New data on the use of lithium, divalproate, and lamotrigine in rapid cycling bipolar disorder

2005 ◽  
Vol 20 (2) ◽  
pp. 92-95 ◽  
Author(s):  
JR Calabrese ◽  
DJ Rapport ◽  
EA Youngstrom ◽  
K. Jackson ◽  
S. Bilali ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Unmet Need ◽  
Depressive Illness ◽  
Term Treatment ◽  
Rapid Cycling ◽  
Double Blind ◽  
Parallel Group Design ◽  
Parallel Group ◽  
Long Term Treatment ◽  
Current Therapies

AbstractThe rapid cycling variant of bipolar disorder is defined as the occurrence of four periods of either manic or depressive illness within 12 months. Patients suffering from this variant of bipolar disorder have an unmet need for effective treatment. This review examines two major studies in an attempt to update understanding of the current therapies available to treat rapid cycling patients. The first trial compares lamotrigine versus placebo in 182 patients studied for 6 months. The second is a recently completed, 20-month trial comparing divalproate and lithium in 60 patients. Both trials had a double-blind, randomized parallel-group design. The data from the latter study indicate that there are no large differences in efficacy between lithium and divalproate in the long-term treatment of rapid cycling bipolar disorder. In addition, lamotrigine has the potential to complement the spectrum of lithium and divalproate through its greater efficacy for depressive symptoms.

scholarly journals Randomized, Ascending Dose, Phase 2 Study of KHK4083, an Anti-OX40 Monoclonal Antibody, in Moderately Active Ulcerative Colitis

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Jaroslaw Kierkus ◽  
Marina Pesegova ◽  
Maria Klopocka ◽  
Marija Brankovic ◽  
Noriyuki Kasai ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Monoclonal Antibody ◽  
Mucosal Healing ◽  
Term Treatment ◽  
Active Ulcerative Colitis ◽  
Phase 2 ◽  
Double Blind ◽  
Parallel Group ◽  
Phase 2 Study ◽  
Long Term Treatment

Abstract Background OX40 (CD134) plays a role in the maintenance of late T-cell proliferation and survival. KHK4083 is a monoclonal antibody directed against OX40. We aimed to assess the safety and preliminary efficacy of KHK4083 in patients with moderately active ulcerative colitis (UC). Methods In this multicenter, double-blind, parallel-group, phase 2 study, patients with moderately active UC patients were randomized to ascending doses of intravenous KHK4083 (1, 3, or 10 mg/kg) or placebo every 2 weeks for 12 weeks. The primary endpoint was safety. The primary efficacy end point was the change from baseline in mean modified Mayo endoscopy subscore at week 12. Treatment with KHK4083 or placebo was continued every 4 weeks for up to 52 weeks in responders. Results Long-term treatment with KHK4083 was well tolerated, with treatment-related adverse events being predominantly transient mild-to-moderate infusion-related reactions. Exploratory analysis of biopsy samples showed the virtually complete elimination of OX40+ cells in colon mucosa after 12 weeks of KHK4083 treatment. There were no significant differences between any of the randomized KHK4083 dose groups and placebo for the mean change in Mayo endoscopy subscore from baseline to week 12. Conclusions KHK4083 can be safely administered intravenously at doses up to 10 mg/kg every 2 or 4 weeks for up to 52 weeks. Proof of pharmacodynamic action was confirmed by depletion of the elevated levels of the OX40+ cells associated with UC at all tested doses. Clinical response and mucosal healing (endoscopic improvement) in this population was not correlated with ablation of OX40+ T cells.

Asenapine for long-term treatment of bipolar disorder: A double-blind 40-week extension study

2010 ◽  
Vol 126 (3) ◽  
pp. 358-365 ◽  
Author(s):  
Roger S. McIntyre ◽  
Miriam Cohen ◽  
Jun Zhao ◽  
Larry Alphs ◽  
Thomas A. Macek ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Extension Study ◽  
Double Blind ◽  
Long Term Treatment

What is the optimal serum lithium level in the long-term treatment of bipolar disorder? A review

2007 ◽  
Vol 40 (06) ◽  
Author(s):  
E Severus ◽  
N Kleindienst ◽  
F Seemüller ◽  
S Frangou ◽  
HJ Möller ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Lithium Level ◽  
Serum Lithium Level ◽  
Long Term Treatment

scholarly journals Defining the role of SGAs in the long-term treatment of bipolar disorder

2017 ◽  
Vol 19 (1) ◽  
pp. 65-67 ◽  
Author(s):  
Gin S Malhi ◽  
Grace Morris ◽  
Amber Hamilton ◽  
Tim Outhred ◽  
Pritha Das
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Long Term Treatment

Long-Term Treatment of Bipolar Disorder with Valproate

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Caitlin S. Yee ◽  
Gustavo H. Vázquez ◽  
Emily R. Hawken ◽  
Aleksandar Biorac ◽  
Leonardo Tondo ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Long Term Treatment

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.

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