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Q:  Human Growth Hormone

Is it safe for someone with bipolar disorder to take human growth hormone?  If not, what may happen?  My husband takes 1000 mg Depakote and 10 mg Lexapro daily.

Dear Suz -- 
As a general psychiatrist, a clinician, not a researcher in the neuroendocrinology of bipolar disorder, I really have little to offer you here. But I'll tell you what I found as I hunted around the literature that comes up when one searches growth hormone bipolar disorder.  Basically, what one finds is that growth hormone has been studied as a marker for how a separate chemical system (not growth hormone itself) is functioning in the brains of people with bipolar disorder, namely the dopamine system.  The point is that growth hormone does not appear to have been studied itself, in terms of possible impact on bipolar disorder.  

That's certainly not the end of the story, though.  Growth hormone is certainly affected by bipolar mood shifts, as shown in a remarkable set of graphs from a patient whose bipolar disorder cycled up and down every 24 hours.  In his case, growth hormone also cycled up and down every 24 hours (here's the graph, in case it will actually come across in an email; if not, look at this essay on Biological Clocks and Bipolar Disorder): 

The data points on the right are after treatment with a mood stabilizer.  

Now, this does not mean that growth hormone is doing something directly involved with bipolar symptoms, and that therefore your husband should not be taking it.  It could be that something else (perhaps even something as well-known as the dopamine noted above) is driving the growth hormone changes shown here, and that growth hormone is simply a passive "innocent bystander" that is fluctuating up and down in response to something else that really is more directly involved in the core chemical problems of bipolar disorder (whatever those are, which remains to be determined -- but in the discussions of which I have never heard mention of growth hormone, for what that's worth).  

The basic answer to your question is "I don't know, I'm not sure if anyone does, and I'm not aware of any data that would suggest that growth hormone could make bipolar disorder worse" (Lexapro could; if things were not going well I'd certainly be looking at that agent long before I'd be wondering about growth hormone; but some people do well on long term antidepressants, so that's not to say it's a bad idea for everyone, just that we know it can have a destabilizing influence for some patients). 

Dr. Phelps

Published January, 2005


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