The treatment of mixed states and the risk of switching to depression

2005 ◽  
Vol 20 (2) ◽  
pp. 96-100 ◽  
Author(s):  
Eduard Vieta
Keyword(s):  
Clinical Trials ◽  
Depressive Symptoms ◽  
Mixed State ◽  
Atypical Antipsychotics ◽  
Randomized Clinical Trials ◽  
Mixed States ◽  
Conventional Antipsychotics

AbstractThere are few controlled studies evaluating the treatment of bipolar mixed states. Evidence suggests that mixed states may be more responsive to some anticonvulsants than to lithium. Olanzapine alone or in combination with divalproate or lithium has been adequately evaluated in randomized clinical trials involving mixed-state patients, whereas risperidone and quetiapine have not. There is also some evidence demonstrating the efficacy of ziprasidone and aripiprazole. The risk of switching to depression is high in mixed states. Conventional antipsychotics, such as haloperidol, may be less efficacious at protecting against a switch to depression than atypical antipsychotics, divalproate or lithium. When choosing drugs for the treatment of mania, and especially for the treatment of mixed states, their efficacy against manic and depressive symptoms, and their safety in terms of the risk of switching to depression should be taken into account.

Dysphoric mania, mixed states, and mania with mixed features specifier: are we mixing things up?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Susan L. McElroy ◽  
Paul E. Keck
Keyword(s):  
Depressive Symptoms ◽  
Mixed State ◽  
Mixed States ◽  
Mixed Features

Various terms have been used to describe mania when it is accompanied by depressive symptoms. In this article, we attempt to define and discuss 3 of these terms: dysphoric mania, mixed state, and mania with mixed features specifier. We conclude that whatever term is used, it is important to be aware that mania is more often unpleasant than pleasant, and that the unpleasantness is not limited to depression.

Non-pharmacological therapies for depressive symptoms in breast cancer patients: Systematic review and meta-analysis of randomized clinical trials

The Breast ◽  
2019 ◽  
Vol 44 ◽  
pp. 135-143 ◽  
Author(s):  
Liliana Coutiño-Escamilla ◽  
Maricela Piña-Pozas ◽  
Aurelio Tobías Garces ◽  
Brenda Gamboa-Loira ◽  
Lizbeth López-Carrillo
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Clinical Trials ◽  
Depressive Symptoms ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Breast Cancer Patients

Dimensions of mania: differences between mixed and pure episodes

2004 ◽  
Vol 19 (5) ◽  
pp. 307-310 ◽  
Author(s):  
Ana González-Pinto ◽  
Ana Aldama ◽  
Asunción González Pinto ◽  
Fernando Mosquera ◽  
José Luis Pérez de Heredia ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Trials ◽  
Depressive Symptoms ◽  
Factorial Analysis ◽  
Mixed States ◽  
Varimax Rotation ◽  
Factor Solution ◽  
Bipolar I Disorder ◽  
Five Dimensions ◽  
Dsm Iv

AbstractObjectiveThe presence of at least five dimensions in mania has recently been established. This study extends previous findings by comparing the dimensions of pure vs. mixed mania.Materials and methodOne hundred and three inpatients with bipolar I disorder, manic or mixed (DSM IV), were assessed with SCID-I, YMRS and HDRS-21. The five-factor solution found after applying factorial analysis with Varimax rotation was compared between manic and mixed patients.ResultsThere were differences between pure mania and mixed states on factor 1 (depression) and factor 3 (hedonism). There was a tendency to present higher values on factor 5 (activation) in the pure manic group. No differences were found in factor 2 (dysphoria) and factor 4 (psychosis).DiscussionHedonism and activation dimensions are present to a lesser degree in mixed states. Although the principal difference between mixed and pure bipolar disorder is the existence of depressive symptoms, the depressive dimension is strongly present in patients with pure mania.ConclusionsThere is need to search for core depressive symptoms in all patients suffering from mania and to evaluate their outcome in clinical trials.

L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials

2019 ◽  
pp. 1-9 ◽  
Author(s):  
Seyed Reza Mirhafez ◽  
Mitra Hariri
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Inflammatory Mediators ◽  
Randomized Clinical Trials ◽  
Randomized Controlled Clinical Trials ◽  
Patients With Cancer ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Human Adults ◽  
Factor Α

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

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