Research Updates This section contains notes on new research and promising therapies for mood disorders. Click on the title to read more: New antioxidant for bipolar depression Savella: a new antidepressant for fibromylagia Creativity and recovery from depression New research on weight loss Suicidality and medication Provigil effective for bipolar depression Agomelatine: a new antidepressant 5.1.9 New antioxidant for bipolar depression One of the ways that stress causes depression is by injuring brain cells through a process called oxidation. Oxidation also contributes to heart disease, dementia and aging. Fortunately the body has natural antioxidants to protect against this damage. Antioxidants are behind many of the health benefits we get from exercise, eating fruits, vegetables and vitamins, and avoiding nicotine and saturated fats. Although some psychiatric medications have antioxidant properties, until now there has never been a medication that treats depression directly through this mechanism. In a study lasting six months, researchers in Australia discovered that the medicine acetylcysteine improves bipolar depression. Acetylcysteine works by increasing a natural antioxidant called glutathione in the brain. Prior to this study, acetylcysteine’s main uses were to treat Tylenol overdose and reduce mucous in the lungs. Acetylcysteine is well tolerated and not associated with major medical risks. 3.22.9 Savella: a new antidepressant for fibromyalgia Savella (Milnacipran) was recently approved in the U.S. for the treatment of fibromyalgia. Although not approved for depression, Savella has been used as an antidepressant in other countries since 1998 and has proven effective for this in 6 research studies. It resembles the antidepressants Cymbalta (duloxetine) and Effexor (venlafaxine) in being a serotonin and norepinephrine reuptake inhibitor. Antidepressants which increase norepinephrine are often used to treat physical pain; in fact Cymbalta is also FDA-approved for fibromyalgia. However, increases of norepinephrine can be dangerous in bipolar disorder, sometimes leading to mania and aggression. 8.2.8 Creativity and recovery from depression Researchers in Canada found that several creative traits can help in recovery from depression: “openness, artistic, dreamy and imaginative, adventurous and unconventional.” Depression can reduce the mind’s ability to see new possibilities, try new things and develop creative solutions. It’s no surprise, then, that having strengths in these areas helps in overcoming depression. Read more about positive traits and positive actions that help prevent depression. 7.24.8 New research in weight loss Mood disorders can affect metabolism in ways that make it difficult to lose weight. Unfortunately, some medications which help mood can also cause weight gain. Until this year, there have been few options to address this problem. Recent research has shed light on two treatments which can help prevent weight gain from atypical mood stabilizers: provigil and metformin. Each of these medications can have side effects and risks. You can read more about the relationships between mood, diet and weight on this site. 3.8.7 Suicidality and medication Two recent updates have been added to the original article on this subject. First, a gene has been discovered which may explain why some people develop suicidal thoughts after starting antidepressants. More research is needed in this area, as first-time discoveries of genes in the brain often turn out to be false-leads. Second, a warning about suicidal thoughts has been added to anticonvulsants, which are used to treat seizures as well as mood disorders. They include lamictal (lamotrigine), depakote (valproate), equetro (carbamazepine) and gabapentin (neurontin). It’s important to understand that this risk is very small and is a risk of suicidal thoughts, not of attempting suicide. The risk with mood stabilizers is very low (around 2 people in 1,000) and is estimated to be 10-times less than the risk with antidepressants. 9.12.7 Provigil effective for bipolar depression Provigil, a medication designed for disorders of sleep/fatigue such as narcolepsy, now has promising evidence to help bipolar depression. Although there is only one good study supporting its use, this is an important advance as there are few treatments for bipolar depression available. Provigil has also been studied for attention-deficit disorder and atypical depression, which are common in bipolar disorder. Common side effects with Provigil include anxiety, headache and insomnia. Rarely, Provigil has been associated with mania, but it is not yet known if it causes mania. Update 2/28/8: Provigil has been associated with extremely rare but serious rashes, including Stevens-Johnson Syndrome. Numerous other medications, including lamictal and tegretol, also carry a risk for this rash. 12.15.7 Agomelatine: a new antidepressant This is the first antidepressant that works through melatonin, a hormone-receptor involved in sleep. Initial studies indicate that agomelatine may have fewer side effects than other available antidepressants. In particular, agomelatine improves sleep quality without causing fatigue. This is unique among antidepressants, many of which can disrupt sleep. Agomelatine is not currently available in the U.S. and will likely be released in Europe soon. Its brand name is Valdoxan.