Psychosis

Is there a purine associated with psychosis?

Aciclovir is a guanosine-similar antiviral medication shown to cause mania-similar psychosis: PMID 17651180. Similar symptoms are caused by valaciclovir (broken down into aciclovir): PMID 19567772. Ganciclovir is similar and is also associated with manic psychosis: PMID 8927071. In a patient I treated with recent valciclovir-induced psychosis, switch to famciclovir (metabolized to penciclovir) made therapeutic doses tolerable.

Guanosine analogues are specifically associated with hyper-religiosity, hypersexuality, and grandiose delusions that typically identify manic psychosis: we would predict that excess guanosine would cause similar symptoms. Guanosine as a pro-psychotic agent also connects with other accepted theories of psychosis, including phenylethylamines and D2/D3 receptor stimulation (below).

Phenylethylamines have long been associated with hallucinations/ psychosis, as memorialized in the 1991 book PiHKAL.

Phenyl refers to a 6-member ring where electrons are shared, rather than being tied to one atom. The pattern persists when the 6-member ring is replaced with a 5-member ring where electrons are shared.

Ethyl indicates the amount of space between the ring and the amine (N) group.

D2/D3 receptor activation is reliably tied to psychosis.

Drugs used to tag/ bind specifically to D2/D3 receptors, quinpirole (PMID 18836703) and quinelorane (PMID 18579193) share polycyclic 2-amino structure with guanosine, rather than mono-cyclic structure with dopamine.

LSD shares the 2-amino structure with guanosine, and causes hallucinations.

Guanosine-derivatives share a 5-member structure similar to phenyl, the ethyl-spacing, and the amine-group position with phenylethylamines.

Guanosine-derivatives preferentially bind to and activate D2/D3 receptors.

Bipolar symptoms need not be treated individually: they respond together, as if they are different sides of the same coin.

This is consistent with compensatory responses and purine re-distribution: as excess I,X,G-derivatives are redistributed into adenosine-derivatives, the sleep cycle returns, psychosis resolves, and excess uric acid production resolves.

Which medications help with sleeplessness in bipolar?

Is there a purine associated with hypersexuality?