Bipolar disorder (BD) is a severe mental illness characterised by dramatic shifts in mood, energy, and activity levels, causing substantial impairment in interpersonal and social functioning. The disease course has recurrent periods of highs (mania) and lows (depression) in a person’s mood and activity levels. Globally, BD is the 4th leading cause of disability in the 15–24-year-old age group. It is associated with substantial functional impairment and carries with it a high risk of suicide.
Dr. Alok Kulkarni, a senior consultant psychiatrist based at the Manas Institute of Mental Health at Hubballi, has been awarded the IMH Marshall Fellowship Award for the year 2022–23. He will be mentored by Professor Lakshmi Yatham, a world authority on mood disorders. Dr. Kulkarni is only the third Indian to bag this prestigious fellowship.
Treatment outcomes have remained poor in BD. Previous research entailing early interventions has shown suboptimal results, making the case for even earlier interventions.
Dr. Alok Kulkarni’s study will identify people who are at high-risk of developing BD, and compare the effectiveness of a medication, minocycline, as compared to a placebo, in preventing the emergence of the aforementioned periods of highs and lows. Research has identified inflammation as the primary contributor for the progression of BD.
As minocycline is an antibiotic commonly used to treat acne in adolescents given its anti-inflammatory properties, it has great potential to arrest the disease progression with its anti-inflammatory and antioxidant actions.
Dr. Kulkarni and Dr. Yatham hypothesize that fewer high-risk subjects receiving minocycline will experience mood episode(s) as against those receiving the dummy pills during the 1-year study period.
If their hypothesis turns out to be true, it will provide the impetus for a larger and more definitive clinical trial. If minocycline’s effectiveness is confirmed in preventing BD in high-risk subjects, it will transform the clinical management of BD.
Dr. Alok Kulkarni aims to return to India after the fellowship to establish a state-of-the-art centre for excellence in mood disorders at Hubballi, which will provide cutting-edge clinical care to people with bipolar disorder, depression, substance misuse, and psychosis. This will be the first-of-its-kind initiative in the country in this niche segment.
Link to read up further on Dr. Kulkarni’s fellowship:
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