Insulin resistance takes center stage: a new paradigm in the progression of bipolar disorder.

ABSTRACT: Bipolar Disorder (BD) is a major psychiatric illness affecting up to 5% of the population. BD can progress over time to a chronic "neuroprogressive" course with cognitive and functional impairment. Currently, there are no validated predictors indicating which patients will develop a neuroprogressive course and there are no specific treatments. This review presents data supporting a novel hypothesis on the mechanisms underlying bipolar neuroprogression. Insulin resistance (IR) is present in 52% of BD patients and is associated with chronic course, treatment nonresponse, adverse brain changes and cognitive impairment. Further, bipolar morbidity increases 12-fold following the onset of IR indicating that IR may modify disease progression. I review evidence that IR is a testable and treatable

SUBMITTER: Calkin CV 

PROVIDER: S-EPMC7877881 | biostudies-literature | 2019 Aug - Sep

REPOSITORIES: biostudies-literature