For generations, Tamoxifen has been the gold standard in treating breast cancer. Now there are indications that the manic cycle of bi-polar disease can also be treated with Tamoxifen.
Almost 6 million American adults have bipolar disorder, whose symptoms can be disabling. They include profound mood swings, from depression to vastly overblown excitement, energy, and elation, often accompanied by severe irritability. Children also can develop the illness.
During the manic phase of bipolar disorder, patients are in "overdrive" and may throw themselves intensely into harmful behaviors they might not otherwise engage in. They might indulge in risky pleasure-seeking behaviors with potentially serious health consequences, for example, or lavish spending sprees they can't afford. The symptoms sometimes are severe enough to require hospitalization.
In a recent study, 65% of the patients treated with tamoxifen improved in 5 days. The control group had only 13% recovery, and the time to stabilize was much longer.
Tamoxifen worked as it can cross the blood-brain barrier. Once in the brain, Tamoxifen blocks an enzyme called protein kinase C (PKC) that regulates activities in brain cells. The enzyme is thought to be over-active during the manic phase of bipolar disorder.
Tamoxifen also decreases estrogen, which is how breast cancer patients are helped. Endometrial cancer is a major side effect of tamoxifen. Tamoxifen, therefore, is not the answer; but it does point to an answer.
Mania isn't just your average mood swing, where any of us might feel upbeat in response to something that happens. It's part of a brain disorder whose behavioral manifestations can severely undermine people's jobs, relationships, and health. The sooner we can help patients get back on an even keel, the more we can help them avoid major disruptions to their lives and the lives of people around them.
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