title: The switch mechanism and the bipolar/unipolar dichotomy.
abstract: During open trials of intravenous and oral S-adenosyl methionine (SAM) and a placebo-controlled trial of intravenous SAM in 29 patients, 25 patients had SAM and four had placebo (27 courses of SAM, two of the patients receiving two trials a piece). Nine of 11 bipolar patients (all SAM-treated) switched into elevated mood state (hypomania, mania and euphoria) and two did not respond. Six endogenous unipolar patients improved and five did not. No non-endogenous patient or placebo patient responded for more than 14 days. No unipolar patient switched into elated mood. In eleven (38%) trials and nine (33%) patients there was a switch from depression to elation. Biochemical data from the cerebrospinal fluid of eight patients suggested that the role of the dopaminergic system should be further explored.
authors.affiliation: Northwick Park Hospital, Harrow, Middlesex.
authors.forename: M W
authors.initials: MW
authors.lastname: Carney
authors.forename: T K
authors.initials: TK
authors.lastname: Chary
authors.forename: T
authors.initials: T
authors.lastname: Bottiglieri
authors.forename: E H
authors.initials: EH
authors.lastname: Reynolds
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000523:psychology*; D002986:Clinical Trials as Topic; D005059:Euphoria; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012436:S-Adenosylmethionine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D012436:S-Adenosylmethionine