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Hypothesis: Bipolar Illness with Complaints of Chronic Musculoskeletal Pain Is a Form of Pseudofibromyalgia

  [ 121 votes ]   [ 1 Comment ]
By DJ Wallace and J Gotto • • June 24, 2007

Journal: Seminars in Arthritis and Rheumatism. 2007 Jun 13; [E-pub ahead of print]

Authors and affiliation: Wallace DJ, Gotto J. Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, California.

PMID: 17570468

Objective: To present a hypothesis accounting for the differential response of bipolar patients diagnosed with Fibromyalgia (FM) to standard therapies, taking into account the markedly statistically significant increase of its prevalence in the syndrome.

Methods: All articles relating to the heading bipolar illness AND fibromyalgia as well as bipolar illness AND pain were searched using PubMed and Medline since 1966. The prevalence of bipolar illness in our last 100 FM consultations was reviewed.

Results: Ten percent of our 100 most recent FM consultations included patients with an established diagnosis of bipolar illness. They had little if no response to traditional FM interventions and appeared to have vague and uncertain tender point examinations. Conclusions: Bipolar illness may be associated with a form of chronic musculoskeletal pain complaints that is not FM. Studies into the role that neurotransmitters play in bipolar patients with complaints of musculoskeletal discomfort deserve further exploration.

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Role of neurotransmitters in BP / FMS
Posted by: ne2954
Oct 17, 2007
I have no letters behind my name however my oldest son developed sudden onset Bipolar at 15 (after ADHD since he was born) 15 yrs ago &, being a voracious (slightly ocd :-) researcher, I discovered that it runs very strong in my family - to varying degrees. I am (& have since been diag'd after a depressive episode) what would be considered slightly bipolar - manic type (meaning I tend to be just a little bit happier than the rest of the world most of the time - with just occasional little dips). Most of my family also has the opposite or 1% side effect reaction to many drugs, especially psychotropics - because they react with the neurotransmitters. As they've discovered with many bp people, I cannot take SSRI's - which inhibit the re-uptake of serotonin in the brain - keeping it there longer - because they tend to induce manic states. My pet theory is it's because we (with BP/manic type, at least) already have more than enough serotonin - the "feel-good" chemical - in our brains. HOWEVER, studies have come out showing that there appears to be a relationship between FM & reduced BLOOD serotonin. Therefore, I would suggest that, instead of a "PSEUDO-fibromyalgia " (with the inherent insinuation that it's "all in our heads", Again), perhaps the scientific branch might start looking at that serotonin link between the Brain & the Blood - & that, by studying the difference & tracing that chemical in bipolar people with FM might show that the difference in serotonin levels - in the brain or blood...or somewhere in between - might lead to a reduction of symptoms/tender points (at least in non-bp FM patients). I may not have conveyed the gist of all this clearly enough to be understandable (I USTA be smart :-) but, the main point is I believe that serotonin - & it's transmission - is at least one key to solving the puzzle of FM & would love to see that avenue researched further.
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