Wednesday, July 7, 2010

Seizural/bipolar connections and inhibitory aminos

The amino acids, GABA, taurine, and glycine function as inhibitory neurotransmitters in the brain, reducing stimulation. They are often employed in natural treatments of certain types of seizures. In fact, some epilepsy meds seem to work by acting on the GABA system.
     At the same time, if indicated, GABA and/or taurine (glycine is milder) seem to be among the more potent mood-stabilizing, mania-moderating nutrients.

But does suppression of seizures have anything to do with promotion of mood stability? 
A number of researchers have suggested subconvulsive limbic seizures may underly bipolar disorder, but the jury is still out. Meanwhile, we might want to consider what bipolar and seizural disorders might have in common.

1 Kindling seems to occur in both disorders
(Post 1982, 89, 97, 2001, Ghaemi 1999, Bell 1992, Brewerton 1997) 
In epilepsy, repeated, continuous or excessive exposure to convulsive stimuli eventually increases the intensity and frequency of reactions. Over time, progressively milder stimulation is capable of triggering symptoms, eventually leading to apparently "spontaneous" seizures.
    Sound familiar? Think about the role of amphetamines, antidepressants, allergens, sugar and junk food, hyperthyroid, environmental stressors, and other stimulants in triggering episodes. And of the tendency of a single initial mania, whatever the cause, to lead to a future episode in 90-95% of cases. And how after years of mood disorder without orthomolecular treatment, episodes often become more frequent, but triggers tend to become more minor and more difficult to identify. 

2 Abnormal signalling plus kindling can induce seizures and may trigger mood episodes
Stoll and Severus (1996) suggest the interaction of kindling and abnormal signal transduction may be a primary trigger of mania and mood instability.
     Consider that all established mood stabilizers dampen excess signalling, and so block kindling. (Most inhibit calcium and sodium transfer across the neural membrane. Several interfere with the creation of inositol- and choline-related second messengers, and/or inhibit kinase and G protein activity.)  Thus, fewer messages are conveyed, and mania and seizures are suppressed.

3 Most mood-stabilizing meds are anticonvulsive and antikindling
(Post 1992, 95, 97, Ketter 1994, Ghaemi 1999, Bell 1992, Weiss 1995)
 Carbamazepine (CBZ), valproate (VPA), lamotrigene, and calcium channel blockers all have significant anticonvulsive properties.

     About two-thirds of bipolars have been found to respond best to CBZ or VPA;  two-thirds, to lithium.  Lithium shows minor anticonvulsive activity, while CBZ and VPA are clearly anticonvulsant and antikindling,  especially in the temporal and limbic regions of the brain associated with mood disorders.  Moreover, neurological problems (e.g., history of seizures, head injury, or abnormal EEGs) strongly suggest responsiveness.
     So the question remains, do these drugs work because they are antikindling and anticonvulsant?

4 Similarly, many nutrients identified as helpful to bipolars are also reputed to have antiseizure or antikindling properties — not only taurine, GABA, and glycine, but also most of the nutrients noted in previous posts (magnesium, zinc, C, and certain B vitamins). 
     More on taurine, GABA, and glycine in future posts. 

For further description of inhibitory aminos, seizural/bipolar connections, biotype issues, etc., and for contraindications and references, see my book: Natural Healing for Bipolar Disorder.

Reminder: Treatment must be tailored to each individual's unique biochemical requirements, including contraindications. If you need treatment for bipolar disorder, epilepsy, or any other medical condition, consult a knowledgeable physician. In some cases, this will be an orthomolecular or other nutritionally-oriented physician.

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