Treatment of bipolar patients in manic phase: A comparison between asenapine and aripiprazole

2016 ◽  
Vol 33 (S1) ◽  
pp. S331-S332
Author(s):  
L. Girardi ◽  
S. Gili ◽  
E. Gambaro ◽  
E. Di Tullio ◽  
E. Gattoni ◽  
...  
Keyword(s):  
Metabolic Profile ◽  
Blood Count ◽  
Complete Blood Count ◽  
Manic Episode ◽  
Acute Effects ◽  
Psychomotor Agitation ◽  
Specific Patient ◽  
Manic Symptoms ◽  
Competing Interest ◽  
Bipolar Patients

IntroductionAgitation is the most evident symptom in an acute manic episode. It can be defined as excessive motor or verbal activity that can degenerate into aggressive behaviour. Both aripiprazole and asenapine are indicated for the treatment of agitation in patients with manic episode.AimsTo retrospectively evaluate the acute effects of drug therapy on psychomotor agitation rated with the PANSS-EC, the change in manic symptoms through the YMRS, the QoL with the SF-36v2 and the cardiometabolic effects of the new oral APS.MethodsWe administered the following tests to 13 patients with DBI at T0 (baseline), T1 (after 1 week), T2 (after 4 weeks), T3 (after 12 weeks) and T4 (after 24 weeks): PANSS-EC, YMRS, SF-36v2, CGI-BD, CGI-S, HAM-D, BPRS. We also considered weight, height, BMI, ECG and complete blood count.ResultsPatients recruitment and statistical analyses are still in progress. Our preliminary results suggest that there is not a marked difference between the two drugs. We highlighted that there has been a noticeable decrease in results at PANSS as well as at YMRS from T0 to T4 and patients showed an improvement in QoL. Only one patient treated with asenapine showed an increase in the results of HAM-D.ConclusionsResults suggest the efficacy of the two new APS but further recruitment and data collection are needed to better understand their impact on agitation and QoL, including the metabolic profile, with the aim to help clinicians to make a more accurate choice of drug for each specific patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Acute effects of electronic and tobacco cigarette smoking on complete blood count

2012 ◽  
Vol 50 (10) ◽  
pp. 3600-3603 ◽  
Author(s):  
Andreas D. Flouris ◽  
Konstantina P. Poulianiti ◽  
Maria S. Chorti ◽  
Athanasios Z. Jamurtas ◽  
Dimitrios Kouretas ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Blood Count ◽  
Complete Blood Count ◽  
Acute Effects ◽  
Tobacco Cigarette

Telemedicine and bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S121-S121
Author(s):  
A. García-Alocén ◽  
C. Bermudez-Ampudia ◽  
M. Martínez-Cengotitabengoa ◽  
I. González-Ortega ◽  
S. Ruiz de Azua ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychoeducational Intervention ◽  
Treatment As Usual ◽  
Patient Functioning ◽  
Manic Symptoms ◽  
Intervention Treatment ◽  
Competing Interest ◽  
Additional Support ◽  
Bipolar Patients ◽  
Web Platform

Show the efficacy of an innovate telemedicine psyeducational invention based on a psychoeducational intervention treatment with a group of bipolar patients.ObjetivesTo assess the efficacy of an innovate telemedicine psyeducational treatment (TPT) based on a psychoeducational intervention (21 sessions) with an additional support through telemedicine which has 12 videos versus treatment as usual (TAU) based on psychiatry reviews. Specifically, the objective was to evaluate patients’ efficacy of psyeducational treatment with telemedicine (TPT) in the fuctionalitity, depressive symptoms and manic symptoms.MethodsThirty-eight patients with bipolar disorder were included in the study and randomly distributed in the two groups. The telemedine treatment is performed through a www.puedoser.es web platform provided by Astra Zeneca. In the web platform is available forums, emails and digital-course with the sessions worked as a reminder. In order to assess the effectiveness of treatments, FAST scale was administered at baseline and 6 months after the intervention. To obtain the results we used coparative data analysis.ResultsIn patients, we found a low daily functionality. The main issues were: interpersonal cognitive area (t = –2.611; P = 0.014) and interpersonal-area (t = –2.617; P = 0.014). We found, at baseline, that TPT group had worse overall results in daily functionality (t = –2.876; P = 0.008). After intervention, there is an improvement in the daily functionality of the TPT group. This improvement occurred in cognitive area (z = –3.24; P < 0.001), leisure area (z = –1.85; P = 0.065) and interpersonal area (z = –1.72; P = 0.086).ConclusionsThe psychoeducational program combined with telemedicine shows to be more effective than TAU in the improvement of general patient functioning in bipolar disorder patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Gender Differences in Complete Blood Count and Inflammatory Ratios among Patients with Bipolar Disorder

2021 ◽  
Vol 11 (3) ◽  
pp. 363
Author(s):  
Laura Fusar-Poli ◽  
Andrea Amerio ◽  
Patriciu Cimpoesu ◽  
Pietro Grimaldi Filioli ◽  
Antimo Natale ◽  
...  
Keyword(s):  
Gender Differences ◽  
Bipolar Disorder ◽  
Blood Count ◽  
Complete Blood Count ◽  
Low Cost ◽  
Female Group ◽  
State Dependent ◽  
And Gender ◽  
Bipolar Patients

Background: Evidence suggested that inflammation may be involved in the etiopathogenesis of bipolar disorder (BD), a chronic psychiatric condition affecting around 2-3% of the general population. However, little is known regarding potential gender differences in peripheral biomarkers of BD, such as neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios. Methods: In total, 197 females and 174 males with BD in different phases (i.e., (hypo)mania, depression, euthymia) were recruited. A blood sample was drawn to perform a complete blood count (CBC). NLR, PLR, and MLR were subsequently calculated, and differences were computed according to the illness phase and gender. Results: PLR was consistently higher in (hypo)manic than depressed patients, in both males and females. No significant gender differences in PLR value were found when considering only (hypo)mania. Conversely, NLR was increased in (hypo)mania only among males, and gender differences were retrieved in the (hypo)manic subgroup. The findings related to MLR were only marginally significant. Higher platelets values were associated with (hypo)mania only in the female group. Basophils and eosinophils appeared gender- but not state-dependent. Conclusions: Our findings provide further evidence that increased PLR levels may be associated with (hypo)mania in bipolar patients, regardless of gender. Moreover, the usefulness of NLR as a peripheral biomarker of BD appeared limited to males while the role of platelets to females. As CBC represents a low-cost and easily accessible test, researchers should investigate in-depth its potential usefulness as a biomarker of BD and other psychiatric disorders.

scholarly journals Comparison of the complete blood count-derived inflammatory markers in bipolar patients with manic and mixed episodes

2019 ◽  
Vol 120 (03) ◽  
pp. 195-199 ◽  
Author(s):  
S. S. Kirlioglu ◽  
Y. H. Balcioglu ◽  
T. Kalelioglu ◽  
E. Erten ◽  
N. Karamustafalioglu
Keyword(s):  
Inflammatory Markers ◽  
Blood Count ◽  
Complete Blood Count ◽  
Bipolar Patients

The late-onset bipolar disease: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S335-S335
Author(s):  
A. Lopes ◽  
P. Sales
Keyword(s):  
Bipolar Disorder ◽  
Late Onset ◽  
Neurological Diseases ◽  
Balance Sheet ◽  
Manic Episode ◽  
The Elderly ◽  
Elderly Subjects ◽  
Psychomotor Agitation ◽  
The Usa ◽  
Competing Interest

The prevalence of bipolar disorder after 65 years is 0.1 to 0.4%. Mania represents 4.6% to 18.5% of all psychiatric admissions in geriatrics in the USA. It has some specificity in terms of clinical presentation, evolution, prognosis and treatment.We report the case of a patient who presented a first manic episode after 65 years. E.H, AP, 67 years old, single, without personal and familial psychiatric history, addressed to psychiatric emergencies for psychomotor agitation and euphoric mood. He presented two months ago a manic access with almost total insomnia, euphoria, psychomotor agitation and delusions of grandeur. The balance sheet reveals no incorrections (blood count, thyroid balance, serology: TPHA, VDRL, hepatitis B and C, HIV). The cerebral CT was normal. The patient has been received a quetiapine 200 mg/day, olanxapine 10 mg/day and valproate 1000 mg/day. The evolution after three weeks was favorable.The late-onset bipolar disorder is characterized by: a less intense euphoria, replaced by anger and irritability, a more elements of persecution, disinhibiting and impulsivity. Respecting to that, this case is an exception. The most common confounding symptoms and behavioral disorders. A higher frequency of neurological diseases is noted in elderly subjects with a bipolar disorder and, so, a neuropsychiatric rigorous evaluation is fundamental to exclude the possibility of an organic pathology for the manic access. The prescription of psychotropic drugs in the elderly must be under monitoring.Disclosure of interest The authors have not supplied their declaration of competing interest.

Clozapine induced blood dyscrasias and a therapeutical approach

2016 ◽  
Vol 33 (S1) ◽  
pp. S613-S613
Author(s):  
A. Gomez Peinado ◽  
P. Cano Ruiz ◽  
S. Cañas Fraile ◽  
M. Gonzalez Cano ◽  
G.E. Barba Fajardo
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Blood Count ◽  
Complete Blood Count ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Simultaneous Treatment ◽  
Clozapine Treatment ◽  
Competing Interest ◽  
Stimulating Factor

IntroductionClozapine is a neuroleptic commonly used in treatments resistant to schizophrenia. However, despite the benefits, clozapine might cause some serious side effects. Hence, it is of the utmost necessity to keep an exacting control of the patients.ObjectivesTo study some of the therapeutical approaches to the treatment of clozapine induced neutropenia and agranulocytosis.MethodsReview of some articles in Mental Health Journals.ResultsThe treatment with clozapine, substratum of aminergic and muscarinic receptors, entails a 0.9% risk of causing agranulocytosis, and approximately a 2.7% risk of causing neutropenia. Both occur, over 80% of them, during the first 18 weeks of treatment. Thus, before starting it, it is necessary to draw some blood and analyze the complete blood count (CBC). Also, we must analyze CBCs weekly during the first 18 weeks. Other dyscrasias like leukopenia, leukocytosis, anaemia, eoshinophilia, thrombocythaemia or thrombocytopenia can also be observed. When agranulocytosis appears, it can be treated by discontinuing the clozapine treatment, but also using granulocyte-colony stimulating factor or lithium, both separated or combined with clozapine. Lithium produces reversible leukocytosis onceplasma levels of > 0.4 mmol/L are reached. Despite the simultaneous treatment with lithium, clozapine can trigger some neurological side effects, it seems that seizure risk remains invariable.ConclusionsSome of the clozapine's side effects, like neutropenia or agranulocytosis, are potentially lethal. Their treatment consists of discontinuing clozapine or initiating granulocyte-colony stimulating factor or lithium. These are good options that can give rise to a later continued treatment with clozapine.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prodromes, coping strategies and course of illness in bipolar affective disorder – a naturalistic study

2001 ◽  
Vol 31 (8) ◽  
pp. 1397-1402 ◽  
Author(s):  
D. LAM ◽  
G. WONG ◽  
P. SHAM
Keyword(s):  
Coping Strategies ◽  
Bipolar Affective Disorder ◽  
Manic Episode ◽  
Psychosocial Interventions ◽  
Naturalistic Study ◽  
Prodromal Stage ◽  
Prodromal Symptoms ◽  
Course Of Illness ◽  
Manic Symptoms ◽  
Bipolar Patients

Background. Psychosocial interventions for bipolar patients often include teaching patients to recognize prodromal symptoms and tackle them early. This prospective study set out to investigate which bipolar prodromal symptoms were reported frequently and reliably over a period of 18 months. Furthermore, we have also investigated which types of coping strategies were related to good outcome.Method. Forty bipolar patients were interviewed for their bipolar prodromal symptoms and their coping strategies at recruitment and 18 months later. Patients were also assessed as to whether they had experienced relapses.Results. Bipolar patients were able to report bipolar prodromal symptoms reliably. Mania prodromal symptoms tended to be behavioural symptoms. A quarter of patients reported difficulties in detecting depression prodromes, which tended to be more diverse and consisted of a mix of behavioural, cognitive and somatic symptoms. Significantly fewer patients who reported the use of behavioural coping strategies to curb excessive behaviour during the mania prodromal stage experienced a manic episode. Similarly, significantly fewer patients who reported the use of behavioural coping strategies experienced depression relapses. How well patients coped with mania prodromes predicted bipolar episodes significantly when the mood levels at baseline were controlled. Ratings of how well subjects coped with mania prodromal symptoms also predicted manic symptoms significantly at T2 when manic symptom at T1 was controlled.Conclusion. Our study suggests that bipolar patients are able to report prodromal symptoms reliably. It is advisable to teach patients to monitor their moods systematically and to promote good coping strategies.

Acute effects of second-hand smoke on complete blood count

2013 ◽  
Vol 24 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Petros C. Dinas ◽  
Giorgos S. Metsios ◽  
Athanasios Z. Jamurtas ◽  
Manolis N. Tzatzarakis ◽  
A. Wallace Hayes ◽  
...  
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
Second Hand Smoke ◽  
Acute Effects

scholarly journals Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder

2021 ◽  
Vol 11 (1) ◽  
pp. 58
Author(s):  
Laura Fusar-Poli ◽  
Antimo Natale ◽  
Andrea Amerio ◽  
Patriciu Cimpoesu ◽  
Pietro Grimaldi Filioli ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Blood Count ◽  
Complete Blood Count ◽  
Independent Predictor ◽  
Manic Episode ◽  
Platelet Volume ◽  
Mean Values ◽  
Markers Of Inflammation ◽  
Cell Counts ◽  
Manic Patients

Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes.

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