A new Halifax physician’s approach to treatment-resistant bipolar disorder involves treating an underlying metabolic disorder to improve the psychiatric condition.
Dr. Cindy Calkin said her research represents a paradigm shift in psychiatry and was recently published in the Journal of Clinical Psychiatry. He spent thousands of his own dollars to make it publicly available.
Calkin worked as a family physician for a decade before training as a psychiatrist. “I was told that my medicine would be of no use to me, but it was a great advantage because I could not stop treating the whole patient,” he said.
Bipolar disorder is a condition that causes dramatic mood swings, from depressed casualties to manic episodes, along with changes in appetite and energy levels.
It is usually treated with lithium and antiepileptic, antipsychotic and antidepressant drugs. But many people find that the drugs lose their effectiveness after a few years, returning them to bipolar disorder.
“What I was finding is that not only did patients with diabetes have worse outcomes, so were other patients. I felt like there was something in front of me that I was missing. And that ended up being insulin resistance,” he told CBC News.
He launched a clinical trial in which people with treatment-resistant bipolar disorder received metformin, a drug that has been used to treat diabetes in Canada for decades, to reverse insulin resistance.
“Patients had been sick on average for 25 years,” he said. “Most of these people had lost any hope of getting better again.”
His research found that 54% of people who have bipolar disorder also have insulin resistance, and half of those patients will be resistant to treatment.
The results were impressive.
“In the sixth week of the study, the patients started to feel good. And in week 14, which was the end point of the study, they stayed well. And even at 26 weeks, they went away. keep well “.
The MRIs he did with Dr. Alon Friedman show a dramatic difference in one of his first patients.
“So this is an MRI of a patient who has a large blood-brain barrier leak. That’s multiple. [images] through his brain. And this is before metformin treatment. He was resistant to insulin and was very depressed. And that’s three months with metformin. The blood-brain barrier has healed, is no longer insulin-resistant and its depression has been in remission for the past six years. “
This MRI shows the change in the brain of a patient with bipolar disorder when treated with metformin. (Submitted by Cindy Calkin)
This barrier is supposed to keep viruses and bacteria out of the brain. “Therefore, I believe that patients with insulin resistance may have had inflammatory molecules that cross the brain, worsening their brain disorder.”
Metabolic psychiatry
He compares it to how people thought peptic ulcers were caused by stress, until two Australian researchers won a Nobel Prize in Medicine for discovering a bacterium in their gut that caused them.
“This is a paradigm shift in our field. This is a completely new way of approaching psychiatry. Metabolic psychiatry has been coined.”
An estimated 33,000 seafarers suffer from treatment-resistant bipolar disorder. Worldwide, the figure reaches millions. Kellie Williams used to count among them.
Kellie Williams says the treatment was a “miracle” that gave her a new life. (Steve Lawrence / CBC)
People had described him as “in a bad mood” for most of his life, and he was diagnosed with bipolar disorder when he was twenty.
“My depression felt like someone had died. That total sadness, that complete despair. I would have this constant, all day, and without anyone dying. I knew there was something very serious then,” he said.
The symptoms affected his life with family, friends and work. She struggled to keep plans, and never knew when she would be incapacitated by a mood disorder.
“There were times, several times, when I contemplated suicide. To try to get rid of that despair or pain I felt, I actually started cutting too, just to try to redirect the pain you feel inside of you. none “.
He saw Calkin’s name on a bulletin board at a mental health clinic recruiting people with bipolar medication whose medication had stopped working. She was surprised when she was tested and told she was insulin resistant. Calkin treated this condition and the devastating disorder disappeared. Calkin believes it allows traditional drugs to work again.
“I couldn’t believe it was gone. I had never felt a sense of well-being in my life,” Williams said. “This is really a miracle. I have my life, I want to respond, but I have my life better.”
She has discovered that she is an avid planner and loves to fill her agenda months in advance.
She says her bipolar is in remission and hopes it stays that way. He said others should also feel hope.
“Don’t be afraid to go out and do a little research. Go online, ask people,” he said. “You have that right to be healthy and happy.”
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