Pharmacological treatment of the maintenance phase of bipolar depression: focus on relapse prevention studies and the impact of design on generalizability

2009 ◽  
pp. 159-178 ◽  
Author(s):  
Keming Gao ◽  
David E. Kemp ◽  
Joseph R. Calabrese
Keyword(s):  
Pharmacological Treatment ◽  
Relapse Prevention ◽  
Bipolar Depression ◽  
Maintenance Phase ◽  
Prevention Studies ◽  
The Impact

scholarly journals Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 433
Author(s):  
Anna Grunze ◽  
Benedikt L. Amann ◽  
Heinz Grunze
Keyword(s):  
Bipolar Disorder ◽  
Drug Interactions ◽  
Relapse Prevention ◽  
Bipolar Depression ◽  
Prophylactic Efficacy ◽  
Medline Search ◽  
Class A ◽  
Prevention Studies ◽  
Bipolar Patients

Background and Objectives: This review is dedicated to the use of carbamazepine and its derivatives oxcarbazepine and eslicarbazepine in bipolar disorder and their relative strengths in treating and preventing new depressive or manic episodes. This paper will discuss the evidence of their efficacy relative to the polarity of relapse from controlled acute and maintenance/relapse prevention studies in bipolar patients. Materials and Methods: A Medline search was conducted for controlled acute and maintenance studies with carbamazepine, oxcarbazepine, and eslicarbazepine in bipolar disorder. In addition, abstracts reporting on controlled studies with these medications from key conferences were taken into consideration. Results: Information was extracted from 84 articles on the acute and prophylactic efficacy of the medications under consideration. They all appear to have stronger efficacy in treating acute mania than depression, which also translates to better protection against manic than depressive relapses for carbamazepine. Still, there is a paucity of controlled acute studies on bipolar depression for all and, with the exception of carbamazepine, a lack of long-term monotherapy maintenance data. For eslicarbazepine, the efficacy in bipolar disorder remains largely unknown. Especially with carbamazepine, tolerability issues and drug–drug interactions need to be kept in mind. Conclusions: Two of the medications discussed in this review, carbamazepine and oxcarbazepine, match Class A criteria according to the criteria proposed by Ketter and Calabrese, meaning acute antimanic efficacy, prevention of manic relapses, and not causing or worsening depression.

scholarly journals New Zealand community mental healthcare provider experience in schizophrenia management with 3-monthly paliperidone palmitate

2020 ◽  
pp. 103985622092886
Author(s):  
Cathal Cassidy ◽  
Wayne Miles
Keyword(s):  
New Zealand ◽  
Relapse Prevention ◽  
Patient Management ◽  
Treatment Effectiveness ◽  
Mental Healthcare ◽  
Paliperidone Palmitate ◽  
Online Questionnaire ◽  
Provider Experience ◽  
Management Changes ◽  
The Impact

Objectives: To understand the impact of 3-monthly treatment with paliperidone palmitate on patient management, including non-adherence and relapse, from a psychiatrist and nurse perspective for 73 patients enrolled in a patient familiarisation programme (PFP) in New Zealand. Methods: An online questionnaire was sent to clinicians with at least 6 months of regular interaction with PFP patients. Questions addressed treatment effectiveness and patient management changes. Analyses are descriptive only and do not represent patient or carer perspectives. Results: Seven psychiatrists, representing 58 of 73 (79.5%) of patients, and 17 nurses responded to the survey. Psychiatrists were satisfied with efficacy and tolerability and relapse prevention. Treatment goals were either ‘met’ (2/7; 28.6%) or ‘exceeded’ (5/7; 71.4%). The focus on adherence issues decreased and the focus on life areas and recovery goals increased. Conclusions: From the clinician perspective, 3-monthly paliperidone palmitate offers patients the potential to remain adherent and improve social functioning.

scholarly journals Genetic Variations Associated with Long-Term Treatment Response in Bipolar Depression

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1259
Author(s):  
Gerard Anmella ◽  
Silvia Vilches ◽  
Jordi Espadaler ◽  
Andrea Murru ◽  
Isabella Pacchiarotti ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Major Depression ◽  
Bipolar Depression ◽  
Scientific Evidence ◽  
Term Treatment ◽  
Response To Treatment ◽  
Clinical Predictors ◽  
Patient Response ◽  
Long Term Treatment ◽  
The Impact

Several pharmacogenetic-based decision support tools for psychoactive medication selection are available. However, the scientific evidence of the gene-drug pairs analyzed is mainly based on pharmacogenetic studies in patients with major depression or schizophrenia, and their clinical utility is mostly assessed in major depression. This study aimed at evaluating the impact of individual genes, with pharmacogenetic relevance in other psychiatric conditions, in the response to treatment in bipolar depression. Seventy-six patients diagnosed with bipolar disorder and an index major depressive episode were included in an observational retrospective study. Sociodemographic and clinical data were collected, and all patients were genotyped using a commercial multigene pharmacogenomic-based tool (Neuropharmagen®, AB-Biotics S.A., Barcelona, Spain). Multiple linear regression was used to identify pharmacogenetic and clinical predictors of efficacy and tolerability of medications. The pharmacogenetic variables response to serotonin-norepinephrine reuptake inhibitors (SNRIs) (ABCB1) and reduced metabolism of quetiapine (CYP3A4) predicted patient response to these medications, respectively. ABCB1 was also linked to the tolerability of SNRIs. An mTOR-related multigenic predictor was also associated with a lower number of adverse effects when including switch and autolytical ideation. Our results suggest that the predictors identified could be useful to guide the pharmacological treatment in bipolar disorder. Additional clinical studies are necessary to confirm these findings.

scholarly journals Psychoeducation as a strategy to improve family support perceived from patient with alcohol dependence and personality disorder

2012 ◽  
Vol 5 (1) ◽  
pp. 18-24
Author(s):  
José Miguel Martínez González ◽  
Natalia Albein Urios ◽  
Pilar Munera ◽  
Antonio Verdejo García
Keyword(s):  
Group Therapy ◽  
Alcohol Dependence ◽  
Personality Disorders ◽  
Relapse Prevention ◽  
Behavioral Therapy ◽  
Individual Therapy ◽  
Psychoeducational Intervention ◽  
Self Report ◽  
Significant Difference ◽  
The Impact

The aim of this study was to prospectively analyze the impact of psychoeducation with relatives of addicted patients with personality disorders. We measured the impact of the psychoeducational intervention using a self-report questionnaire designed to assess perceived familiar support. The sample was composed by 37 patients with alcohol dependence following outpatient treatment. They underwent a cognitive-behavioral therapy relapse prevention program especially tailored for addicted individuals with comorbid personality disorders. 56.8% of patients followed individual therapy, and 43.2% followed group therapy. The relatives of the subgroup patients following group therapy simultaneously received the psychoeducational intervention. The analyses of the familiar support questionnaire across treatment showed a significant difference between groups as a function of treatment modality. Patients whose relatives followed the psychoeducational intervention had greater perception of familiar support throughout the treatment process.

scholarly journals Placebo controls in clinical trials: concerns about use in relapse prevention studies in schizophrenia

BMJ ◽  
2016 ◽  
pp. i4728 ◽  
Author(s):  
Robin Emsley ◽  
W Wolfgang Fleischhacker ◽  
Silvana Galderisi ◽  
Lisa J Halpern ◽  
Joseph P McEvoy ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Relapse Prevention ◽  
Placebo Controls ◽  
Prevention Studies
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