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Bipolar polypharmacy

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https://www.readbyqxmd.com/read/29651981/lamotrigine-for-people-with-borderline-personality-disorder-a-rct
#1
Mike J Crawford, Rahil Sanatinia, Barbara Barrett, Gillian Cunningham, Oliver Dale, Poushali Ganguli, Geoff Lawrence-Smith, Verity C Leeson, Fenella Lemonsky, Georgia Lykomitrou-Matthews, Alan Montgomery, Richard Morriss, Jasna Munjiza, Carol Paton, Iwona Skorodzien, Vineet Singh, Wei Tan, Peter Tyrer, Joseph G Reilly
BACKGROUND: No drug treatments are currently licensed for the treatment of borderline personality disorder (BPD). Despite this, people with this condition are frequently prescribed psychotropic medications and often with considerable polypharmacy. Preliminary studies have indicated that mood stabilisers may be of benefit to people with BPD. OBJECTIVE: To examine the clinical effectiveness and cost-effectiveness of lamotrigine for people with BPD. DESIGN: A two-arm, double-blind, placebo-controlled individually randomised trial of lamotrigine versus placebo...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29620698/complex-polypharmacy-in-patients-with-schizophrenia-spectrum-disorders-before-a-psychiatric-hospitalization-prescribing-patterns-and-associated-clinical-features
#2
Brandon A Gaudiano, Carolina Guzman Holst, Alexandra Morena, Lauren E Reeves, Valerie J Sydnor, Gary Epstein-Lubow, Lauren M Weinstock
BACKGROUND: Current evidence-based guidelines provide unclear support for many common polypharmacy practices in schizophrenia. Excessive or complex polypharmacy (≥4 psychotropics) has been studied in patients with bipolar disorder, but not in schizophrenia to date. METHODS: We conducted a digital medical record data extraction of 829 patients consecutively admitted to a psychiatric hospital and diagnosed as having schizophrenia-spectrum disorders. RESULTS: In those prescribed psychiatric medication preadmission, 28...
April 3, 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29564469/pharmacological-treatment-for-schizoaffective-disorder-a-comparison-with-schizophrenia-and-bipolar-disorder
#3
H-J Assion, A Schweppe, H Reinbold, U Frommberger
BACKGROUND: Bipolar disorder and schizophrenia are severe mental illnesses, each with a prevalence of approximately 1-2% in the general population. There is considerable controversy about differentiating schizophrenia from schizoaffective or bipolar disorder owing to many similarities in psychopathology, progression, and biological factors. The aim of this study was to identify similarities and differences in the pharmacological treatment of these disorders by comparing the prescription patterns...
March 21, 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/29540121/psychotropic-polypharmacy-among-youths-with-serious-emotional-and-behavioral-disorders-receiving-coordinated-care-services
#4
Benjamin Wu, Eric J Bruns, Ming-Hui Tai, Bethany R Lee, Ramesh Raghavan, Susan dosReis
OBJECTIVE: The study examined differences in psychotropic polypharmacy among youths with serious emotional and behavioral disorders who received coordinated care services (CCS) that used a wraparound model and a matched sample of youths who received traditional services. METHODS: A quasi-experimental design compared psychotropic polypharmacy one year before and one year after discharge from CCS. The cohort was youths with serious emotional and behavioral disorders who were enrolled in CCS from December 2009 through May 2014...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29527636/possible-pharmacodynamic-and-pharmacokinetic-drug-drug-interactions-that-are-likely-to-be-clinically-relevant-and-or-frequent-in-bipolar-disorder
#5
REVIEW
Jose de Leon, Edoardo Spina
PURPOSE OF REVIEW: Patients with bipolar disorder are frequently treated with polypharmacy. This article should provide clinicians with an understanding of how polypharmacy can contribute to pharmacokinetic and pharmacodynamic drug-drug interactions (DDIs). RECENT FINDINGS: The pharmacokinetics and pharmacodynamics of lithium and other mood stabilizers (valproate, lamotrigine, carbamazepine, oxcarbazepine, and eslicarbazepine), antipsychotics, and selective serotonin reuptake inhibitors (SSRIs) were reviewed and summarized in the first four tables describing their pharmacokinetic and pharmacodynamic mechanisms...
March 12, 2018: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29488058/fatal-intoxication-with-antidepressants-a-case-with-many-culprits
#6
Antonis Goulas, Nikolaos Raikos, Diamantis Krokos, Orthodoxia Mastrogianni, Amvrosios Orphanidis, Konstantinos Zisopoulos, Androniki Tsepa
Serotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age...
February 27, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29471411/mechanisms-underpinning-the-polypharmacy-effects-of-medications-in-psychiatry
#7
Chiara C Bortolasci, Briana Spolding, Edward Callaly, Sheree Martin, Bruna Panizzutti, Srisaiyini Kidnapillai, Timothy Connor, Kyoko Hasebe, Mohammadreza Mohebbi, Olivia M Dean, Sean L McGee, Seetal Dodd, Laura Gray, Michael Berk, Ken Walder
Background: Bipolar disorder (BD) is a mental health condition with progressive social and cognitive function disturbances. Most patients' treatments are based on polypharmacy, but with no biological basis and little is known of the drugs' interactions. The aim of this study was to analyse the effects of lithium, valproate, quetiapine and lamotrigine, and the interactions between them, on markers of inflammation, bioenergetics, mitochondrial function and oxidative stress in neuron-like cells (NT2) and microglial cells...
February 19, 2018: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/29168795/antipsychotic-polypharmacy-among-children-and-young-adults-in-office-based-or-hospital-outpatient-department-settings
#8
Minji Sohn, Meghan Burgess, Mohamed Bazzi
The purpose of the study was three-fold: (1) to estimate the national trends in antipsychotic (AP) polypharmacy among 6- to 24-year-old patients in the U.S.; (2) to identify frequently used AP agents and mental disorder diagnoses related to AP polypharmacy; and (3) to assess the strength of association between AP polypharmacy and patient/provider characteristics. We used publicly available ambulatory health care datasets to evaluate AP polypharmacy in office-based or hospital outpatient department settings to conduct a cross-sectional study...
November 23, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28964996/psychotropic-use-and-risk-of-stroke-among-patients-with-bipolar-disorders-10-year-nationwide-population-based-study
#9
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...
January 15, 2018: 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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