drug often effective in treating mania.

Brain Chemistry

The Lundbeck Institute's Brain Explorer website explains that studies of serotonin receptors show "substantial evidence for the role of serotonin in patients with bipolar disorder." Research about serotonin and the way it is metabolized indicates a reduced concentration of serotonin metabolites in bipolar disorder patients.

The neurotransmitter serotonin is involved in causing mood disorders, but theories suggesting an excess of neurotransmitters occur during a manic episode and fewer occur during depression are too simplistic. The Brain Explorer discusses research on "The Nature of Bipolar Disorder," conducted by Drs. Husseini K. Manji and Robert H. Lenox, psychiatrists at Wayne State University School of Medicine, that suggests "it is the effectiveness of the cell functioning under the modification and control of neurotransmitters that underlies the pathoetiology of mood disorders."

The Lundbeck Institute's Brain Explorer website explains that studies of serotonin receptors show "substantial evidence for the role of serotonin in patients with bipolar disorder."



Husseini K. Manji and Robert H. Lenox, psychiatrists at Wayne State University School of Medicine, that suggests "it is the effectiveness of the cell functioning under the modification and control of neurotransmitters that underlies the pathoetiology of mood disorders."

Depression

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Serotonin plays an important part in mood regulation, and medications affecting serotonin in the brain are used to treat people suffering from depressive illness and depressive phases of bipolar disorder. However, Drs.

SSRI antidepressants are often the first medications given to bipolar patients, but without an accompanying mood stabilizer, mania could be induced, worsening the illness 2.

Mania

Serotonin-regulating medications may not be appropriate treatment for bipolar disorder, because they may cause manic episodes and rapid cycling between depression and mania. When SSRIs are used for bipolar disorder, they should be prescribed in conjunction with a mood stabilizer to prevent the switch to mania.

Serotonin Syndrome

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Combining certain medications increases serotonin levels and may trigger serotonin syndrome, a rare but serious condition.