Collections Adult Psychiatric Unit: Bipola...

Adult Psychiatric Unit: Bipolar Disorder
Rachel Franklin, Sam Zorowitz, Andrew K Corse, Alik S Widge, Thilo Deckersbach
Bipolar disorder (BD) is a debilitating and difficult-to-treat psychiatric disease that presents a serious burden to patients' lives as well as health care systems around the world. The essential diagnostic criterion for BD is episodes of mania or hypomania; however, the patients report that the majority of their time is spent in a depressive phase. Current treatment options for this component of BD have yet to achieve satisfactory remission rates. Lurasidone is a drug in the benzisothiazole class approved by the US Food and Drug Administration in June 2013 for the acute treatment of bipolar depression...
2015: Neuropsychiatric Disease and Treatment
Michael J Ostacher, Roy H Perlis, John Geddes
No abstract text is available yet for this article.
June 2015: American Journal of Psychiatry
Andreas Carlborg, Marcus Thuresson, Lena Ferntoft, Johan Bodegard
OBJECTIVES: The objective of this work was to study characteristics and clinical treatment patterns of bipolar disorder (BD) patients admitted to hospital and treated with quetiapine (immediate-release [IR] or extended-release [XR] formulations). METHODS: BD patients admitted to hospital and prescribed quetiapine IR were followed by linking two Swedish nationwide registries; the hospitalization and drug dispense registries [ identifier: NCT01455961]...
February 2015: Therapeutic Advances in Psychopharmacology
Joseph Stoklosa, A Blythe Rose, Elizabeth S Liebson, Mark J Goldblatt, Ross J Baldessarini
No abstract text is available yet for this article.
July 2015: Harvard Review of Psychiatry
Mark Sanford, Sohita Dhillon
Lurasidone (Latuda(®)), a benzisothiazole derivative antipsychotic, is approved in the USA and Canada for the treatment of adults with major depressive episodes (MDE) associated with bipolar I disorder; this article reviews studies of lurasidone in this indication. In two 6-week, placebo-controlled trials in adults with bipolar I depression, lurasidone 20-120 mg/day reduced depressive symptoms, either as monotherapy or as an adjunct to lithium or valproate. Lurasidone reduced the mean Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline (primary endpoint) by >50 %; the reductions in scores were significantly greater than with placebo...
March 2015: CNS Drugs
Gustavo H Vázquez, Jessica N Holtzman, Leonardo Tondo, Ross J Baldessarini
BACKGROUND: Depression in bipolar disorder is a major therapeutic challenge associated with disability and excess mortality. METHODS: We reviewed findings from randomized placebo-controlled trials concerning efficacy and adverse effects of treatments for acute bipolar depression, including anticonvulsants, antidepressants, lithium, and modern antipsychotics, to compare numbers-needed-to-treat (NNT) versus -to-harm (NNH). RESULTS: Included were data from 22 reports involving 33 drug-placebo pairs...
September 1, 2015: Journal of Affective Disorders
Roger S McIntyre, Josephine Cucchiaro, Andrei Pikalov, Hans Kroger, Antony Loebel
OBJECTIVE: Mixed (subsyndromal hypomanic) features are prevalent in patients with bipolar depression and are associated with more severe and complex illness, including increased risk for suicide attempts, higher switch to mania during antidepressant therapy, and a higher rate of recurrence. The aim of this post hoc analysis was to evaluate the efficacy and safety of lurasidone in the treatment of patients with bipolar depression presenting with mixed features. METHOD: Patients with a DSM-IV-TR diagnosis of major depressive episode associated with bipolar I disorder, with or without rapid cycling, and with a Montgomery-Asberg Depression Rating Scale (MADRS) score ≥ 20 and a Young Mania Rating Scale (YMRS) score ≤ 12 were randomly assigned to 6 weeks of double-blind, once-daily treatment with lurasidone 20-60 mg, lurasidone 80-120 mg, or placebo...
April 2015: Journal of Clinical Psychiatry
Joseph R Calabrese, Paul E Keck, Anju Starace, Kaifeng Lu, Adam Ruth, István Laszlovszky, György Németh, Suresh Durgam
OBJECTIVE: This phase 3 trial evaluated the efficacy, safety, and tolerability of low- and high-dose cariprazine in patients meeting DSM-IV-TR criteria for acute manic or mixed episodes associated with bipolar I disorder. METHOD: This multicenter, randomized, double-blind, placebo-controlled, parallel-group, fixed/flexible-dose study was conducted from February 2010 to December 2011. Patients were randomly assigned to placebo, cariprazine 3-6 mg/d, or cariprazine 6-12 mg/d for 3 weeks of double-blind treatment...
March 2015: Journal of Clinical Psychiatry
Sagar V Parikh
No abstract text is available yet for this article.
December 1, 2014: American Journal of Psychiatry
Marc Valentí, Isabella Pacchiarotti, Juan Undurraga, C Mar Bonnín, Dina Popovic, José M Goikolea, Carla Torrent, Diego Hidalgo-Mazzei, Francesc Colom, Eduard Vieta
OBJECTIVES: The aim of this study was to investigate the clinical factors associated with the development of rapid cycling, as well as to elucidate the role of antidepressants. METHODS: The present study (NCT01503489) is a prospective, naturalistic cohort study conducted in a sample of 289 patients diagnosed with bipolar disorder followed and treated for up to 14 years. The patients were divided into two groups on the basis of the development of a rapid cycling course (n = 48) or no development of such a course (n = 241), and compared regarding sociodemographic, clinical, and outcome variables...
August 2015: Bipolar Disorders
Sanna Pallaskorpi, Kirsi Suominen, Mikko Ketokivi, Outi Mantere, Petri Arvilommi, Hanna Valtonen, Sami Leppämäki, Erkki Isometsä
OBJECTIVES: The long-term outcome of bipolar disorder (BD) has been extensively investigated. However, previous studies may be biased towards hospitalized patients with bipolar I disorder (BD-I), and generalizability to the current treatment era remains uncertain. In this naturalistic study, we followed a secondary-care cohort of patients with BD. METHODS: In the Jorvi Bipolar Study, 191 patients with BD-I and bipolar II disorder (BD-II) were followed using a life-chart method...
June 2015: Bipolar Disorders
Richard A Epstein, Katherine M Moore, William V Bobo
Treating pregnant women with bipolar disorder is among the most challenging clinical endeavors. Patients and clinicians are faced with difficult choices at every turn, and no approach is without risk. Stopping effective pharmacotherapy during pregnancy exposes the patient and her baby to potential harms related to bipolar relapses and residual mood symptom-related dysfunction. Continuing effective pharmacotherapy during pregnancy may prevent these occurrences for many; however, some of the most effective pharmacotherapies (such as valproate) have been associated with the occurrence of congenital malformations or other adverse neonatal effects in offspring...
2015: Drug, Healthcare and Patient Safety
Calvert G Warren, Steven L Dubovsky
Bipolar disorder is a prevalent disorder that tends to become progressive without treatment and with inadequate treatment. Second generation (atypical) antipsychotic drugs have increasingly been used as adjunctive treatment or monotherapy for mania, but they have the potential for significant adverse effects and their role in maintenance treatment remains unclear. Asenapine is a new atypical antipsychotic medication formulated in a sublingual preparation that has been studied for mania but not maintenance therapy...
2013: Neuropsychiatric Disease and Treatment
Steven L Dubovsky
INTRODUCTION: A proprietary combination of the atypical antipsychotic drug olanzapine and the serotonin reuptake inhibitor fluoxetine (OFC, Symbyax) was approved for the treatment of bipolar depression based on a double-blind, placebo-controlled comparison of olanzapine, OFC, and placebo. AREAS COVERED: This review considers published controlled and uncontrolled studies of the efficacy, pharmacodynamics, pharmacokinetics, interactions, and adverse effects of OFC...
February 2013: Expert Opinion on Drug Metabolism & Toxicology
Mark A Frye, Susan L McElroy, Miguel L Prieto, Kelly L Harper, Denise L Walker, Simon Kung, Mohit Chauhan, Scott Crow, Bruce Sutor, Christine W Galardy, Marin Veldic, Brian A Palmer, Jennifer R Geske, Manuel Fuentes, Alfredo B Cuellar-Barboza, Lisa R Seymour, Nicole Mori, Joanna M Biernacka
INTRODUCTION: Identifying clinical and genetic risk factors associated with antidepressant-induced mania (AIM) may improve individualized treatment strategies for bipolar depression. METHOD: From 2009 to 2012, bipolar depressed patients, confirmed by DSM-IV-TR-structured interview, were screened for AIM. An AIM+ case was defined as a manic/hypomanic episode within 60 days of starting or changing dose of antidepressant, while an AIM- control was defined as an adequate (≥ 60 days) exposure to an antidepressant with no associated manic/hypomanic episode...
February 2015: Journal of Clinical Psychiatry
Ji Hyun Baek, Kyooseob Ha, Lakshimi N Yatham, Jae Seung Chang, Tae Hyon Ha, Hong Jin Jeon, Kyung Sue Hong, Sung Man Chang, Yong Min Ahn, Hyun Sang Cho, Eunsoo Moon, Boseok Cha, Jung Eun Choi, Yeon Ho Joo, Eun Jeong Joo, Se Young Lee, Yunseong Park
This study aimed to investigate the overall prescription pattern for patients with bipolar disorders in Korea and its relevance to the practice guidelines. Prescription records from all patients with bipolar I and II disorders who have been admitted or who started the outpatient treatment during the year of 2009 in 10 academic setting hospitals were reviewed. A total of 1447 patients with bipolar I and II disorders were included in this study. Longitudinal prescription patterns of inpatients and outpatients were analyzed by episode types and compared with the clinical practice guideline algorithms...
October 2014: Journal of Clinical Psychopharmacology
Michael Berk, John W G Tiller, Jun Zhao, Lakshmi N Yatham, Gin S Malhi, Emmanuelle Weiller
OBJECTIVE: Depression is the predominant psychosocial and suicide burden in bipolar disorder, yet there is a paucity of evidence-based treatments for bipolar depression. METHODS: This post hoc subgroup analysis of data pooled from two 3-week, randomized, placebo- and olanzapine-controlled trials (December 2004-April 2006, N = 489 and November 2004-April 2006, N = 488) examined a subgroup of patients meeting criteria for moderate-to-severe mixed major depressive episodes, defined using DSM-IV-TR criteria for mixed episodes (mania and major depression simultaneously) with a baseline Montgomery-Asberg Depression Rating Scale (MADRS) total score ≥ 20...
June 2015: Journal of Clinical Psychiatry
Francisco Romo-Nava, Dení Alvarez-Icaza González, Ana Fresán-Orellana, Ricardo Saracco Alvarez, Claudia Becerra-Palars, Julia Moreno, Martha P Ontiveros Uribe, Carlos Berlanga, Gerhard Heinze, Ruud M Buijs
OBJECTIVE: Second-generation antipsychotics (SGAs) are among the first-line treatments for bipolar disorder and schizophrenia, but have a tendency to generate metabolic disturbances. These features resemble a metabolic syndrome for which a central autonomic imbalance has been proposed that may originate from the hypothalamic suprachiasmatic nuclei. In a clinical trial, we hypothesized that melatonin, a hormone that regulates the suprachiasmatic nucleus, could attenuate SGA-induced adverse metabolic effects...
June 2014: Bipolar Disorders
Ayşegül Özerdem, Zeliha Tunca, Dilek Çımrın, Ceren Hıdıroğlu, Gül Ergör
BACKGROUND: Previous studies have provided evidence of subtle thyroid hormone metabolism abnormalities in patients with mood disorders. Although these studies are informative, the precise role of the hypothalamic-pituitary-thyroid axis in bipolar disorder, especially in women, remains unclear. We sought to further corroborate thyroid function in patients with bipolar disorder in comparison to patients with other psychiatric, as well as non-psychiatric, diagnoses. METHODS: In this retrospective, cross-sectional, naturalistic study, serum thyroid-stimulating hormone (TSH) levels in a total sample of 3,204 patients were compared...
February 2014: Bipolar Disorders
Michael Bauer, Tasha Glenn, Maximilian Pilhatsch, Andrea Pfennig, Peter C Whybrow
OBJECTIVES: Thyroid hormones play a critical role in the functioning of the adult brain, and thyroid diseases impair both mood and cognition. This paper reviews gender differences in thyroid system function that are relevant to the diagnosis and treatment of bipolar disorder. METHODS: The study comprised a comprehensive literature review of gender differences in thyroid disease that are pertinent to mood disorders. RESULTS: The prevalence of thyroid disease was found to be much higher in females than males, and to increase with age...
February 2014: Bipolar Disorders
2015-01-15 02:09:51
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