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mood stabiliser

Philip Boyce, Anne Buist
BACKGROUND: Women with bipolar disorder have a high risk of relapse following childbirth. The risk of relapse can be reduced by mood stabilisers, but they are potentially harmful to the developing fetus. OBJECTIVE: The objective of this article is to provide an up-to-date review of the strategies for managing women with bipolar disorder over the perinatal period. DISCUSSION: Discussing the risks of taking mood stabilisers or having a medication-free pregnancy is essential for women with bipolar disorder...
December 2016: Australian Family Physician
Erik Roj Larsen, Kristina Saric
OBJECTIVE: Bipolar disorder in pregnancy may be difficult to treat. The dilemma is whether the women should continue medication throughout pregnancy, and maybe accept a minor risk to harm their unborn child, or discontinue medication and increase the risk of recurrence, which can lead to maternal morbidity, thereby endangering themselves and their foetus. Design and methods In September 2016, three electronic search databases; PubMed, Scopus and PsycInfo, were used searching for clinical trials concerning this question...
November 17, 2016: Acta Neuropsychiatrica
Marie Rusner, Marie Berg, Cecily Begley
BACKGROUND: Bipolar Disorder (BD) is a mental disorder usually diagnosed between 18 and 30 years of age; this coincides with the period when many women experience pregnancy and childbirth. As specific problems have been reported in pregnancy and childbirth when the mother has BD, a systematic review was carried out to summarise the outcomes of pregnancy and childbirth, in mother and child, when the mother has BD diagnosed before pregnancy. METHODS: An a priori protocol was designed and a systematic search conducted in PubMed, CINAHL, Scopus, PsycINFO and Cochrane databases in March 2015...
October 28, 2016: BMC Pregnancy and Childbirth
Mojtaba Keshavarz
OBJECTIVE: The exact pathophysiology of bipolar disorder (BD) is not yet fully understood, and there are many questions in this area which should be answered. This review aims to discuss the roles of glial cells in the pathophysiology of BD and their contribution to the mechanism of action of mood-stabilising drugs. METHODS: We critically reviewed the most recent advances regarding glial cell roles in the pathophysiology and treatment of BD and the neuroprotective and neurotrophic effects of these cells...
October 24, 2016: Acta Neuropsychiatrica
Chandni Prakash, Susan Hatters-Friedman, Charmian Moller-Olsen, Abigail North
INTRODUCTION: Pregnancy is a vulnerable period for recurrence of bipolar disorder. Discontinuation of mood stabilisers during pregnancy and the postpartum period can significantly increase the risk of recurrence of bipolar disorder. Lamotrigine is an anti-epileptic drug that has been approved for the maintenance treatment of bipolar disorder. Epilepsy literature has indicated that lamotrigine has a reassuring safety profile in pregnancy but there is little information on its effectiveness and safety in pregnant women with mental disorders...
August 15, 2016: Psychopharmacology Bulletin
Francesco Franza
BD-II has been consistently associated with cognitive dysfunction across a broad range of cognitive domains. Atypical antipsychotic drugs, or SGAs are effective antipsychotics in these diseases, often in combination with antidepressants and mood stabilizers. Data on the possible effect of antipsychotics on neuro-cognition are rare and conflicting. The main objective of our study was to assess the effectiveness and possible risks to cognitive function in a group of inpatients affected by BD-II. Forty-five inpatients with Bipolar II Disorder (DSM-5) were included in a two-year observational study...
September 2016: Psychiatria Danubina
Giuseppe Tavormina
Very often clinicians meet great difficulties in making a correct diagnosis of mood disorders which they are assessing, above all when mixed states are present: this because the patients mainly focus on their own symptoms of depressive uneasiness; mixed symptoms can insidiously infiltrate into the mood and life of the patients causing a chronic and worsening clinical state. It is essential not to forget that the depression is only one phase of a broader bipolar mood disorder, and this has to be the illness to be treated by psychiatrists and, generally, by clinicians managing an appropriate polytherapy with mood-stabilisers and antidepressants...
September 2016: Psychiatria Danubina
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
September 13, 2016: Lancet
Katie Pigott, Ilaria Galizia, Kamini Vasudev, Stuart Watson, John Geddes, Allan H Young
BACKGROUND: Bipolar disorder is a common recurrent illness with high levels of chronicity. Previous trials have suggested that the anticonvulsant topiramate may be efficacious in bipolar disorder. This is an update of a previous Cochrane review (last published 2006) on the role of topiramate in bipolar disorder. OBJECTIVES: To assess the effects of topiramate for acute mood episodes in bipolar disorder in adults compared to placebo, alternative pharmacological treatment, and combination pharmacological treatment as measured by treatment of symptoms on specific rating scales for individual episodes...
September 3, 2016: Cochrane Database of Systematic Reviews
T R W M Walrave, S Mohammad, R R Ploeger
We report two cases of adults who developed mania after taking the antibiotic clarithromycin. Clarithromycin is a frequently used antibiotic, but it can lead to a rare but significant psychiatric complication in the form of a manic episode. Mania is commonly associated with bipolar disorder, but the causes can be pharmacological, metabolic or neurologic, particularly when it occurs in patients who themselves or whose families have no past history of psychiatric illness. New-onset mania calls for detailed clinical and laboratory testing and neuro-imaging so that somatic causes can be ruled out...
2016: Tijdschrift Voor Psychiatrie
Jean-Paul Fagot, Anne Cuerq, Solène Samson, Anne Fagot-Campagna
AIMS: Previous studies have shown that the recommended minimum 6-month period for antidepressant treatment is actually observed for only a minority of patients. The objectives of this study were to characterise patients with newly prescribed antidepressant treatment in France and identify factors possibly associated with insufficient duration of treatment or the occurrence of certain events such as sick leave, hospitalisations and suicide attempts. METHODS: Data were extracted from the French health insurance database (SNIIRAM) and the national hospitalisation database (PMSI) for patients covered by the main French health insurance scheme representing 75% of the French population...
September 2016: International Journal of Clinical Practice
E Heyde, M Dhar, H Hellemans, E Schoentjes, D Van West
BACKGROUND: Very little information is available concerning the prevalence of the use of medication for treatment of individuals with autism spectrum disorder (ASD), particularly in European countries. Earlier studies have shown that a large number of patients with ASD use at least one psychoactive drug and that the numbers are increasing. Even in the nineties, studies suggested that the frequent use of psychoactive medication was widespread, although at the time there were only limited grounds for this assumption...
2016: Tijdschrift Voor Psychiatrie
Seon-Cheol Park, Min-Soo Lee, Sang Woo Hahn, Tian-Mei Si, Shigenobu Kanba, Mian-Yoon Chong, Chee Kok Yoon, Pichet Udomratn, Adarsh Tripathi, Norman Sartorius, Naotaka Shinfuku, Margarita M Maramis, Yong Chon Park
OBJECTIVE: Using data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) study, we aimed to present the rates and clinical correlates of suicidal thoughts/acts in patients recruited from a total of 40 centres in 10 Asian countries/areas: China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Singapore, Taiwan, and Thailand. METHODS: Data from 1122 patients with depressive disorders in the REAP-AD study were used. The ICD-10 was employed to diagnose depressive episodes and recurrent depressive disorder...
June 16, 2016: Acta Neuropsychiatrica
Florian Brugger, Kailash P Bhatia, Frank M C Besag
Valproate was first approved as an antiepileptic drug in 1962 and has since also become established as a mood stabiliser and as prophylaxis for migraine. In 1979, Lautin published the first description of a valproate-associated extrapyramidal syndrome. Many cases of valproate-associated parkinsonism have subsequently been published, but uncertainties remain concerning its prevalence, risk factors and prognosis. The aim of this paper is to provide a critical review of the existing literature on valproate-associated parkinsonism and to discuss possible mechanisms...
June 2016: CNS Drugs
Phillip Gregoire, Michael Tau, David Robertson
Cannabinoid hyperemesis syndrome is a rare, recently described, clinically diagnosed condition that is characterised by a chronic history of cannabis use, cyclic nausea and vomiting, symptomatic relief with hot water bathing, and resolution with cessation of use. We present a case of this syndrome concurrent in a patient with bipolar mania. We suggest that a 3-week period of vomiting in the context of this syndrome contributed to the precipitation of a manic episode by lowering mood stabiliser serum levels, and that this syndrome will have significant consequences for the patient's mental health...
2016: BMJ Case Reports
Irene Petersen, Rachel L McCrea, Cormac J Sammon, David P J Osborn, Stephen J Evans, Phillip J Cowen, Nick Freemantle, Irwin Nazareth
BACKGROUND: Although many women treated with psychotropic medication become pregnant, no psychotropic medication has been licensed for use in pregnancy. This leaves women and their health-care professionals in a treatment dilemma, as they need to balance the health of the woman with that of the unborn child. The aim of this project was to investigate the risks and benefits of psychotropic medication in women treated for psychosis who become pregnant. OBJECTIVE(S): (1) To provide a descriptive account of psychotropic medication prescribed before pregnancy, during pregnancy and up to 15 months after delivery in UK primary care from 1995 to 2012; (2) to identify risk factors predictive of discontinuation and restarting of lithium (multiple manufacturers), anticonvulsant mood stabilisers and antipsychotic medication; (3) to examine the extent to which pregnancy is a determinant for discontinuation of psychotropic medication; (4) to examine prevalence of records suggestive of adverse mental health, deterioration or relapse 18 months before and during pregnancy, and up to 15 months after delivery; and (5) to estimate absolute and relative risks of adverse maternal and child outcomes of psychotropic treatment in pregnancy...
March 2016: Health Technology Assessment: HTA
V Benard, G Vaiva, M Masson, P A Geoffroy
INTRODUCTION: Bipolar disorder (BD) is a severe and recurrent psychiatric disorder. The severity of prognosis in BD is mainly linked to the high rate of suicide in this population. Indeed, patients with BD commit suicide 20 to 30 times more frequently than the general population, and half of the BD population with an early age of onset have a history of suicide attempt. International therapeutic guidelines recommend lithium (Li) as the first-line treatment in BD for its prophylactic action on depressive or manic episodes...
June 2016: L'Encéphale
Philippe Conus, Fabrice Herrera, Sylvie Berney, Bénédicte Gailland, Véronique Beretta, Frederik Vandenberghe, Chin B Eap
Three issues are discussed: i) While number of psychiatric beds has been reduced in most countries and although treatments proposed in psychiatric hospitals have evolved, they continue to be viewed as asylums implementing constraints. Considering this prevents their adequate use and leads to patients' stigmatisation, promotion of a better knowledge of contemporary hospital treatments is needed. 2) In addition, most psychiatric disorders emerging during adolescence and early adulthood, it is important to develop accessible care on university campuses...
January 13, 2016: Revue Médicale Suisse
Kate E A Saunders, Andrea Cipriani, Jennifer Rendell, Mary-Jane Attenburrow, Natalie Nelissen, Amy C Bilderbeck, Sridhar R Vasudevan, Grant Churchill, Guy M Goodwin, Anna C Nobre, Catherine J Harmer, Paul J Harrison, John R Geddes
BACKGROUND: Despite lithium's being the most effective drug for bipolar disorder and in clinical use for decades, we still know very little about its early effects relevant to its mode of action. METHODS/DESIGN: The Oxford Lithium Trial is a double-blind, randomised, placebo-controlled study of 6-week lithium treatment in participants with bipolar disorder and mood instability. Its aim is to identify early clinical, neurocognitive and biological effects. Participants (n = 40) will undergo an intensive battery of multi-modal investigations, including remote monitoring of mood, activity and physiology, as well as cognitive testing, fMRI and magnetoencephalography, together with biochemical and gene expression measurements to assess renal, inflammatory and circadian effects...
2016: Trials
V E Knott, G Gilligan, L Maksimovic, D Shen, M Murphy
Despite the need to urgently reduce smoking rates among Indigenous Australians, in order to close-the-gap in life expectancy, little is known regarding how this can be achieved. This study aimed to explore whether a focus on gender specific determinants of smoking among Indigenous Australians could be identified, thus providing a potentially novel approach to underpin future efforts at intervention. A qualitative research design was employed. Eighty-two participants, comprised of 43 Indigenous women (mean age 32...
March 2016: European Journal of Cancer Care
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