Welcome to the 21st WCP Virtual Congress Program Scheduling

Mitochondrial dysfunction was found to be a problem in Bipolar disorders. Here, we postulate that this relates to a genetic predisposition in thyroid metabolism, with unique and distinct physiological markers, which result in affective disorders expression. We explore treatment options using precision medicine aimed stimulating mitochondrial function at the molecular level. The treatments are in some guidelines, yet not widely used. We discuss the genetics of thyroid hormones and thyroid hormones homeostasis and their role in bipolar disorders. We also discuss the role of neuromodulation in enhancing molecular function and reducing the need for polypharmacy, side effect burden and treatment non compliance . A real life multidisciplinary team approach combining Psychiatry, genetics, Neuromodulation and Endocrinology is explored and illustrated in practice with favourable outcomes, high compliance rates, and low side effect profile. During our session, we will be present clinical data from the rTMS clinic of Medical Psychotherapeutic Center (ΙΨΚ) in Thessaloniki and London Psychiatry Centre in London, one of the largest rTMS clinics in Europe. We speculate that rapid cycling bipolar disorder may be a form of cerebral hypothyroidism and that high dose levothyroxine helps to overcome the deficit while robust inactivating deiodinases in the periphery protect from systemic thyrotoxicosis. This is evidenced by findings of normal clinical examination and elevated rT3, while rTMS exercises its well established neuroplastic effect, helping to achieve and maintain remission as an adjunct to high dose levothyroxine.