Why Does It Take so Long?

You may know the story about lithium. It was discovered from a mistaken focus on urate. Until today, however, I did not realize that the first use of lithium was not in 1948 by Dr. John Cage in Australia -- but rather, nearly a century before, in 1871. (Here is a very brief little history of lithium).

Why does it take so long for an effective treatment to be recognized?

Certainly it helps if there is a pharmaceutical company spending millions of dollars on advertising. A medication like olanzapine (Zyprexa), for example, sprung into widespread use within a few years after its release -- in part because one only needs to prescribe it a few times before recognizing that it has remarkable effectiveness. (Unfortunately, one only has to prescribe it a few times more than that before discovering that it has remarkable weight gain effects as well).

Recently I have become interested in two treatment approaches for bipolar disorder which, lacking pharmaceutical company advertising, could easily go several decades relatively unnoticed. Neither of them is clearly established as an effective treatment yet, in part because there is no pharmaceutical company funding research.

First, we have the new data arriving about use of thyroid hormone as a mood stabilizer. This is a very unusual approach relative to the standard recommendations. Learn more on my webpage posted today about high-dose thyroid hormone.

Second, regular readers here will probably have come across my enthusiasm for darkness as a potential mood stabilizer. This too has very limited data supporting its use, but it is cheap and widely available and unlikely to be harmful and therefore worth knowing about. See my webpages on Dark Therapy, and the related big-picture view of this approach, Light and Darkness In Bipolar Disorder.

Maybe in this age of aggressive patient self-education, and widespread Internet access, it will not take so long for a treatment -- even one without $millions in advertising -- to become widely known.

Dr. Phelps