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This study examined choline augmentation of lithium for rapid-cycling bipolar disorder.
Choline bitartrate was given openly to 6 consecutive lithium-treated outpatients with
rapid-cycling bipolar disorder. Five patients also underwent brain proton magnetic
resonance spectroscopy. Five of 6 rapid-cycling patients had a substantial reduction
in manic symptoms, and 4 patients had a marked reduction in all mood symptoms during
choline therapy. The patients who responded to choline all exhibited a substantial
rise in the basal ganglia concentration of choline-containing compounds. Choline was
well tolerated in all cases. Choline, in the presence of lithium, was a safe and effective
treatment for 4 of 6 rapid-cycling patients in our series. A hypothesis is suggested
to explain both lithium refractoriness in patients with bipolar disorder and the action
of choline in mania, which involves the interaction between phosphatidylinositol and
phosphatidylcholine second-messenger systems.
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Article info
Publication history
Received in revised form:
July 14,
1995
Received:
December 30,
1994
Footnotes
This research was supported in part by NARSAD Young Investigator Awards (ALS, PFR), and the Theodore and Vada Stanley Foundation (PFR).
Identification
Copyright
© 1996 J. Benjamin. Published by Elsevier Inc.
