Anti-Estrogens - A Potential Treatment For Bipolar Affective Disorder In Women?
Funder
National Health and Medical Research Council
Funding Amount
$239,250.00
Summary
Bipolar Affective Disorder (BPAD) or Manic-Depressive Illness is a serious mental illness with high morbidity and mortality. The cause of the illness is still unclear and the underlying neurochemical changes are different for the manic phase compared with the depressive phase. The current treatments for BPAD are limited in scope and not biochemically well understood. There are gender differences in the presentation and outcomes for BPAD which adds to the complexity of the illness. We are proposi ....Bipolar Affective Disorder (BPAD) or Manic-Depressive Illness is a serious mental illness with high morbidity and mortality. The cause of the illness is still unclear and the underlying neurochemical changes are different for the manic phase compared with the depressive phase. The current treatments for BPAD are limited in scope and not biochemically well understood. There are gender differences in the presentation and outcomes for BPAD which adds to the complexity of the illness. We are proposing a study to develop a new type of treatment for the manic phase of BPAD and are exploring the use of anti-estrogens in women with mania. The background to our proposed study comes from a few case reports suggesting that anti-estrogen agents such as progesterone and tamoxifen may be useful adjuncts to treatment. We conducted a small pilot study comparing the addition of oral tamoxifen with oral progesterone and placebo in 10 women with mania and found that the women who received tamoxifen made significantly better improvements in their manic symptoms over a 28-day trial. The research study we are now proposing is a larger, three-arm, double blind, placebo controlled, 28-day adjunctive study in women with mania to expand and clarify our pilot study findings. Patients in our proposed study would receive either 40mg per day tamoxifen or 20mg per day progesterone or placebo in addition to standardised lithium medication. We will measure enzyme activity (protein kinase C) and estrogen-progesterone levels to understand more about the mechanisms of action by these new hormone treatments. BPAD is a crippling disorder and if we are successful, then tamoxifen treatment may be an important new treatment. This proposed study will also shed new light on some of the neurochemical mechanisms underlying BPAD as well as opening up the new area of hormone treatments for serious mental illness.Read moreRead less
Psychosocial Predictors Of Developing Breast Cancer In Women From High Risk Breast Cancer Families
Funder
National Health and Medical Research Council
Funding Amount
$337,018.00
Summary
Systematic review of the literature on psychosocial predictors of developing breast cancer has highlighted the possible roles of life events and distress, possibly mediated by social support and personality. To date there has been little prospective assessment of psychosocial factors in the development of breast cancer. Furthermore, no research in this area has specifically targeted women at increased risk because of their family history, nor explored whether the impact of psychosocial factors s ....Systematic review of the literature on psychosocial predictors of developing breast cancer has highlighted the possible roles of life events and distress, possibly mediated by social support and personality. To date there has been little prospective assessment of psychosocial factors in the development of breast cancer. Furthermore, no research in this area has specifically targeted women at increased risk because of their family history, nor explored whether the impact of psychosocial factors systematically varies according to genetic mutation status. Over the past 5 years it has become possible to isolate two breast cancer genes (BRCA1 and BRCA2). Female carriers of mutations in these susceptibility genes have an estimated lifetime risk of breast cancer of between 37% and 85%. The Kathleen Cuningham Consortium for Research into Familial Breast Cancer (KConFab) was established four years ago to co-ordinate the collection of genetic, epidemiological and clinical data in Australian families with a dominantly inherited predisposition to breast cancer. The systematic recruitment of large numbers of high risk women by KConFab provides a unique and temporary opportunity to address questions concerning psychosocial predictors of disease development in a prospective design with sufficient power, due to the higher rates of breast and ovarian cancer events in this population. We will also be able to explore interactions with genetic mutation status. The study will be a world first, and provide the most rigorous data to date in this area. If this study demonstrates a relationship between psychosocial factors and the development of breast cancer in women from high risk families, subsequent identification of vulnerable individuals and the implementation of appropriate interventions may have a real impact on reducing morbidity and mortality in this population. Furthermore, the results may have implications for all women in reducing breast cancer incidence.Read moreRead less