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Resistant bipolar disorder precipitated by Behcet's syndrome
B Alevizos1, C Anagnostara, G N Christodoulou
1Department of Psychiatry, University of Athens, Eginition Hospital, Athens, Greece. valeviz@med.uoa.gr
Bipolar Disorders
|May 1, 2004
Summary
Behcet's syndrome may precede and contribute to the development of treatment-resistant bipolar disorder (BD). Effective management involved a combination of sodium valproate, carbamazepine, and olanzapine.
Area of Science:
- Neuroimmunology
- Psychiatry
- Rheumatology
Background:
- Behcet's syndrome is a rare multisystemic inflammatory disorder.
- The association between Behcet's syndrome and psychiatric disorders, particularly bipolar disorder (BD), is not well-established.
- Treatment resistance in bipolar disorder poses a significant clinical challenge.
Observation:
- A 62-year-old woman with a history of Behcet's syndrome developed treatment-resistant bipolar disorder.
- The onset of BD occurred 6 years after the initial Behcet's syndrome diagnosis.
- Following BD onset, Behcet's symptoms lessened, while BD progressed to a rapid cycling pattern.
Findings:
- Standard BD medications like lithium and carbamazepine were ineffective.
- A combination therapy of sodium valproate, low-dose carbamazepine, and olanzapine achieved mood stabilization.
- This case suggests Behcet's syndrome might serve as an organic substrate for BD.
Implications:
- Immune-mediated disorders like Behcet's syndrome may contribute to the neurobiology of BD in select individuals.
- Understanding these links could inform novel therapeutic strategies for complex psychiatric conditions.
- Further research is warranted to explore the relationship between systemic inflammatory diseases and mood disorders.