Bipolar Disorder and Compulsive Behavior
Bipolar
disorder is characterized by alternating periods of mania and
depression. The manic phase can be productive but can also be disruptive and
physically exhausting. Bipolar disorder often responds to treatment with
lithium, which is rapidly absorbed from the GI tract and is distributed
throughout the body. Lithium may reduce neuronal activity by inhibiting
cellular phosphoinositide pathways involving the second messengers inositol
trisphosphate and diacylglycerol. Compulsive behaviors impair social
interaction and disrupt daily activities. OCD affects at least 2%
of the population (males and females approximately equally), with a genetic
predisposition. The TCA clomipramine and SSRIs are usually chosen for OCD
therapy. Other drugs, given individually or as combination therapy, include
different TCAs, lithium, buspirone, clonazepam, dopamine antagonists (eg,
haloperidol), and trazodone. Drugs used together with behavioral or
psychosocial therapy are usually optimal.
