The term ‘uric acid’ is almost always mentioned in reference to gout—an inflammatory type of arthritis that result from excessive uric acid in the blood. With that said, it may come as a surprise that it has recently been link to an entirely different type of disease: bipolar disorder. Elevated uric acid levels have been recently observed in patients with acute mania, and reducing uric acid improves symptoms.
Uric-acid forms when a compound called purines breakdown in the body. High levels of uric acid can indicate that these compounds are breaking down too readily. There is a type of purine called ‘adenosine’, which is a neurotransmitter believed to play a key role in neurotransmission as well as generate sedative, anticonvulsant, and anti-aggressive effects.
A new study done by Dr. Francesco Bartoli researched individuals with various forms of severe mental illness and found that individuals diagnosed with bipolar disorder were the only ones linked to uric acid levels.
Outside of the too rapid breakdown of adenosine, other possible explanations for increased uric acid in those with bipolar disorder include metabolic abnormalities and frequent consumption of purine-rich foods and drinks, such as liver, legumes, anchovies, and alcohol. Fructose could also be a variable because it inhibits uric acid excretion. Dietary interventions could potentially reduce uric acid levels, but medication is typically used if diet changes are insufficient.
The link between uric acid and bipolar disorder points to novel new treatment targets. A double-blind randomized trial was conducted to investigate the efficacy of allopurinol, a gout medication that reduces uric acid levels, and its effectiveness with bipolar patients during acute mania. For four weeks 50 patients received a mood stabilizer (standard treatment) in conjunction with either allopurinol or a placebo. The allopurinol group showed significant reductions in uric acid levels and mania symptoms, as well as rates of remission that were 23 times greater than the control group.
These findings are novel on many accounts. Firstly, doctors may find it useful to incorporate diet and uric-acid specific medication in the treatment of bipolar patients. Second, this research is timely in regards to the broader research focusing on the connection between the stomach and the brain—the so-called gut-brain axis.