Bipolar disorder is a mood disorder in which people have periods of depression that alternate with episodes of being manic. Researchers say bipolar disorder is caused by a distortion of brain chemistry. There are changes in neurotransmitters and changes in neuropeptides that may cause the illness. About 8 million people in the United States are currently living with the disorder.
Patients with bipolar disorder are 10 times more likely to attempt suicide than the normal population. Researchers know those attempts usually occur in the depressive phase of the disorder. The problem is there aren't any effective treatments.
"If you were to ask what's the conventional wisdom regarding treatment, the answer would be there's no good consensus … The medications that we currently have, to my knowledge, have never been shown to have an acute effect on suicide," Dr. Joseph Calabrese from University Hospitals of Cleveland said.
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Treating bipolar depression
The antipsychotic drug Seroquel is being studied to determine if it can help patients with bipolar depression.
 
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Calabrese is studying the antipsychotic drug Seroquel to determine if it can help patients with bipolar depression. The drug is currently FDA-approved for schizophrenia and the manic phase of bipolar disorder. In the study, about 540 patients were given either 300 milligrams of the drug, 600 milligrams of the drug, or a placebo. The study was conducted at 19 cites in the United States.
"This study is very important because we have very few treatments for bipolar depression. We have lots of treatments for the manic phase of the illness. We have lots and lots of treatments for schizophrenia. They have many treatments for folks who have unipolar depression, but for bipolar depression, and for those folks who are in the depressed phase, we have very few treatments," Calabrese said.
Results of the study show Seroquel was nearly twice as effective at reducing suicidal thoughts as placebo.
"That's remarkable. It's really a significant development. The compound not only works on the physical symptoms like improving sleep, but it also works on improving the core symptoms of depression -- feeling sad, feeling depressed … It literally diminishes hopelessness and helplessness," Calabrese said.
Calabrese said the fact that Seroquel worked in bipolar depression patients was a bit of a surprise.
"You would expect this medicine to work in psychotic patients. The issue that was the surprise was the magnitude of the effect, so the effect size was so large. An effect size that's large can frequently be used as a monotherapy -- a medicine by itself," he said.
Calabrese said patients who participated in the study reported few side effects. However, the most common side effect was feeling tired throughout the day.
