The Role of the Aminergic Systems in the Pathophysiology of Bipolar Disorder

Walderhaug, Espen; Varga, Monica; Pedro, Michelle San; Hu, Jintao; Neumeister, Alexander

doi:10.1007/7854_2010_72

Cited by 5 publications

(3 citation statements)

References 95 publications

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“…In this framework, further studies, when evaluating the mechanisms of action of mirtazapine on sleep, should focus on clarifying the role of an altered function of nucleus subcoeruleus, which could be related to Parkinson's disease, prolonged treatment with anticholinergic drugs, and advanced age [ 22 , 24 ]. Moreover, abnormal aminergic pressure on these structures, which often occurs during treatments with aminergic drugs, in chronic stress and chronic alarm conditions associated mood disorders, borderline personality disorder, and PTSD, could further impair the function of nucleus subcoeruleus [ 25 ]. These mechanisms may represent two sides of the same neuropathological pathway, which ultimately would lead to an increased presentation of nightmares with the use of mirtazapine.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients

Dell’Osso

Lorenzi

Nardi

et al. 2023

Case Reports in Psychiatry

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Introduction. Sleep disturbance and insomnia are some of the most frequent complaints in patients suffering from depression. Some common antidepressant with excitatory effects may worsen sleep qualities, whereas others (like mirtazapine), thanks to their antihistaminergic action, are associated with sedative properties and can quickly improve sleep quality. In the case of mirtazapine, even if its mechanisms of action on sleep remain controversial, beneficial changes in sleep pattern may be observable since the first dose and are associated with a faster onset of the antidepressive action. Case Presentation. Despite these documented beneficial effects, we reported five cases of elderly patients (age ranging from 69 to 79) with various diagnoses and comorbidities (severe or recurrent depression, general anxiety disorder, borderline personality disorder, and Parkinson’s disease) assessed during clinical daily routine for whom the use of mirtazapine was linked to the onset of nightmares so impressive and dramatic that made it necessary to interrupt the treatment. Discussion. This peculiar side effect is still scarcely documented, and the literature on this topic remains conflicting; however, considering that the cases were collected in a short range of time, the exacerbation of nightmares caused by mirtazapine may be more frequent than previously believed. Furthermore, some common features shared by all the cases reported have been highlighted such as the onset of the nightmares being chronologically associated with the initiation of the therapy with mirtazapine, the disappearance with the interruption, the similar age range of all, and the occurrence of the episodes described during fall season.

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Section: Discussionmentioning

confidence: 99%

Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients

Dell’Osso

Lorenzi

Nardi

et al. 2023

Case Reports in Psychiatry

View full text Add to dashboard Cite

show abstract

“…What is clear is that mood is a highly complex phenotype that emerges from a number of signalling pathways. The monoamine hypothesis proposes a role of three major neurochemical signalling molecules in determining mood phenotype, with their deregulation contributing to the development of affective disorders: noradrenaline, serotonin and dopamine [33,34]. This hypothesis may be further sub-divided into three hypotheses, each centred on an individual monoamine.…”

Section: ! Can a Systems Biology Approach Determine How The Phenotymentioning

confidence: 99%

Can a systems approach produce a better understanding of mood disorders?

Plant

2017

Biochimica et Biophysica Acta (BBA) - General Subjects

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“…Many antidepressant compounds are designed to increase monoamine levels in the central nervous system (CNS). The strategy for drug treatments for other disorders can vary since the symptomatology can be diverse and dynamic (Bowden 2005;Walderhaug et al 2011). Current research focuses on other novel treatment options include the exploration of peptidergic ligands.…”

Section: Neuromodulators and Psychiatric Disordersmentioning

confidence: 99%

Orexin and Circadian Influences in Sleep and Psychiatric Disorders: A Review of Experimental and Computational Modelling Studies

et al. 2015

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Psychiatric disorders such as unipolar depression have complex pathologies, which include disruptions in circadian and sleep-wake cycles. At the neurochemical level, psychiatric diseases can also be accompanied by changes in neuromodulator systems such as orexin/hypocretin and the monoamines. Indeed, for decades the monoamine hypothesis of depression has been instrumental in driving discoveries and developments of antidepressant drugs. Recent preclinical and clinical advancement strongly suggests that neuropeptides such as orexin can play an important part in the pathophysiology of depression. Due to the complexity and extensive connectedness of neurobiological systems, understanding the biological causes and mechanisms of psychiatric disorders present major research challenges. In this chapter, we review experimental and computational studies investigating the complex relationship between orexinergic, monoaminergic, circadian oscillators, and sleep-wake neural circuitry. Our main aim is to understand how these physiological systems interact and how alteration in any of these factors can contribute to the behaviours commonly observed in depressive patients. Further, we examine how modelling across different levels of neurobiological organization enables insight into these interactions. We propose that a multiscale systems approach is necessary to understand the complex neurobiological systems whose dysfunctions are the underlying causes of psychiatric disorders. Such an approach could illuminate future treatments.

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The Role of the Aminergic Systems in the Pathophysiology of Bipolar Disorder

Cited by 5 publications

References 95 publications

Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients

Occurrence of Terrifying Nightmares after Few Days of Mirtazapine Use in Elderly Patients

Can a systems approach produce a better understanding of mood disorders?

Orexin and Circadian Influences in Sleep and Psychiatric Disorders: A Review of Experimental and Computational Modelling Studies

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