A Magnetic Resonance Spectroscopy Study of Lovastatin for Treating Bipolar Mood Disorder: A 4-Week Randomized Double-Blind, Placebo- Controlled Clinical Trial.
BACKGROUND
No trial has examined the effect of lovastatin on the brain metabolites in patients with bipolar mood disorder.


OBJECTIVE
Current medications for treating bipolar disorders cause metabolic syndrome. It is supposed that lovastatin not only decreases the rate of metabolic syndrome but also impacts some brain metabolites and their ratio like common treatments that are measured by Magnetic Resonance Spectroscopy.


METHODS
27 Manic phase patients were randomly allocated into two groups, lovastatin and placebo as their adjuant medication. Clinical symptoms were assessed at baseline, weeks 2, 4. The brain metabolites were measured at baseline and week 4.


RESULTS
Regarding the change of clinical symptoms, no significant difference was found between two groups. However, lovastatin significantly increased the level of NAA in cingulate gyrus in comparison to the placebo group. Moreover, lovastatin more than placebo increased creatine in the left basal ganglia. Furthermore, choline/ creatine showed a significant decrease in the left basal ganglia in lovastatin group.


CONCLUSIONS
Using MRS after treating with lovastatin showed lovastatin increases NAA in cingulate gyrus, indicating the possible effect of NAA for increasing the reduced viable neuron. Moreover, the increment of Cr by lovastatin in the left basal ganglia suggests the role of lovastatin for maintaining energy homeostasis, anti-apoptotic activity and ATP production in bipolar disorder. Some patents using lovastatin as an adjuant therapy for treating bipolar patients and depression in MDD patients are also outlined. This trial was registered in the Iranian Clinical Trials Registry (http://www.irct.ir/) (IRCT201302203930N18).
Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz. Iran.
Mehrzad
M
Lotfi
Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz. Iran.
Sara
S
Shafiee
Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.|Department of Psychiatry, Shiraz University of Medical Sciences, School of Medicine, Shiraz. Iran.
Ahmd
A
Ghanizadeh
Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.
Motahar O
MO
Sigaroudi
Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.|Department of Psychiatry, Shiraz University of Medical Sciences, School of Medicine, Shiraz. Iran.
Leila
L
Razeghian
D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D007492:Iran; D008148:Lovastatin / Q000008:administration & dosage / Q000494:pharmacology*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010330:Patents as Topic; D013997:Time Factors; D055815:Young Adult
D018692:Antimanic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001224:Aspartic Acid; C000179:N-acetylaspartate; D008148:Lovastatin; D003401:Creatine; D002794:Choline
Magnetic Resonance Spectroscopy; N-Acetyleaspartate; bipolar mood disorder; choline; creatine; lovastatin