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Bipolar treatment

Nicolas Clementy, Yann Ancedy, Arnaud Bisson, Clémentine Andre, Bertrand Pierre, Laurent Fauchier, Dominique Babuty
INTRODUCTION: Ablation of premature ventricular contractions has emerged as a safe and effective treatment in patients experiencing a high premature ventricular contractions burden. Mapping of premature ventricular contractions origin may sometimes be challenging. We sought to evaluate the accuracy of a new electrophysiological criterion, the Distal-to-Proximal Delay, at localizing the optimal site for ablation of ventricular ectopic foci. METHODS AND RESULTS: Consecutive patients with ablation attempts of symptomatic premature ventricular contractions were included...
December 5, 2018: Journal of Cardiovascular Electrophysiology
R Laun, S Tanner, J-P Grassmann, J Schneppendahl, M Wild, M Hakimi, J Windolf, P Jungbluth
BACKGROUND: Radial head arthroplasty represents a widely accepted treatment for elbow injuries with non-reconstructible radial head fractures. The aim of this retrospective multicenter study was to assess mid-term results of patients with clearly defined elbow injuries including type III fractures of the radial head according to Mason's classification type III after primary arthroplasty using a cemented bipolar design. MATERIALS AND METHODS: In 45 cases a primary cemented bipolar arthroplasty of the radial head was implanted for elbow injuries combined with an acute Mason type III radial head fracture...
December 4, 2018: Musculoskeletal Surgery
Kai Zhang, Kenji Hashimoto
Depression is one of the most disabling diseases worldwide. Approximately one-third of depressed patients are treatment-resistant to the currently available antidepressants and there is a significant therapeutic time lag of weeks to months. There is a clear unmet need for rapid-acting and more efficacious treatments. (R,S)-ketamine, an old anesthetic drug, appears now to be going through a renaissance. Areas covered: This paper reviews recent literature describing the antidepressant effects of ketamine and its enantiomer (S)-ketamine in patients with major depressive disorder (MDD) and bipolar disorder (BD)...
December 4, 2018: Expert Review of Neurotherapeutics
Anees Bahji, Emily R Hawken, Amir A Sepehry, Casimiro A Cabrera, Gustavo Vazquez
OBJECTIVE: In this systematic review and meta-analysis, the response, remission, and speed of response in adults with major depressive disorder (MDD) and bipolar disorder in depressive episode (BDD) receiving an acute course of electroconvulsive therapy (ECT) were quantitatively analyzed. METHODS: Using the PRISMA guidelines, 1660 citations were identified through five electronic databases. 19 articles met final inclusion criteria for meta-analysis. RESULTS: The pooled response and remission rates with ECT in MDD were 74...
December 3, 2018: Acta Psychiatrica Scandinavica
Giorgio Marotta, Giuseppe Delvecchio, Alessandro Pigoni, Gianmario Mandolini, Valentina Ciappolino, Lucio Oldani, Domenico Madonna, Marika Grottaroli, Alfredo Carlo Altamura, Paolo Brambilla
OBJECTIVES: Psychotic symptoms are a common feature in bipolar disorder (BD), especially during manic phases, and are associated with a more severe course of illness. However, not all bipolar subjects experience psychosis during the course of their illness, and this difference often guides assessment and pharmacological treatment. The aim of the present study is to elucidate, for the first time, the FDG uptake dysfunctions associated with psychosis in BD patients with and without a history of past psychotic symptoms, through a positron emission tomography (PET) approach...
December 1, 2018: Bipolar Disorders
E Garcia-Rill, S D'Onofrio, S Mahaffey, V Bisagno, F J Urbano
OBJECTIVES: This limited review examines the role of the reticular activating system (RAS), especially the pedunculopontine nucleus (PPN), one site of origin of bottom-up gamma, in the symptoms of bipolar disorder (BD). METHODS: The expression of neuronal calcium sensor protein 1 (NCS-1) in the brains of BD patients is increased. It has recently been found that all PPN neurons manifest intrinsic membrane beta/gamma frequency oscillations mediated by high threshold calcium channels, suggesting that it is one source of bottom-up gamma...
December 1, 2018: Bipolar Disorders
Eline M P Poels, Hilmar H Bijma, Megan Galbally, Veerle Bergink
Lithium is an effective treatment in pregnancy and postpartum for the prevention of relapse in bipolar disorder. However, lithium has also been associated with risks during pregnancy for both the mother and the unborn child. Recent large studies have confirmed the association between first trimester lithium exposure and an increased risk of congenital malformations. Importantly, the risk estimates from these studies are lower than previously reported. Tapering of lithium during the first trimester could be considered but should be weighed against the risks of relapse...
December 2, 2018: International Journal of Bipolar Disorders
Michael J Gitlin
The proper place and the optimal use of antidepressants in treating bipolar depression continues to be an area of great interest and greater controversy with passionate opinions more common than good studies. Even the handful of meta-analyses in the area disagree with each other. Overall, the evidence that antidepressants are effective in treating bipolar depression is weak. Additionally, many experts and clinicians worry greatly about the capacity of antidepressants to cause affective switching or mood destabilization...
December 1, 2018: International Journal of Bipolar Disorders
Takashi Hirata, Kazuyuki Yasuda, Takuji Uemura, Masataka Ohtsuki, Keita Kobayashi, Tetsuya Ueda, Yu Aruga, Toshio Tamaoki, Takefumi Suzuki
BACKGROUND: Electroconvulsive therapy (ECT) is indicated for critical psychiatric conditions, which themselves constitute a risk for deep venous thrombosis (DVT) owing to prolonged immobility, dehydration, and venous stasis. OBJECTIVE: We describe challenging instances of ECT implementation while taking direct oral anticoagulants (DOACs). METHOD: We report on 8 patients receiving DOACs for DVT who were successfully treated with ECT at the University of Yamanashi Hospital...
November 7, 2018: Psychosomatics
Caroline Balling, Iwona Chelminski, Kristy Dalrymple, Mark Zimmerman
INTRODUCTION: Vöhringer et al. identified a triad of items on the Mood Disorder Questionnaire (MDQ) that best discriminated between borderline personality disorder (BPD) and bipolar disorder (BD) in a tertiary mood clinic setting [23]. The present study aimed to replicate and extend these findings by examining the performance of the triad across a range of cut-off scores and comparing the operating characteristics of the triad to the full MDQ. METHODS: Patients presenting for treatment were assessed with the Structured Clinical Interview for DSM-IV (SCID) and the BPD module of the Structured Interview for DSM-IV Personality (SIDP-IV)...
November 22, 2018: Comprehensive Psychiatry
T B Kristensen, E Dybvik, O Furnes, L B Engesæter, J-E Gjertsen
AIMS: The aim of this large registry-based study was to compare mid-term survival rates of cemented femoral stems of different designs used in hemiarthroplasty for a fracture of the femoral neck. PATIENTS AND METHODS: From the Norwegian Hip Fracture Register (NHFR), 20 532 primary cemented bipolar hemiarthroplasties, which were undertaken in patients aged > 70 years with a femoral neck fracture between 2005 and 2016, were included. Polished tapered stems (n = 12 065) (Exeter and CPT), straight stems (n = 5545) (Charnley, Charnley Modular, and Spectron EF), and anatomical stems (n = 2922) (Lubinus SP2) were included...
December 2018: Bone & Joint Journal
Megan Galbally, Jacqueline Frayne, Stuart J Watson, Martien Snellen
There is little known about real world psychopharmacological prescribing practices in managing pregnant women with severe mental illness (SMI). This study utilised a sample of 535 women with a SMI across two hospitals in Australia. This included women with psychotic disorders, bipolar disorder and a range of non-psychotic disorders. The majority of women with a SMI in pregnancy were prescribed psychotropic medication as part of their management. Furthermore, more than one class of agent was prescribed for 31% of women with psychotic disorders and 30% of women with bipolar disorder...
November 26, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Barbara Patrizi, María V Navarro-Haro, Miquel Gasol
Inhaled Loxapine (IL) has demonstrated efficacy in the treatment of agitation in schizophrenic and bipolar patients, although data in patients with Personality Disorder (PD) are scarce. To evaluate the effectiveness and safety of IL in the treatment of agitation in PD, data from 41 patients who presented at our unit with acute agitation and were treated with 9.1 mg of IL were collected retrospectively. The results showed that IL significantly decreased agitation within 10 minutes and its effect was greater at 20 minutes (Positive and Negative Syndrome Scale-excited component: from 22...
November 26, 2018: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
Takeshi Suzuki, Kazuo Mihara, Goyo Nagai, Shoko Kagawa, Akifumi Nakamura, Kenji Nemoto, Tsuyoshi Kondo
BACKGROUND: In a previous study the authors had shown that in treatment-resistant depressive disorder an early therapeutic response to lamotrigine augmentation therapy is dependent on its plasma concentrations. Lamotrigine is mainly metabolized by UGT1A4 and UGT2B7 and polymorphisms of said UGTs that affect enzyme activities have been reported. The present study investigated the effect of these polymorphisms on the steady-state plasma concentrations (Css) of lamotrigine in patients with treatment-resistant depressive disorder receiving lamotrigine as augmentation therapy...
November 22, 2018: Therapeutic Drug Monitoring
Ari A Gershon, Revital Amiaz, Haim Shem-David, Leon Grunhaus
OBJECTIVE: Evidence both from animal and human studies suggests a role for dopaminergic pathways in the treatment of depression. Ropinirole, a selective agonist of dopamine D2/D3, is in use for the treatment of parkinsonism. Preliminary evidence suggests that such agonists might be useful as antidepressants. We tested whether an add-on ropinirole is an effective in depressed patients. METHODS: We conducted a double-blind, randomized, placebo-controlled trial of add-on ropinirole in depressed patients unresponsive to at least one antidepressant...
November 26, 2018: Journal of Clinical Psychopharmacology
Michael J McCarthy, Heather Wei, Caroline M Nievergelt, Andrea Stautland, Adam X Maihofer, David K Welsh, Paul Shilling, Martin Alda, Ney Alliey-Rodriguez, Amit Anand, Ole A Andreasson, Yokesh Balaraman, Wade H Berrettini, Holli Bertram, Kristen J Brennand, Joseph R Calabrese, Cynthia V Calkin, Ana Claasen, Clara Conroy, William H Coryell, David W Craig, Nicole D'Arcangelo, Anna Demodena, Srdjan Djurovic, Scott Feeder, Carrie Fisher, Nicole Frazier, Mark A Frye, Fred H Gage, Keming Gao, Julie Garnham, Elliot S Gershon, Kara Glazer, Fernando Goes, Toyomi Goto, Gloria Harrington, Petter Jakobsen, Masoud Kamali, Elizabeth Karberg, Marisa Kelly, Susan G Leckband, Falk Lohoff, Melvin G McInnis, Francis Mondimore, Gunnar Morken, John I Nurnberger, Sarah Obral, Ketil J Oedegaard, Abigail Ortiz, Megan Ritchey, Kelly Ryan, Martha Schinagle, Helle Schoeyen, Candice Schwebel, Martha Shaw, Tatyana Shekhtman, Claire Slaney, Emma Stapp, Szabolcs Szelinger, Bruce Tarwater, Peter P Zandi, John R Kelsoe
Bipolar disorder (BD) is a serious mood disorder associated with circadian rhythm abnormalities. Risk for BD is genetically encoded and overlaps with systems that maintain circadian rhythms. Lithium is an effective mood stabilizer treatment for BD, but only a minority of patients fully respond to monotherapy. Presently, we hypothesized that lithium-responsive BD patients (Li-R) would show characteristic differences in chronotype and cellular circadian rhythms compared to lithium non-responders (Li-NR). Selecting patients from a prospective, multi-center, clinical trial of lithium monotherapy, we examined morning vs...
November 16, 2018: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
Vida Alizad, Marcus Meinzer, Laurent Frossard, Remco Polman, Simon Smith, Graham Kerr
BACKGROUND: Gait difficulties are common and frequently devastating to people with Parkinson's disease (PD). These difficulties are often followed by an increased risk of falls, leading to injury, hospitalization and mortality. The dysfunction in the basal ganglia-thalamocortical motor circuits and reduced activity in the premotor and primary motor cortices has raised interest in transcranial direct current stimulation (tDCS) as an adjunct intervention in PD. tDCS might provide a potentially safe and non-invasive treatment by modulating cortical excitability and behavioural outcomes...
November 29, 2018: Trials
Carsten Tschöpe, Behrouz Kherad, Oliver Klein, Axel Lipp, Florian Blaschke, David Gutterman, Daniel Burkhoff, Nazha Hamdani, Frank Spillmann, Sophie Van Linthout
Heart failure (HF) is responsible for substantial morbidity and mortality and is increasing in prevalence. Although there has been remarkable progress in the treatment of HF with reduced ejection fraction (HFrEF), morbidity and mortality are still substantial. Cardiac contractility modulation (CCM) signals, consisting of biphasic high-voltage bipolar signals delivered to the right ventricular septum during the absolute refractory period, have been shown to improve symptoms, exercise tolerance and quality of life and reduce the rate of HF hospitalizations in patients with ejection fractions (EF) between 25% and 45%...
November 28, 2018: European Journal of Heart Failure
François L Mayer, Eddy Sánchez-León, James W Kronstad
Pathogenic microorganisms employ specialized virulence factors to cause disease. Biofilm formation and the production of a polysaccharide capsule are two important virulence factors in Cryptococcus neoformans, the fungal pathogen that causes meningoencephalitis. Here, we show that the bipolar disorder drug lithium inhibits formation of both virulence factors by a mechanism involving dysregulation of the ubiquitin/proteasome system. By using a chemical genetics approach and bioinformatic analyses, we describe the cellular landscape affected by lithium treatment...
October 31, 2018: Microbial Cell
Massimo Clerici, Andrea de Bartolomeis, Sergio De Filippis, Giuseppe Ducci, Icro Maremmani, Giovanni Martinotti, Fabrizio Schifano
Patients with severe psychotic disorders such as schizophrenia, schizoaffective, and bipolar disorders frequently suffer from concomitant substance use disorders (SUDs)-Dual Disorder (DD) patients. In order to better understand current practices for management of patients with psychotic episodes and concomitant SUD in Italy, we carried out a survey of psychiatrists on current routine practice among prescribers. These aspects can help to identify at-risk patients, improve current prescribing practices, and favor early intervention...
2018: Frontiers in Psychiatry
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