Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations

[pattismith]

Fibromyalgia and Bipolar Disorder: Emerging Epidemiological Associations and Shared Pathophysiology
2016

Fibromyalgia (FM) is a prevalent disorder defined by the presence of chronic widespread pain in association with fatigue, sleep disturbances and cognitive dysfunction.

Recent studies indicate that bipolar spectrum disorders frequently co-occur in individuals with FM.

Furthermore, shared pathophysiological mechanisms anticipate remarkable phenomenological similarities between FM and BD. A comprehensive search of the English literature was carried out in the Pubmed/MEDLINE database through May 10th, 2015 to identify unique references pertaining to the epidemiology and shared pathophysiology between FM and bipolar disorder (BD). Overlapping neural circuits may underpin parallel clinical manifestations of both disorders.

Fibromyalgia and BD are both characterized by functional abnormalities in the hypothalamic-pituitary-adrenal axis, higher levels of inflammatory mediators, oxidative and nitrosative stress as well as mitochondrial dysfunction.

An over-activation of the kynurenine pathway in both illnesses drives tryptophan away from the production of serotonin and melatonin, leading to affective symptoms, circadian rhythm disturbances and abnormalities in pain processing.
In addition, both disorders are associated with impaired neuroplasticity (e.g., altered brain-derived neurotrophic factor signaling). The recognition of the symptomatic and pathophysiological overlaping between FM and bipolar spectrum disorders has relevant etiological, clinical and therapeutic implications that deserve future research consideration.

 

[anni66]

Dopamine is a player in both these conditions.

 

[pattismith]

Dopamine is a player in both these conditions.

anni, you may like this article:

The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment

"These models thus provide evidence that hypodopaminergia may induce depressive-like behaviours and hyperdopaminergia may induce manic-like behaviour."

I wonder if CFS/ME is also a hypodopaminergia state? In this case, maybe drugs inducing Manic episode in BP (or drugs with some efficiency at managing hypodopaminergia in BP) could have a positive effect on us?

 

[anni66]

Having had to learn up some biochemistry ( probably badly as i dip in and out) since my daughter developed ME , i think that everyone is slightly different because this condition is like systems engineering- something goes wrong somewhere and the body " recalibrates" - how it does this in terms of altered signalling, paths, energy management etc may be idiosyncratic which depends on where your weaknesses are- this could be linked to nature of onset/ epigenetics/ genetics.once feedback loops are affected , both positive and negative reinforcement is possible, but the body will try and balance things out at a state where damage is limited.Many molecules multitask and so have a variety of functions - i wish i had more time to look into things.

It' s a bit like global warming in this respect- once you get to a tipping point from feedback change is inevitable, and it can be accelerated change as the feedbacks have lost their designed purpose

I think there is a common end state, but many paths to it.

 

[andyguitar]

Yet more interesting stuff from @pattismith! There is no stopping her!! I would take issue with the idea that lack of Serotonin is a problem. Excess is more likely in my opinion. The connection between dopamine and bi-polar seems pretty sound to me. There was something i read about the use of an anti-psychotic being used for CFS/ME. It was not available in the UK but was in France. Results were supposed to be good. Sounds drastic to use that class of drug but some of them have an effect that is different from that which the manufacturers intend. Will search my mind to try and remember it.

 

[andyguitar]

Drug is Amisulpride. Is available in UK but not in USA. Said to affect Dopamine levels but some of these types of drugs also have an effect on other chemicals. So best not to take what the scientific community or even the manufacturers say as being the absolute truth. Might even wake the bear up!!

 

[pattismith]

Drug is Amisulpride. Is available in UK but not in USA. Said to affect Dopamine levels but some of these types of drugs also have an effect on other chemicals. So best not to take what the scientific community or even the manufacturers say as being the absolute truth. Might even wake the bear up!!

Of course I couldn't agree more, some ME patients got worse with anti-psychotic treatments and most of it didn't treat the root of our disease, and have bad side effects....

Did you see there is a long thread about Amisulpride on PR? I will cetainly read it !

 

[andyguitar]

I have a question for both @pattismith and @anni66. Was my post about Amisulpride the first time you had heard of it? One thing I should point out is that it is one of the 'New' types of anti-psychotic. So the fact the some ME patients have done badly on the older type of drugs in that class is not an indication that Amisulpride will have the same adverse effect. Something else worth remembering is that Anti-psychotics are not just used to treat psychosis. I first started looking at them when investigating drugs used for migraine.

 

[pattismith]

Did you see there is a long thread about Amisulpride on PR? I will cetainly read it !

@andyguitar , some PR members do well with Amisulpride and @Hip is a great advocate of it, did you see the thread I quoted above?

 

[anni66]

I have a question for both @pattismith and @anni66. Was my post about Amisulpride the first time you had heard of it? One thing I should point out is that it is one of the 'New' types of anti-psychotic. So the fact the some ME patients have done badly on the older type of drugs in that class is not an indication that Amisulpride will have the same adverse effect. Something else worth remembering is that Anti-psychotics are not just used to treat psychosis. I first started looking at them when investigating drugs used for migraine.

Pretty new to this so still looking into lots of options. I know that there are lots of drugs with alternative use, there are probably a whole lot more from other conditions which could have an application for particular subgroups . I hadn' t cone across amprisulphide, but will look at the thread. Thanks

 

[andyguitar]

Yes @pattismith I have had a look at the thread. At the moment I have what is probably the flu so my cognition is not good The accounts I read about the benefits of the drug did not come from that thread. I wish I could remember where i read it but it was a couple of years ago now. The comments were very positive and I had assumed that everyone with ME/CFS had heard about it and probably given it a go. I understand the way it is supposed to work but think that something else, which the manufacturer is unaware of, is going on. The concerns that suffers have about side effects are fair enough but, as with any drug, if you start taking it and it has no benefit or the side effects are worse that ME/CFS just stop taking it. What struck me about its benefits was how it was said to relieve symptoms that are common in Migraine and are also common in ME/CFS. I will have a dig around to see what else I can find out about it when I am a bit more with it.

 

[pattismith]

@andyguitar , don't worry we all know we are not always at our best.
I caught myself a cold and an acute viral sinusitis
Let's hope your flu will not be as bad as the one I had one year ago! Take care

 

[andyguitar]

Just found a scrap of paper with the name of a drug on it and a note to myself about it. It's called 'Abilify'. Cant remember when I came across it but the note says 'reported to have changed lives of some- is expensive- not easy to get'. So @pattismith, @anni66 and anyone else on this thread, it's worth a look. I suspect I came across it the same time I found Amisulpride. But it was'nt on this website.

 

[andyguitar]

Interesting to note that neither Amisulpride or Ablifiy have any antiviral or antibiotic effect. In contrast, some of the drugs used by those who believe their ME/CFS is caused by infection do have an effect on neurotransmitters. Just came across an antiviral called Amantadine. Also used for Parkinsons disease. It has a novel effect. Releases dopamine.