schizophrenia

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Some Thoughts on the “Nasal spray device for mental illness” Post

I saw the article “Nasal spray device for mental illness” (http://www.neuroscientistnews.com/clinical-updates/nasal-spray-device-mental-illness) article late last night and decided to simply post it because it was so interesting (https://bipolar1blog.wordpress.com/2015/08/28/nasal-spray-device-for-mental-illness/) Somehow, even though I didn’t post it on my FB Bipolar1Blog page, my statistics show that it’s gotten 25 views! That is a huge amount of traffic in less than 12 hours! People are looking for new ways to treat mental illness, obviously, we all are. And here is a novel way, using a nasal spray. Although not so novel if you think about people whose noses are/were rimmed with white powder in rest rooms of fancy restaurants, coming out with glassy eyes and torrential conversations and activity. That would be the first intranasal “therapy” for whatever you thought ailed you. Just something that occurred to me, no disrespect to people with mental illness or old or new or developing treatments for mental illness! Anyway, we’ve known for a long time that substances can reach the brain through the nose, (nose http://www.webmd.com/brain/news/20010222/this-nasal-spray-may-clear-your-brain-not-your-sinuses) There are nerve endings in the nose from two very powerful nerves, the olfactory nerve and the trigeminal nerve. And both these nerves obviously have their roots in the brain. So if substances can travel these nerve “super highways”, they can get directly into the brain without having to go into the bloodstream, thereby avoiding the blood brain barrier. Large molecules such as Oxytocin, cannot cross the blood brain barrier. It is also faster to send molecules to the brain through the nasal route than to have them enter the bloodstream, go to the heart and then be pumped out to the rest of the body and brain.

So these researchers in Oslo decided to look at Oxytocin, a molecule that promotes social interaction, eases pregnancy, childbirth, and milk letdown after the birth of the infant. They observe that people with autism, schizophrenia, and bipolar d/o have poor social functioning, so a dose of Oxytocin will help them be better in social interactions. Since Oxytocin is a large molecule, it wouldn’t pass the blood brain barrier, so they decided to try this nasal route. It helps if you have a big nose, and if you breathe. The Oxytocin goes directly to the brain and “The research showed that only those administered a low dose of oxytocin experienced an effect on how they perceived social signals.”

The researchers say that these effects were seen in only the men who received low doses of Oxytocin intranasally. The effects were not seen in men who received Oxytocin intravenously.

Whatever the effects were, whether Oxytocin can be used as a therapy for mental illness or not, this study is important because it shows that drugs can be delivered intranasally, directly to the brain, avoiding the blood circulation and the blood brain barrier and or GI/stomach problems. More drugs can be tested for intranasal delivery. A quicker and hopefully more effective route into the brain, leading to more effective therapies for treating mental/neurological illnesses.

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Researchers identify signature of microbiomes associated with schizophrenia (!!!)

Oh my god! Could it be that simple? Fix the microbiomes of patients and they’ll be cured of schizophrenia? No, I doubt it, but still this is a phenomenal discovery! That the throat microbiomes of schizophrenia patients and people who don’t have schizophrenia (controls) are significantly different. The microbiome is the collection of bacteria, viruses, and fungi that live in our bodies with us. Once again this brings the immune system into the picture, and as I posted in my very last post, it also brings the gut nervous system (aka gut brain) and gut immune system into play. Why are different bacteria, fungi, viruses growing in the throats of people who have schizophrenia? Is their immune system different? If so, why is their immune system different? How is it different? Are the bacteria in the gut also different since the throat all the way to the anus is about 9 feet of the alimentary canal. If the microbiome is different, what affect is it having on the gut nervous system and also ultimately on the brain, also known as the central nervous system? Phenomenal discovery! Also shows how interconnected everything is! Studying the brain or the gut or the immune system in isolation is all well and good, but we have to study relationships within these systems and how they affect one another and us. Also a very important question for me: Is this also the case for people who have bipolar d/o? Do we also have microbiomes that are different from control individuals? And again, all the questions I asked above apply in this case too.

http://www.neuroscientistnews.com/research-news/researchers-identify-signature-microbiomes-associated-schizophrenia

“Recent studies have shown that microbiomes—the communities of microbes living within our bodies—can affect the immune system and may be connected to mental health.

Research linking immune disorders and schizophrenia has also been published, and this study furthers the possibility that shifts in oral communities are associated with schizophrenia.

Mr. Castro-Nallar’s research sought to identify microbes associated with schizophrenia, as well as components that may be associated with or contribute to changes in the immune state of the person. In this study, the group found a significant difference in the microbiomes of healthy and schizophrenic patients.

“Our results suggesting a link between microbiome diversity and schizophrenia require replication and expansion to a broader number of individuals for further validation,” said Keith Crandall, director of the CBI and contributing author of the study. “But the results are quite intriguing and suggest potential applications of biomarkers for diagnosis of schizophrenia and important metabolic pathways associated with the disease.”

The study helps to identify possible contributing factors to schizophrenia. With additional studies, researchers may be able to determine if microbiome changes are a contributing factor to schizophrenia, are a result of schizophrenia or do not have a connection to the disorder.

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Disruption of Communication Between Two Regions of the Brain Contributes to Symptoms of Psychiatric Illnesses

Basically, when the synaptic transmission between the hippocampus and the prefrontal cortex is disrupted, symptoms of mental illnesses such as schizophrenia are seen. This has been known for a long time. What wasn’t known was how is this communication between the hippocampus and prefrontal cortex disrupted? That is, what are the mechanisms responsible for the disruption of communication between these two regions of the brain? Well, in this paper below, they show over activation of the D2-like Dopamine receptors leads to a decrease in another type of receptor called the NMDA receptor. This leads to a marked disruption of synaptic transmission between the two brain regions. This newly discovered relationship between the Dopamine and NMDA receptors may lead to treatment options for people with mental illnesses like schizophrenia.

“Synaptic transmission between the hippocampus and prefrontal cortex is required for many executive cognitive functions. It is believed that disruption of this communication contributes to symptoms observed in psychiatric disorders including schizophrenia. Hyperdopaminergic tone and hypofunction of NMDA receptor-mediated glutamate transmission are distinctive elements of schizophrenia. Here we demonstrate that activation of low-affinity D2-like dopamine receptors leads to a lasting depression of NMDA receptors at the hippocampal– prefrontal projection of juvenile rats, leading to a marked disruption of synaptic transmission. These data demonstrate a link between dopamine and hypofunction of NMDA receptormediated transmission with potential implications for psychiatric disease.”

http://www.pnas.org/content/early/2015/08/18/1512064112.full.pdf

“New research has identified the mechanisms that trigger disruption in the brain’s communication channels linked to symptoms in psychiatric disorders including schizophrenia. The University of Bristol study, published in the Proceedings of National Academy of Sciences, could have important implications for treating symptoms of brain disorders.

Many of our everyday cognitive functions such as learning and memory rely on normal communication between the two regions of the brain – the hippocampus and prefrontal cortex. While previous studies have identified disruption to communication channels in these two areas of the brain contribute to symptoms in psychiatric disorders, the mechanisms that lead to these disturbances have been largely unknown, until now.

In this study, led by Professor Zafar Bashir from Bristol’s School of Physiology and Pharmacology, the researchers studied the neurotransmitters glutamate and dopamine, which work together in controlling normal transmission between these brain regions by communicating chemical information throughout our brain and are disrupted in schizophrenics.

The team found that subtle changes in the interplay of these transmitters completely altered the flow of information from the hippocampus to prefrontal cortex. Over-activation of the D2 class of dopamine receptors led to suppression of the function of NMDA receptors, which are activated by the neurotransmitter glutamate, at the synaptic connection between hippocampus and prefrontal cortex. This in turn leads to a marked disruption of communication between these brain regions.

Dr Paul Banks, one of the researchers, said: “Our findings demonstrate a mechanism for how dopamine neurotransmission can influence NMDA receptor function at a connection in the brain needed for complex mental tasks which are disrupted in schizophrenic patients. It has been known for some time that dopamine and NMDA receptor function are altered in schizophrenic patients – our data mirror the direction of these changes and therefore might give insight into how these changes come about mechanistically.”

http://www.neuroscientistnews.com/research-news/study-identifies-cause-disruption-brain-linked-psychiatric-disorder

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Why Don’t Animals Get Schizophrenia (and How Come We Do)? Article in Scientific American

schizophrenia

Short answer: Because their brains aren’t as complex as human brains. Unfortunately that’s the price we people with prefrontal cortexes pay. In bipolar disorder, as in schizophrenia, people with these illnesses can become out of touch with reality. This is called psychosis, or being psychotic. Auditory hallucinations happen to 90% of people with schizophrenia, i.e. they hear voices, this also happens up to 80% of people with bipolar d/o. There are also visual hallucinations (seeing things), even olfactory hallucinations, where you may smell something that isn’t there! (Luckily for me, I have never had auditory hallucinations, I am forever grateful for this! Interestingly enough, I have had olfactory hallucinations, I smelled the scent of Camay soap once when it was nowhere to be found.)

Let’s get back to the point of this article from Scientific American. It basically says that schizophrenia 9and I assume bipolar d/o in psychosis) are the price we pay for a much more complex brain. It is a defect of the gamma amino butyric acid (GABA) system. This is an inhibitory neurotransmitter, meaning it inhibits neurons from firing, in part by suppressing dopamine in certain parts of the brain. So when there is a problem with this system, then neurons that wouldn’t normally be firing are firing, and dopamine is also not suppressed, and this is happening in the prefrontal cortex (PFC). This leads to hallucinations. See quote below.

Yes the psychotic brain, whether in schizophrenia or bipolar d/o runs amok. And it can run so crazily amok because it is so complicated. So complicated that when things go wrong, they go wrong in a big way. Hence hallucinations.

http://www.scientificamerican.com/article/why-don-t-animals-get-schizophrenia-and-how-come-we-do/

“They also found that these culprit genes are involved in various essential human neurological functions within the PFC, including the synaptic transmission of the neurotransmitter GABA. GABA serves as an inhibitor or regulator of neuronal activity, in part by suppressing dopamine in certain parts of the brain, and it’s impaired transmission is thought to be involved in schizophrenia. If GABA malfunctions, dopamine runs wild, contributing to the hallucinations, delusions and disorganized thinking common to psychosis. In other words, the schizophrenic brain lacks restraint.”

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Not Just Others.

not just others

Not just others, it is we who have and suffer from mental illnesses. Yes it is more difficult to know what a person with schizophrenia experiences with their illness. The following link to a video shows what a schizophrenic person hears in a psychotic, which means out of touch with reality, phase. And it is literally terrifying. The voices, the words, the tone of voice, how could anyone function like that? They can’t. I have a friend who suffers from schizophrenia and while I did know that neurons in their auditory cortex fire and make these voices, until today I did not know their experience was so horrifying and their mind had turned on them in such a cruel way!  (https://www.youtube.com/watch?v=qb8wQjwVu2g)

People with BPD 1 (bipolar disorder 1) also can be psychotic, that doesn’t mean they are psychos, again it means someone out of touch with reality. Oh so fortunately, people with BPD 1 do not hear voices. Thank goodness, the only voices I’ve heard are real voices, thank goodness a thousand times for that. People with Schizo-Affective disorder do hear voices, this is a combination of BPD 1 and schizophrenia. Some psychiatrists think this is just plain schizophrenia. So while we people with BPD 1 can get suicidally depressed, insanely manic, we still have the lesser of the two evil diseases.

There are a plethora of videos that show people who are manic and depressed. And yes they show how we are acting on the outside, talking 100 miles per minute, jumping from topic to topic, having delusions of grandeur, all in mania; crying, being hopeless, anxious, expressing suicidal ideation, all in depression. They do not show how we are feeling on the inside. Depression is especially painful, it is like someone literally broke your heart into pieces and it hurts. And pure mania is exhilarating and joyful. If your thoughts weren’t so scattered, you might actually come up with some brilliant ideas. Mixed phases aren’t so much fun because anxiety predominates in these. I unfortunately have mostly mixed phases, but that may have been because I was on SSRI’s (selective serotonin reuptake inhibitors) and now that I’m off them, hopefully I won’t have mixed phases, my hope and prayer.

Anyway, the point of this post is to of course reiterate that it’s not others who have mental illness and also to give my readers an idea of what it feels like to have these extremely awful diseases. Maybe now people will respect and understand people with mental illness as strong people who are fighting battles daily with their illness and hopefully winning. That is the intent of this post.