Although there have been substantial gains with lithium(Drug information on lithium), valproate(Drug information on valproate), carbamazepine(Drug information on carbamazepine), and atypical antipsychotic drugs, the researchers said, those drugs may take more than a week to start working and many patients don't respond adequately to or can't tolerate the side effects of the treatment.
The researchers acknowledge that tamoxifen(Drug information on tamoxifen) is unlikely to become the drug of choice because it may cause endometrial cancer if taken for extended periods. However, they noted, by pointing to protein kinase C as a target for new medications, the study raises the possibility of developing faster-acting treatments for the often-destructive early manic phase of the illness.
The tamoxifen findings came from a double-blind, placebo-controlled pilot study of 16 patients with manic or mixed bipolar disorder, with or without psychotic features.
The study included 14 men and two women, mean age 35.4, with a mean length of illness of 16.4 years, and a mean duration of the current manic episode of 33.9 days. Of these more than half had a lifetime diagnosis of any substance abuse or dependence.