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Bipolar disorder treatment

Kai G Kahl, Michael Deuschle, Brendon Stubbs, Ulrich Schweiger
Background Severe mental illnesses (SMIs), i.e. major depression, schizophrenia and bipolar disorder, are associated with an elevated risk for the development of type-2 diabetes mellitus and cardiovascular disorders. Several factors have been associated with increased cardiometabolic morbidity and mortality in SMI, including lifestyle factors (smoking, inactivity, unhealthy diet), endocrine and immunologic alterations; however, the underlying mechanisms remain to be fully uncovered. It is now well accepted that visceral adipose tissue (VAT) promotes the development of cardiometabolic disorders, at least in part by inflammatory and metabolic functions...
March 16, 2018: Hormone Molecular Biology and Clinical Investigation
Yijun Pan, Jennifer L Short, Stephanie A Newman, Kwok H C Choy, Durgesh Tiwari, Christopher Yap, Danielle Senyschyn, William A Banks, Joseph A Nicolazzo
Epidemiological evidence suggests that people with bipolar disorder prescribed lithium exhibit a lower risk of Alzheimer's disease (AD) relative to those prescribed other mood-stabilizing medicines. Lithium chloride (LiCl) reduces brain β-amyloid (Aβ) levels, and the brain clearance of Aβ is reduced in AD. Therefore, the purpose of this study was to assess whether the cognitive benefits of LiCl are associated with enhanced brain clearance of exogenously-administered Aβ. The brain clearance of intracerebroventricularly (icv) administered125 I-Aβ42 was assessed in male Swiss outbred mice administered daily oral NaCl or LiCl (300 mg/kg for 21 days)...
March 12, 2018: Brain, Behavior, and Immunity
Ali Sahraian, Zahra Ehsaei, Arash Mowla
BACKGROUND AND OBJECTIVE: Our Objective is to study the effects of aripiprazole as an adjuvant treatment for obsessive and compulsive (OC) symptoms in patients with bipolar disorder (BD) type I, manic phase. PATIENTS AND METHODS: In this 8-week, double-blind, placebo-controlled randomized clinical trial, 56 patients with BD who had OC symptoms were randomly allocated to receive aripiprazole or placebo plus their routine medication regimen (lithium + clonazepam)...
March 12, 2018: Progress in Neuro-psychopharmacology & Biological Psychiatry
Emanuele F Osimo, Rudolf N Cardinal, Peter B Jones, Golam M Khandaker
Low-grade inflammation is a risk factor for depression, psychosis and other major psychiatric disorders. It is associated with poor response to antidepressant and antipsychotics, and could potentially be a treatment target. However, there is limited data on the prevalence of low-grade inflammation in major psychiatric disorders, and on the characteristics of patients who show evidence of inflammation. We examined the prevalence of low-grade inflammation and associated socio-demographic and clinical factors in acute psychiatric inpatients...
March 1, 2018: Psychoneuroendocrinology
Bruno Romeo, Lisa Blecha, Katia Locatelli, Amine Benyamina, Catherine Martelli
The objective of this meta-analysis is to assess the efficacy and safety of partial and complete dopamine agonists in the treatment of acute mood disorder episodes. Randomized, double-blind and placebo-controlled trials of dopamine agonists in the treatment of acute mood disorder episodes were identified in the MEDLINE and PsycINFO databases and included in the meta-analysis. In monotherapy of mania, improved remission rates were found for cariprazine (odds ratio (OR): 2.08, P < 0.01) and for high-dose aripiprazole (OR: 3...
March 1, 2018: Journal of Psychopharmacology
Sally-Ann Cooper, Elita Smiley, Linda Allan, Jillian Morrison
BACKGROUND: Incidence and determinants of affective disorders among adults with intellectual disabilities are unknown. Aims To investigate affective disorder incidence, and determinants of unipolar depression, compared with general population reports. METHOD: Prospective cohort study measuring mental ill health of adults with mild to profound intellectual disabilities living within a defined community, over 2 years. RESULTS: There was 70% cohort retention (n = 651)...
March 15, 2018: British Journal of Psychiatry: the Journal of Mental Science
Gin S Malhi, Tim Outhred, Grace Morris, Philip M Boyce, Richard Bryant, Paul B Fitzgerald, Malcolm J Hopwood, Bill Lyndon, Roger Mulder, Greg Murray, Richard J Porter, Ajeet B Singh, Kristina Fritz
In December 2015, the Royal Australian and New Zealand College of Psychiatrists published a comprehensive set of mood disorder clinical practice guidelines for psychiatrists, psychologists and mental health professionals. This guideline summary, directed broadly at primary care physicians, is an abridged version that focuses on bipolar disorder. It is intended as an aid to the management of this complex disorder for primary care physicians working in collaboration with psychiatrists to implement successful long term management...
March 19, 2018: Medical Journal of Australia
Moritz E Wigand, Fabian U Lang, Annabel S Müller-Stierlin, Lea Reichhardt, Silvana Trif, Thomas G Schulze, Werner Strik, Thomas Becker, Markus Jäger
BACKGROUND: A neurobiologically informed, system-specific psychopathological approach has been suggested for use in schizophrenia. However, to our knowledge, such an approach has not been used to prospectively describe the course of schizophrenia. SAMPLING AND METHODS: We assessed psychopathology in a well-described sample of 100 patients with schizophrenia or schizoaffective disorder with the Bern Psychopathology Scale (BPS) at 6-month intervals for up to 18 months...
March 14, 2018: Psychopathology
Lakshmi N Yatham, Sidney H Kennedy, Sagar V Parikh, Ayal Schaffer, David J Bond, Benicio N Frey, Verinder Sharma, Benjamin I Goldstein, Soham Rej, Serge Beaulieu, Martin Alda, Glenda MacQueen, Roumen V Milev, Arun Ravindran, Claire O'Donovan, Diane McIntosh, Raymond W Lam, Gustavo Vazquez, Flavio Kapczinski, Roger S McIntyre, Jan Kozicky, Shigenobu Kanba, Beny Lafer, Trisha Suppes, Joseph R Calabrese, Eduard Vieta, Gin Malhi, Robert M Post, Michael Berk
The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments...
March 14, 2018: Bipolar Disorders
Nancy Byatt, Lucille Cox, Tiffany A Moore Simas, Nisha Kini, Kathleen Biebel, Padma Sankaran, Holly A Swartz, Linda Weinreb
To elucidate (1) the challenges associated with under-recognition of bipolar disorder in obstetric settings, (2) barriers pregnant and postpartum women with bipolar disorder face when trying to access psychiatric care, and (3) how obstetric settings can identify such women and connect them with mental health services. Structured, in-depth interviews were conducted with 25 pregnant and postpartum women recruited from obstetric practices who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II, or not otherwise specified using the Mini International Neuropsychiatric Interview...
March 13, 2018: Archives of Women's Mental Health
P Riedel, M N Smolka, M Bauer
More than half of the patients diagnosed with schizophrenia and a subgroup of patients diagnosed with bipolar disorder show impairment in neurocognitive and social cognitive performance. The degree of impairment varies from person to person. An improvement of cognitive impairment results in increased subjective quality of life and increased psychosocial functioning, to a much greater extent than successful treatment of other symptoms. Therefore, it is reasonable to not only recognize and bear decreased cognitive functioning in mind but also to offer specific treatment of impairments...
March 13, 2018: Der Nervenarzt
Lili Zhang, Zhaomin Fan, Yuechen Han, Lei Xu, Wenwen Liu, Xiaohui Bai, Meijuan Zhou, Jianfeng Li, Haibo Wang
Valproic acid (VPA), a medication primarily used to treat epilepsy and bipolar disorder, has been applied to the repair of central and peripheral nervous system injury. The present study investigated the effect of VPA on functional recovery, survival of facial motor neurons (FMNs), and expression of proteins in rats after facial nerve trunk transection by functional measurement, Nissl staining, TUNEL, immunofluorescence, and Western blot. Following facial nerve injury, all rats in group VPA showed a better functional recovery, which was significant at the given time, compared with group NS...
March 12, 2018: Journal of Molecular Neuroscience: MN
Brawnie Petrov, Ayat Aldoori, Cindy James, Kefeng Yang, Guillermo Perez Algorta, Aejin Lee, Liwen Zhang, Tao Lin, Reem Al Awadhi, Jonathan R Parquette, Arpad Samogyi, L Eugene Arnold, Mary A Fristad, Barbara Gracious, Ouliana Ziouzenkova
Genetic, dietary, and inflammatory factors contribute to the etiology of major mood disorders (MMD), thus impeding the identification of specific biomarkers to assist in diagnosis and treatment. We tested association of vitamin D and inflammatory markers in 36 adolescents with bipolar disorder (BD) and major depressive disorder (MDD) forms of MMD and without MMD (non-mood control). We also assessed the overall level of inflammation using a cell-based reporter assay for nuclear factor kappa-B (NFκB) activation and measuring antibodies to oxidized LDL...
March 13, 2018: Translational Psychiatry
Deborah A Perlick, Carlos Jackson, Savannah Grier, Brittney Huntington, Andrew Aronson, Xiaodong Luo, David J Miklowitz
OBJECTIVES: Caregivers of people with bipolar disorder often have depression and health problems. This study aimed to evaluate the sustained effects of a 12-15 week psychoeducational intervention on the health and mental health of caregivers of persons with bipolar disorder. We also evaluated the effects of the intervention on patients' mood symptoms over 6 months post-treatment. METHODS: Caregivers of 46 persons with bipolar disorder were randomized to 12-15 weeks of a caregiver-only adaptation of family-focused treatment (FFT), in which caregivers were instructed on self-care strategies and ways to assist the patient in managing the illness, or to 8-12 sessions of standard health education...
March 12, 2018: Bipolar Disorders
Margaret O Akinhanmi, Joanna M Biernacka, Stephen M Strakowski, Susan L McElroy, Joyce E Balls Berry, Kathleen R Merikangas, Shervin Assari, Melvin G McInnis, Thomas G Schulze, Marion LeBoyer, Carol Tamminga, Christi Patten, Mark A Frye
OBJECTIVES: Health disparities between individuals of African and European ancestry are well documented. The disparities in bipolar disorder may be driven by racial bias superimposed on established factors contributing to misdiagnosis, including: evolving empirically based diagnostic criteria (International Classification of Diseases [ICD], Research Diagnostic Criteria [RDC] and Diagnostic and Statistical Manual [DSM]), multiple symptom domains (i.e. mania, depression and psychosis), and multimodal medical and additional psychiatric comorbidity...
March 12, 2018: Bipolar Disorders
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
Michele Fornaro, Annalisa Anastasia, Francesco Monaco, Stefano Novello, Andrea Fusco, Felice Iasevoli, Domenico De Berardis, Nicola Veronese, Marco Solmi, Andrea de Bartolomeis
BACKGROUND: Treatment-emergent affective switch (TEAS), including treatment-emergent mania (TEM), carry significant burden in the clinical management of bipolar depression, whereas the use of antidepressants raises both efficacy, safety and tolerability concerns. The present study assesses the prevalence and clinical correlates of TEM in selected sample of Bipolar Disorder (BD) Type-II (BD-II) acute depression outpatients. METHODS: Post-hoc analysis of the clinical and psychopathological features associated with TEM among 91 BD-II depressed outpatients exposed to antidepressants...
March 1, 2018: Journal of Affective Disorders
Farnaz Hooshmand, Dennis Do, Saloni Shah, Anda Gershon, Dong Yeon Park, Hyun Kim, Laura D Yuen, Bernardo Dell'Osso, Po W Wang, Terence A Ketter, Shefali Miller
AIMS: Antidepressant use is controversial in bipolar disorder (BD) due to questionable efficacy/psychiatric tolerability. We assessed demographic/clinical characteristics of baseline antidepressant use in BD patients. METHODS: Prevalence and correlates of baseline antidepressant use in 503 BD I and BD II outpatients referred to the Stanford Bipolar Clinic during 2000-2011 were assessed with the Systematic Treatment Enhancement Program for BD (STEP-BD) Affective Disorders Evaluation...
February 27, 2018: Journal of Affective Disorders
Katherine Elizabeth Triplett, Ronan Murray, Matthew Anstey
A 51-year-old female presented with acute confusion associated with a non-specific headache and lethargy. The patient's history included bipolar disorder on valproate and recent travel to northern Vietnam. The patient was subsequently found to have hyperammonaemia as well as a urinary tract infection and bacteraemia with Klebsiellapneumoniae The patient was presumed to have a multifactorial non-cirrhotic hyperammonaemic encephalopathy due to a combination of a urinary tract infection and bacteraemia with K...
March 9, 2018: BMJ Case Reports
Sergio Apfelbaum, Pilar Regalado, Laura Herman, Pablo Gagliesi
INTRODUCTION: Many patients with bipolar disorder (BD) spend around 10 years without a diagnosis and appropriate treatment. The difficulty in distinguishing bipolar from unipolar depression, the prevalence of depressive symptoms along the course of BD and patients' bias in recalling their hypomanic symptoms are some of the factors that contribute to this problem. OBJECTIVE: This study compares the efficiency of several screening instruments for BD detection in a group of patients (n=63) with mood disorders, or cluster B personality disorders...
May 2017: Vertex: Revista Argentina de Psiquiatriá
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