Choline in the treatment of rapid-cycling bipolar disorder: Clinical and neurochemical findings in lithium-treated patients

This study examined choline augmentation of lithium for rapid-cycling bipolar disorder. Choline bitartrate was given openly to 6 consecutive lithium-treated outpatients with rapid-cycling bipolar disorder. Five patients also underwent brain proton magnetic resonance spectroscopy. Five of 6 rapid-cyc...

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Bibliographic Details
Published in:Biological psychiatry (1969) 1996-09, Vol.40 (5), p.382-388
Main Authors: Stoll, Andrew L., Sachs, Gary S., Cohen, Bruce M., Lafer, Beny, Christensen, James D., Renshaw, Perry F.
Format: Article
Language:English
Subjects:
Adult
Affect
Antimanic Agents - pharmacokinetics
Antimanic Agents - therapeutic use
Basal Ganglia - metabolism
Biological and medical sciences
bipolar disorder
Bipolar Disorder - drug therapy
Bipolar Disorder - psychology
brain
Choline
Choline - pharmacokinetics
Choline - therapeutic use
Drug Resistance
Drug Therapy, Combination
Female
human
Humans
lithium
Lithium Chloride - pharmacokinetics
Lithium Chloride - therapeutic use
Magnetic Resonance Spectroscopy
Male
Medical sciences
Middle Aged
Neuropharmacology
Nootropic Agents - pharmacokinetics
Nootropic Agents - therapeutic use
Pharmacology. Drug treatments
Psychiatric Status Rating Scales
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
rapid cycling
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Summary:This study examined choline augmentation of lithium for rapid-cycling bipolar disorder. Choline bitartrate was given openly to 6 consecutive lithium-treated outpatients with rapid-cycling bipolar disorder. Five patients also underwent brain proton magnetic resonance spectroscopy. Five of 6 rapid-cycling patients had a substantial reduction in manic symptoms, and 4 patients had a marked reduction in all mood symptoms during choline therapy. The patients who responded to choline all exhibited a substantial rise in the basal ganglia concentration of choline-containing compounds. Choline was well tolerated in all cases. Choline, in the presence of lithium, was a safe and effective treatment for 4 of 6 rapid-cycling patients in our series. A hypothesis is suggested to explain both lithium refractoriness in patients with bipolar disorder and the action of choline in mania, which involves the interaction between phosphatidylinositol and phosphatidylcholine second-messenger systems.
ISSN:0006-3223
1873-2402
DOI:10.1016/0006-3223(95)00423-8