Clipboard, Search History, and several other advanced features are temporarily unavailable. Bipolar 2 and its many cousins: diagnosis/treatmentThis page is really old. 2000 Jun;2(2):108-19. doi: 10.1034/j.1399-5618.2000.020204.x.Ostacher MJ, Iosifescu DV, Hay A, Blumenthal SR, Sklar P, Perlis RH.Bipolar Disord. I tried it with several patients and was not particularly impressed myself.Then I met Dr. Steve Dubovsky, an eminent researcher from University of Colorado, who had done much of the original work on this medication. Chen HM, DeLong CJ, Bame M, et al. Free PMC article Nature Publishing Group
And they have just published a study showing further support for verapamil’s effectiveness in women with bipolar disorder. There is one observation that has been published by Bob Post and colleagues at the NIMH which apparently represents the entire literature base for use of this agent:When verapamil was blindly substituted for nimodipine, two BP patients failed to maintain improvement but responded again to nimodipine and remained well with a blind transition to another dihydropyridine L-type calcium channel blocker (CCB), isradipine.There are no other articles found searching “isradipine bipolar” on PUB MED or Google (7/2004).Both isradipine and verapamil are in the FDA’s Pregnancy Category C, which means that the medication is neither clearly safe, nor clearly unsafe.Nimodipine was the main calcium channel blocker used in the study described immediately above.
Given the increasingly strong evidence for calcium signalling dysfunction in bipolar disorder, the therapeutic candidacy of this class of drugs has become stronger, and hence we also discuss issues relevant to their future development and evaluation. The International Society for Bipolar Disorders (ISBD) consensus guidelines for the safety monitoring of bipolar disorder treatments. But there’s something true in here. We have therefore conducted a systematic review of LTCC antagonists in the treatment and prophylaxis of bipolar disorder. Please enable it to take advantage of the complete set of features!
This may be related to it’s action on calcium channels, the small pores in cells that allow calcium to move in and out. In particular, we consider how genetic, molecular and pharmacological data can be used to improve the selectivity, efficacy and tolerability of LTCC antagonists. We suggest that a renewed focus on LTCCs as targets, and the development of 'brain-selective' LTCC ligands, could be one fruitful approach to innovative pharmacotherapy for bipolar disorder and related phenotypes.
Although in “open trial” design, there were actually quite a few more patients in this study than in Dubovsky’s original workThere is some concern about immediate-release versions of verapamil having a negative effect on heart function. l-type calcium channel (LTCC) antagonists have been used in bipolar disorder for over 30 years, without becoming an established therapeutic approach. Some research suggests that calcium channel blockers may be effective in treating anxiety and bipolar disorder.
Epub 2020 Jul 8.Popović N, Morales-Delgado N, Vidal Mena D, Alonso A, Pascual Martínez M, Caballero Bleda M, Popović M.Front Pharmacol. It’s in the class of blood pressure medications called “calcium channel blockers”.However, this is just one more study, added to the mixture of results below. see a review by Isradipine is another calcium channel blocker. But it is extremely expensive — $1200 for a 21-day course, several years ago — and must be taken every four hours, which may be why we don’t see it in regular use in bipolar disorder. Calcium seems to be part of the story of As a result of this “mixed” evidence, interest in verapamil has been very limited (in addition, because it is available in multiple generics, there is no manufacturer willing to pump money into research and advertising for this medication, so it “looks” less attractive than it really is). Data for other LTCC antagonists (diltiazem, nimodipine, nifedipine, methyoxyverapamil and isradipine) and for other phases of the illness are limited to observational studies, and therefore no robust conclusions can be drawn.
It’s not updated beyond about 2009, as I recall…Verapamil has been around a long time, and as a result there are multiple generics around (thus no trade name above).
l-type calcium channel (LTCC) antagonists have been used in bipolar disorder for over 30 years, without becoming an established therapeutic approach.
Nimodipine acts on the CACNA1C calcium influx gene.
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