In a recently published study from Turkey, close to 50% of manic patients who took the drug Tamoxifen had fewer manic episodes during the three weeks of treatment, compared to just 5% of placebo-treated patients. About 25 percent of Tamoxifen-treated patients and none of the placebo-treated patients achieved remissions.
At the end of three weeks of treatment, the Tamoxifen-treated patients had markedly lower scores on clinical tests designed to measure severity of manic symptoms, while the scores of placebo-treated patients increased slightly. Tamoxifen-treated patients also required less lorazepam in the second and third weeks of the study.
The only negative of the study was that it only involved 50 patents. However, this is not the first study to show that Tamoxifen decreases manic symptoms in individuals with bipolar disorder. A previous National Institute of Mental Health Study reported that 63% of patients had reduced manic symptoms when treated with tamoxifen after three weeks, compared to about less than 10 percent of placebo-treated patients.
Tamoxifen has been observed to be very safe for short-term use. Usually treatment for mania is only used for days or weeks, and once the mania is under control, individuals are then maintained on a variety of mood stabilizers.
The drug Tamoxifen is quite effective but its estrogen inhibitory activity is worrisome in the long-term treatment of bipolar individuals. There is experimental evidence that long term use of Tamoxifen may induce uterine cancer. That is why Tamoxifen is not currently recommended for long-term use. There is currently a search for drugs like tamoxifen but do not have the ability to block estrogen receptors.
The above study will hopefully enable researchers to develop better and safer drugs to help treat bipolar treatments. Researchers are working to find similar drugs which target the exact PKC enzymes associated with mania.
The findings are published in the March issue of the Archives of General Psychiatry.