I've seen anecdotal evidence of a potential relationship between bipolar and sodium deficiency, but I'm looking for empirical evidence of such a correlation. Can anyone recommend articles or other resources?
There are hardly any (recent) studies on this topic, but you might want to have a look at
http://www.sciencedaily.com/releases/2008/08/080817223548.htm
http://www.sciencedirect.com/science/article/pii/0024320574901751
http://www.ncbi.nlm.nih.gov/pubmed/2561682
Valproat of sodium was the first preparation which started being applied as an alternative to lithium [Lambert P.A. and , 1968]. Efficiency of a preparation is studied in a number of the open and controlled researches uniting some thousands of patients [Lambert P.A., 1984; Calabrese J.R., Deluccini C.A. 1990, etc.]. Their results prove efficiency of a valproat at BAR. In randomized double blind comparative placebo - controlled research [Bowden C.L. , 2000] valproat in comparison with placebo more I increased time before development of a maniacal episode, than time before development of a depression. It also more increased time before development of any episode in comparison with lithium and placebo. In group of a valproat the number of the patients who left research was smaller, than in group of lithium.
The range of normotimichesky action of a valproat is similar to a lithium range: it more prevents development of maniacal phases in comparison with depressive [Mosolov S.N., 1983, Calabrese J.R., Deluccini C.A., 1990; Mosolov S.N., 1991, Mosolov S.N. and соавт., 1994; Mosolov S.N., 1996; Bowden C.L. and соавт., 2000; Kuzavkova M. V., 2001].
my idea is that when there is sodium deficiency of any cause, lithium levels arise. Therefore, it s effective in lower dosage. But this has nothing to do with the pathophysiology of Bipolar Disorder, which is hardly understood.
There seems to be an association between hyponatremia and BD, particularly in the elderly with their precarious renal function. It can also trigger anxiety symptoms which may be prominent in some bipolar presentation. PPD and SIADH are the two common causes of hyponatremia in psychiatric settings.
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