In mania, increased catecholaminergic neurotransmission associated with a state of
increased arousal is hypothesized. However, hypnotics and neuroleptics may not rapidly
improve manic symptoms. Furthermore, in some but not in all manic patients, rapid
declines of vigilance levels and intrusion of sleep spindles occur within the first
minute of electroencephalography (EEG) under resting conditions with eyes closed (
1
,
2
). Based on this observation, one could infer that manic behavior may also reflect
an autoregulatory attempt to stabilize vigilance by creating a stimulating environment
(
3
). Such a mechanism could apply to the hyperactive behavior of patients with attention-deficit/hyperactivity
disorder (ADHD) (
4
), which is associated with an unstable regulation of vigilance (
5
). Accordingly, the seemingly paradoxical therapeutic effects of psychostimulants
in ADHD could be explained by their vigilance-stabilizing properties (
6
). Positive effects of psychostimulants have been observed in children with ADHD and
severe mood dysregulation (
7
).To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 08, 2010
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© 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
