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Bipolar polypharmacy

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https://www.readbyqxmd.com/read/28964996/psychotropic-use-and-risk-of-stroke-among-patients-with-bipolar-disorders-10-year-nationwide-population-based-study
#1
Chi-Shin Wu, Kuan-Yi Wu, Yu-Ru Lo, Ya-Wen Huang, Yu-Ting Tsai, Yashiun Li, Hui-Ju Tsai
OBJECTIVES: To investigate the association between psychotropic agents (including antipsychotics, antidepressants and mood stabilizers) and risk of stroke among patients with bipolar disorders. METHODS: We conducted a disease risk score-matched nested case-control study and identified patients with bipolar disorders (ICD-9 codes: 296.0x, 296.1x, 296.4x, 296.5x, 296.6x, 296.7x, 296.80, 296.81 or 296.89) from the National Health Insurance Research Database in Taiwan...
September 21, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28953820/study-on-the-prescribing-patterns-of-antipsychotic-medication-in-a-rural-england-community-mental-health-team
#2
Madhavan Seshadri, Ahmed Elsemary, Madhusudan Deepak Thalitaya, Lawrence Chikodzore, Priya Nagalingam
INTRODUCTION: Providing comprehensive services for about 400 patients in the South Herefordshire area, the community mental health team manages cases of varying severity and complexity, ranging from Schizophrenia, to neuroses and disorders of adult personality. Antipsychotic medication remains a mainstay of treatment and management for patients under the team case load; hence a need exists for a detailed look into the prescription patterns of such medications. AIM: The aim of this study was to look into the prescribing patterns of antipsychotics for a sample of 50 patients in the South Herefordshire community team during the year of 2016 (from Jan 2016 to Dec 2016), as well as investigate whether these antipsychotics were licensed to be used for the corresponding diagnoses of these patients...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28665044/mood-symptoms-in-pregnant-and-postpartum-women-with-bipolar-disorder-a-naturalistic-study
#3
Kara E Driscoll, Dorothy K Y Sit, Eydie L Moses-Kolko, Emily Pinheiro, Amy Yang, Jody D Ciolino, Heather F Eng, James F Luther, Crystal T Clark, Stephen R Wisniewski, Katherine L Wisner
OBJECTIVE: We conducted a prospective naturalistic study of pregnant women with bipolar disorder (BD) to evaluate symptoms of BD across childbearing and assess whether pharmacotherapy reduced their severity. METHODS: Assessments were scheduled at 20, 30, and 36 weeks' gestation and 2, 12, 26, and 52 weeks postpartum. Symptoms were assessed using the Structured Interview Guide for the Hamilton Depression Rating Scale-Atypical Depression Supplement (SIGH-ADS) and Mania Rating Scale (MRS)...
June 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28628769/complex-psychotropic-polypharmacy-in-bipolar-disorder-across-varying-mood-polarities-a-prospective-cohort-study-of-2712-inpatients
#4
Julia C Golden, John W Goethe, Stephen B Woolley
BACKGROUND: It is common for patients with bipolar disorder (BP) to receive multiple psychotropics, but few studies have assessed demographic and clinical features associated with risk for receiving complex psychotropic polypharmacy. METHODS: This longitudinal cohort study examined 2712 inpatients with a DSM-IV clinical diagnosis of BP to assess associations between complex polypharmacy (defined as ≥4 psychotropics) and demographic and clinical features; associations with risk of rehospitalization were also examined...
October 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28590601/patient-characteristics-associated-with-use-of-lurasidone-versus-other-atypical-antipsychotics-in-patients-with-bipolar-disorder-analysis-from-a-claims-database-in-the-united-states
#5
Mauricio Tohen, Daisy Ng-Mak, Krithika Rajagopalan, Rachel Halpern, Chien-Chia Chuang, Antony Loebel
Objective: To compare patient characteristics, medical comorbidities, health care utilization, and health care costs among patients with bipolar disorder who initiated lurasidone versus other atypical antipsychotics in usual clinical practice. Methods: A retrospective analysis of administrative claims data was conducted using the US Optum Research Database (December 30, 2012, through February 27, 2014). Adult, commercially insured patients with bipolar disorder with an atypical antipsychotic prescription between June 28, 2013, and November 30, 2013, were included...
June 1, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28480482/long-term-response-to-mood-stabilizer-treatment-and-its-clinical-correlates-in-patients-with-bipolar-disorders-a-retrospective-observational-study
#6
Sung Woo Ahn, Ji Hyun Baek, So-Yung Yang, Yongkang Kim, Youngah Cho, Yujin Choi, Kounseok Lee, Taesung Park, Kyung Sue Hong
BACKGROUND: The efficacy and utility of long-term prophylactic treatment in patients with bipolar disorders (BDs) have not been fully explored. This study aims to estimate the long-term clinical response of patients with BDs to mood stabilizer treatment and to identify the clinical factors associated with that response. METHODS: The study subjects consisted of 80 patients with bipolar I or bipolar II disorder who had been receiving treatment with lithium and/or valproate for more than 2 years at a single bipolar disorder clinic...
December 2017: International Journal of Bipolar Disorders
https://www.readbyqxmd.com/read/28261061/molecular-mechanisms-of-bipolar-disorder-progress-made-and-future-challenges
#7
REVIEW
Yeni Kim, Renata Santos, Fred H Gage, Maria C Marchetto
Bipolar disorder (BD) is a chronic and progressive psychiatric illness characterized by mood oscillations, with episodes of mania and depression. The impact of BD on patients can be devastating, with up to 15% of patients committing suicide. This disorder is associated with psychiatric and medical comorbidities and patients with a high risk of drug abuse, metabolic and endocrine disorders and vascular disease. Current knowledge of the pathophysiology and molecular mechanisms causing BD is still modest. With no clear biological markers available, early diagnosis is a great challenge to clinicians without previous knowledge of the longitudinal progress of illness...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/28073041/major-depressive-disorder-with-subthreshold-hypomanic-mixed-features-a-real-world-assessment-of-treatment-patterns-and-economic-burden
#8
Roger S McIntyre, Daisy Ng-Mak, Chien-Chia Chuang, Rachel Halpern, Pankaj A Patel, Krithika Rajagopalan, Antony Loebel
BACKGROUND: To compare outcomes for individuals with major depressive disorder (MDD) with or without subthreshold hypomania (mixed features) in naturalistic settings. METHODS: Using the Optum Research Database (1/1/2009─10/31/2014), a retrospective analysis of individuals newly diagnosed with MDD was conducted. Continuous enrollment for 12-months before and after the initial MDD diagnosis was required. MDD with subthreshold hypomania (mixed features) (MDD-MF) was defined based on ≥1 hypomania diagnosis within 30 days after an MDD diagnosis during the one-year follow-up period, in the absence of bipolar I diagnoses...
March 1, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28040641/psychopharmacological-drug-utilization-patterns-in-pregnant-women-with-bipolar-disorder-a-nationwide-register-based-study
#9
S C Broeks, H Thisted Horsdal, K Glejsted Ingstrup, C Gasse
BACKGROUND: Bipolar disorder is often associated with a lifetime indication for treatment with psychotropic drugs, thus pregnant women face the dilemma whether to continue treatment or not. This study describes the psychopharmacological drug utilization patterns among women with bipolar disorder from 12 months preconception to 12 months postpartum. METHODS: We conducted a register-based cohort study among all Danish women aged 15-55 with a diagnosis of bipolar disorder, who gave birth to their first and singleton child between January 1997 and December 2012...
March 1, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28008349/dosing-patterns-and-medication-adherence-in-bipolar-disorder-patients-treated-with-lurasidone-a-us-retrospective-claims-database-analysis
#10
Martha Sajatovic, Daisy Ng-Mak, Caitlyn T Solem, Fang-Ju Lin, Krithika Rajagopalan, Antony Loebel
BACKGROUND: The aim of this study was to describe dosing patterns and medication adherence among bipolar patients who initiated lurasidone in a real-world setting. METHODS: Adult bipolar patients who initiated lurasidone between 1 November 2010 and 31 December 2012 (index period) with 6-month pre- and post-index continuous enrollment were identified from the IMS RWD Adjudicated Claims US database. Patients were grouped by starting lurasidone daily dose: 20 mg (7...
December 2016: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/27575827/prevalence-and-correlates-of-coprescribing-anxiolytic-medications-with-extensive-prescription-opioid-use-in-veterans-health-administration-patients-with-metastatic-cancer
#11
Declan T Barry, Mehmet Sofuoglu, Robert D Kerns, Ilse R Wiechers, Robert A Rosenheck
OBJECTIVE: To examine the prevalence and correlates of concomitant anxiolytic prescription fills in Veterans Health Administration (VHA) patients with metastatic cancer who have extensive prescription opioid use. DESIGN, SETTING, AND PARTICIPANTS: National VHA data for fiscal year 2012 were used to identify veterans diagnosed with metastatic cancer (ICD-9 codes 196-199) who also had extensive prescription opioid use (at least 10 opioid prescriptions during the year, comprising the highest 29 percent of opioid users)...
July 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27530736/behavioral-measures-and-self-report-of-impulsivity-in-bipolar-disorder-no-association-between-stroop-test-and-barratt-impulsiveness-scale
#12
Elisa Sophie Strasser, Paula Haffner, Jana Fiebig, Esther Quinlivan, Mazda Adli, Thomas Josef Stamm
BACKGROUND: Impulsivity as a tendency to act quickly without considering future consequences has been proposed as a dimensional factor in bipolar disorder. It can be measured using behavioral tasks and self-report questionnaires. Previous findings revealed patients to show worse performance on at least one behavioral measure of impulsivity. Additionally, self-reported impulsivity seems to be higher among bipolar patients, both parameters being possibly associated with a more severe course of illness...
December 2016: International Journal of Bipolar Disorders
https://www.readbyqxmd.com/read/27180355/polypharmacy-may-be-the-cause-of-acute-lithium-intoxication-at-the-second-day-of-treatment
#13
Irfan Tursun, Gokhan Tazegul, Ogur Karhan, Neslihan Gunes, Ece Ulukal, Muge Arpali Atcakarlar, Tolgahan Akca, Erkan Coban
UNLABELLED: Lithium is frequently used as a mood stabilizer in patients with mood disorders. Lithium has a narrow therapeutic index and high toxicity. Predisposing factors for intoxication are advanced age, diet disturbances, comorbid medical conditions affecting heart, kidneys or central nervous system and polypharmacy. CASE REPORT: Here we present a case of a 74-year-old woman with a history of Parkinson's disease, hypertension and bipolar disorder. She was using quetiapine, valsartan with hydrochlorothiazide and levodopa with carbidopa...
July 2015: Folia Medica
https://www.readbyqxmd.com/read/27179557/an-individualized-approach-to-treatment-resistant-bipolar-disorder-a-case-series
#14
Michael I Gurevich, Cassandra L Robinson
CONTEXT: Treatment-resistant bipolar disorder (TRBD) is an increasingly prevalent, debilitating condition with substandard treatment outcomes. Polypharmacy has become the mainstay among practitioners though long-term efficacy of this method has not been adequately tested. OBJECTIVE: Determine retrospectively if individualized, integrative treatment strategies applied while withdrawing pharmaceuticals were beneficial and safe among a TRBD clinic population. DESIGN: A chart review was performed for six adult patients, treated in a private psychiatric practice...
July 2016: Explore: the Journal of Science and Healing
https://www.readbyqxmd.com/read/27099503/prevalence-and-clinical-features-associated-with-bipolar-disorder-polypharmacy-a-systematic-review
#15
REVIEW
Michele Fornaro, Domenico De Berardis, Ann Sarah Koshy, Giampaolo Perna, Alessandro Valchera, Davy Vancampfort, Brendon Stubbs
BACKGROUND: Uncertainty exists regarding the prevalence and clinical features associated with the practice of polypharmacy in bipolar disorder (BD), warranting a systematic review on the matter. METHODS: Three authors independently searched major electronic databases from inception till September 2015. Articles were included that reported either qualitative or quantitative data about the prevalence and clinical features associated with polypharmacy in adult cases of BD...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/26992156/polypharmacy-in-maintenance-of-bipolar-disorder
#16
Eric D Peselow, Lancer Naghdechi, Demetria Pizano, Waguih William IsHak
OBJECTIVES: To track the outcomes of bipolar patients who had remitted from an acute manic episode on single- and multiple-drug regimens including lithium (LI), valproate (VPA), and carbamazepine (CBZ), in order to compare relapse rates on 1, 2, or 3 medications. METHODS: Following treatment of an acute manic episode and a 1-month period of no signs of mood episodes, patients were evaluated at 1- to 2-month intervals as to the kind of regimen required to maintain their stability while continuing on this regimen for 2 years...
May 2016: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/26869795/a-critical-appraisal-of-paliperidone-long-acting-injection-in-the-treatment-of-schizoaffective-disorder
#17
REVIEW
Pierre Chue, James Chue
Schizoaffective disorder (SCA) is a chronic and disabling mental illness that presents with mixed symptoms of schizophrenia and affective disorders. SCA is recognized as a discrete disorder, but with greater heterogeneity and symptom overlap, leading to difficulty and delay in diagnosis. Although the overall prognosis is intermediate between schizophrenia and mood disorders, SCA is associated with higher rates of suicide and hospitalization than schizophrenia. No treatment guidelines exist for SCA, and treatment is frequently complex, involving off-label use and polypharmacy (typically combinations of antipsychotics, mood stabilizers, and antidepressants)...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/26802019/treatment-of-severe-perinatal-mood-disorders-on-a-specialized-perinatal-psychiatry-inpatient-unit
#18
Mary C Kimmel, S Lara-Cinisomo, K Melvin, A Di Florio, A Brandon, S Meltzer-Brody
Perinatal patients with bipolar and psychotic mood disorder exacerbations are challenging to treat and often receive suboptimal care. We sought to examine the treatment patterns and outcomes on one of the only US-based Perinatal Psychiatry Inpatient Units (PPIU). Perinatal patients admitted to the PPIU completed self-report measures at admission and before discharge. Retrospective chart reviews extracted history, diagnoses (current and past), and medication treatment. Patients who had discharge diagnoses of bipolar disorder, major depression with psychotic features, or postpartum psychosis were included...
August 2016: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/26529124/symptom-severity-self-reported-adherence-and-electronic-pill-monitoring-in-poorly-adherent-patients-with-bipolar-disorder
#19
Martha Sajatovic, Jennifer B Levin, Johnny Sams, Kristin A Cassidy, Kouri Akagi, Michelle E Aebi, Luis F Ramirez, Steven A Safren, Curtis Tatsuoka
OBJECTIVES: This analysis of screening and baseline data from an ongoing trial examined self-report versus automated adherence monitoring and assessed the relationship between bipolar disorder (BD) symptoms and adherence in 104 poorly adherent individuals. METHODS: Adherence was measured with the Tablets Routine Questionnaire (TRQ) and the Medication Event Monitoring System (MEMS). Symptoms were measured with the Montgomery-Åsberg Depression Rating Scale (MADRS), the Young Mania Rating Scale (YMRS), and the Brief Psychiatric Rating Scale (BPRS)...
September 2015: Bipolar Disorders
https://www.readbyqxmd.com/read/26480221/pharmacological-agents-under-research-for-the-maintenance-treatment-in-bipolar-disorder
#20
REVIEW
S Dimitrakopoulos, G Konstantakopoulos
The treatment of bipolar disorder is a current challenge for clinicians and despite progress in psychopharmacology, options remain limited and results are often unsatisfactory. Current research focuses on finding new pharmaceutical agents for all phases of bipolar disorder, i.e. mania, bipolar depression and maintenance. Particularly, relapse prevention and longterm stabilization is a major therapeutic target. Combination treatment and polypharmacy are the most common choices concerning relapse prevention. Furthermore, during maintenance phase patients often experience residual mood symptoms, cognitive deficits and functional decline, which altogether illustrate the inadequate effectiveness of existing treatments and the need for new, targeted, effective and safe treatments for bipolar disorder...
July 2015: Psychiatrikē, Psychiatriki
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