Alternative treatment strategies for lithium in bipolar disorder

1993 ◽  
Vol 5 (3) ◽  
pp. 55-59
Author(s):  
P.F. Bouvy
Keyword(s):  
Bipolar Disorder ◽  
Valproic Acid ◽  
Adverse Effects ◽  
Alternative Treatment ◽  
Calcium Antagonists ◽  
Treatment Strategies ◽  
Bipolar Disorders ◽  
Preventive Treatment ◽  
Acute Mania

SummaryIndications for lithium in the treatment of bipolar disorders are acute mania, depression and preventive treatment. In the case of insufficient efficacy or adverse effects the first alternative for lithium in acute mania is carbamazepine. However, the role of carbamazepine in preventive treatment is still uncertain. Well designed prospective research is hardly done. Clearly positive reports on the efficacy of carbamazepine concern specific lithium-resistant groups such as the ‘rapid-cyclers’. Valproic acid has been found effective in a few studies in bipolar disorders, especially in acute mania. Clonazepam is sometimes mentioned as a possible alternative, however recent research seriously questions the efficacy of clonazepam in bipolar disorders. Calcium-antagonists, especially verapamil, may have some efficacy in the treatment of acute mania, their role is still very uncertain.

Psychological Treatments and Prevention in Bipolar Disorder - Recent Developments

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Kuehner
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Disorders ◽  
Behavioural Therapy ◽  
Psychological Interventions ◽  
Cognitive Behavioural ◽  
Recent Developments ◽  
Social Rhythm ◽  
Future Work ◽  
High Risk Children

This contribution provides a systematic review on recent developments in psychological interventions for bipolar disorder. The main focus of research to date has investigated the role of different psychotherapeutic approaches (cognitive behavioural therapy, family focused therapy, interpersonal and social rhythm therapy, psychoeducation) as an adjunct to pharmacotherapy for remission and relapse prevention. The review will assess efficacy and effectiveness of these interventions, their common ingredients, limitations and predictors of outcome. It will further explore the potential role of psychological interventions for primary prevention of bipolar disorders in high risk children and adolescents. Suggestions will be made for future work in these areas.

Loading Strategies in Acute Mania

CNS Spectrums ◽  
2001 ◽  
Vol 6 (11) ◽  
pp. 919-922, 930 ◽  
Author(s):  
Brendan T. Carroll ◽  
Arthur Thalassinos ◽  
Jay D. Fawver
Keyword(s):  
Valproic Acid ◽  
Length Of Stay ◽  
Adverse Effects ◽  
Patient Selection ◽  
High Light ◽  
Acute Mania ◽  
Divalproex Sodium ◽  
Haloperidol Decanoate ◽  
Potential Benefits ◽  
Selection For

AbstractTreatment of acute mania has been greatly influenced by loading strategies. Loading has potential benefits, including rapid symptom reduction in mania and a shortened length of stay. Disadvantages include an increased likelihood of adverse effects of the medications. Loading strategies for lithium, valproic acid (divalproex sodium), carbamazepine, oxcarbazepine, olanzapine, and haloperidol decanoate in the treatment of acute mania are discussed. Recent studies high-light this treatment option for selected patients. It is the unique properties of the medications that influence their use in loading. Issues in patient selection for loading strategies with each medication are also considered.

The Expanding Role of Antipsychotics

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S1) ◽  
pp. 7-12
Author(s):  
Philip G. Janicak
Keyword(s):  
Bipolar Disorder ◽  
Manic Episode ◽  
Acute Mania ◽  
Psychotic Symptoms ◽  
Primary Therapy ◽  
Obsessive Compulsive ◽  
Stabilizing Agent ◽  
Compulsive Disorder ◽  
Bipolar Patients

Antipsychotics have been utilized in the treatment of bipolar disorder for many decades and were the mainstay of treatment before lithium was reintroduced in the late 1960s. Today, many bipolar patients who present with psychotic features are misdiagnosed and prescribed an antipsychotic for another disorder. Estimates of psychotic symptoms in bipolar disorder, particularly during a manic episode, are ≥50% by clinical assessment and even higher by individual reports. Thus, antipsychotics are frequently used: as first treatment for psychosis not recognized as bipolar disorder, and as an adjunct to a mood-stabilizing agent in bipolars with psychotic symptoms.Most recently, antipsychotics have been examined for their mood-stabilizing properties as well (Slide 9). One may conceptualize using a selective serotonin reuptake inhibitor (SSRI) antidepressant for disorders such as panic disorder or obsessive-compulsive disorder, and using an antiepileptic as a mood-stabilizing agent; however, it is more difficult to accept that an agent approved for treatment of psychosis can be a primary therapy for bipolar disorder. Data from the monotherapy trials suggest that second-generation antipsychotics (SGAs) are at least as effective as lithium and valproic acid for acute mania. There is a very large database indicating that SGAs can be utilized as monotherapy for acute mania. However, there is limited data on the role of these agents in prevention of relapse and recurrence and in their efficacy for depression in the context of bipolar disorder. More studies will be needed to clarify whether SGAs should be used as monotherapy or whether they would be best used as augmenting agents in severe and psychotically manic or depressed patients.

Alternative treatment strategies for neuropathic pain: Role of Indian medicinal plants and compounds of plant origin-A review

2017 ◽  
Vol 92 ◽  
pp. 634-650 ◽  
Author(s):  
Hasandeep Singh ◽  
Sakshi Bhushan ◽  
Rohit Arora ◽  
Harpal Singh Buttar ◽  
Saroj Arora ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Medicinal Plants ◽  
Alternative Treatment ◽  
Treatment Strategies ◽  
Plant Origin ◽  
Indian Medicinal Plants

New Anticonvulsant Medication Uses in Bipolar Disorder

CNS Spectrums ◽  
2003 ◽  
Vol 8 (12) ◽  
pp. 930-947 ◽  
Author(s):  
Po W. Wang ◽  
Terence A. Ketter ◽  
Olga V. Becker ◽  
Cecylia Nowakowska
Keyword(s):  
Bipolar Disorder ◽  
Controlled Trial ◽  
Bipolar Disorders ◽  
The United States ◽  
Similar Efficacy ◽  
Acute Mania ◽  
Divalproex Sodium ◽  
Analgesic Effects ◽  
Anticonvulsant Medication ◽  
Clinical Profiles

ABSTRACTTherapy of bipolar disorders is a rapidly evolving field. Lithium has efficacy in classic bipolar disorders whereas divalproex sodium and carbamazepine may have broader spectrum efficacy that includes non-classic bipolar disorder. In the last 10 years, a series of anticonvulsants have been approved for marketing in the United States. Gabapentin has indirect γ-aminobuytric acid-ergic actions, is generally well tolerated, and appears to have anxiolytic, analgesic, and hypnotic effects. Lamotrigine has antiglutamatergic actions and is generally well tolerated (aside from rash in 1 in 10, and serious rash in 1 in 1,000 patients). Lamotrigine is indicated for maintance treatment in bipolar disorder. Emerging evidence suggests lamotrigine may have utility in bipolar disorder patients with depression and treatment-refractory rapid cycling, as well as analgesic effects. Topiramate and zonisamide may allow both weight loss, while topiramate may have specific efficacy in bulimia, binge eating disorder, and alcohol dependence. Two small studies found oxcarbazepine had similar efficacy to lithium and haloperidol in acute mania. Phenytoin, an older anticonvulsant, may have adjunctive acute mania efficacy. Levetiracetam, a newer anticonvulsant, may be worth exploring and has minimal drug-drug interactions. None of these newer agents has been shown effective in a large placebo controlled trial for acute mania. Although the clinical profiles of these newer anticonvulsants do not appear to overlap markedly with divalproex and carbamazepine (except perhaps for oxcarbazepine), these novel agents may still offer important new options in relieving a variety of specific target symptoms in patients with bipolar disorder.

The Use of Antiepileptic Drugs in Bipolar Disorders: A Review Based on Evidence From Controlled Trials

CNS Spectrums ◽  
2006 ◽  
Vol 11 (10) ◽  
pp. 788-799 ◽  
Author(s):  
Richard H. Weisler ◽  
Andrew J. Cutler ◽  
James C. Ballenger ◽  
Robert M. Post ◽  
Terence A. Ketter
Keyword(s):  
Bipolar Disorder ◽  
Mood Disorders ◽  
Antiepileptic Drugs ◽  
Bipolar Disorders ◽  
Acute Mania ◽  
Controlled Trials ◽  
Rapid Cycling ◽  
Comorbid Conditions ◽  
United States Food ◽  
States Food

ABSTRACTAntiepileptic drugs (AEDs) have diverse psychotropic profiles. Some AEDs have proven to be efficacious in the treatment of mood disorders, especially bipolar disorder. Others are ineffective as primary treatments but may be useful adjuncts for mood disorders or comorbid conditions. Valproate (acute mania and mixed episodes), carbamazepine (acute mania and mixed episodes), and lamotrigine (maintenance to delay recurrence) have United States Food and Drug Administration indications for the treatment of bipolar disorder. This article provides an overview of data on the use of AEDs in bipolar disorder, including acute mania and depression, prophylaxis, and rapid cycling.

scholarly journals Evaluation of the Role of ABCB1gene Polymorphic Variants on Psychiatric Disorders Predisposition in Macedonian Population

PRILOZI ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 71-88
Author(s):  
Zorica Naumovska ◽  
Aleksandra K. Nestorovska ◽  
Zoran Sterjev ◽  
Ana Filipce ◽  
Aleksandra Grozdanova ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Cell Activation ◽  
Bipolar Disorders ◽  
Control Group ◽  
Microglia Cell ◽  
Increased Risk ◽  
And Function

Abstract The psychiatric and other CNS disorders are characterized with unregulated neuro-inflammatory processes and chronic microglia cell activation resulting with detrimental effect. ABCB1gene polymorphismsC1236T, G2677T/Aand C3435T are associated with P-glycoprotein expression and function andare linked with predisposition to psychiatric disorders such as schizophrenia and bipolar disorders. The relationship between mood disorders and glucocorticoids has been confirmed and ABCB1 SNPs influence the glucocorticoids access to the brain. The aim of the study is evaluation of the influence of the three most common ABCB1SNPs on predisposition to psychiatric disorders in Macedonian population. In the study 107 unrelated healthy Macedonians of both sexes were enrolled as a control group and patient population of 54 patients (22 to 65 years old) diagnosed with schizophrenia or bipolar disorder. ABCB1 for three polymorphisms were analyzed by Real-Time PCR in both groups. The results have confirmed the role of the ABCB1 gene in predisposition to psychiatric disorders and increased risk of developing bipolar disorder in carriers of the heterozygotes and mutant homozygotes for polymorphic variations in 1236 and 2677 in comparison to the normal genotype carriers. Three-fold higher risk was estimated for psychiatric illness in women that are 1236 and 2677 heterozygous carrier (heterozygous and mutant homozygous) compared to healthy control (men and women) population and four-fold higher risk in comparison only to healthy women population. Mutant allele carriers for 1236 and 2677 polymorphisms that are 35 years and below in patients population have almost three-fold higher risk for development of psychiatric illness.

Psychosocial Approaches to the Treatment and Prevention of Bipolar Disorder

2016 ◽  
pp. 489-498
Author(s):  
Noreen A. Reilly-Harrington
Keyword(s):  
Bipolar Disorder ◽  
Behavioral Therapy ◽  
Treatment Strategies ◽  
Psychosocial Treatment ◽  
Future Research ◽  
Pediatric Bipolar Disorder ◽  
Treatment And Prevention ◽  
Social Rhythm ◽  
Psychosocial Approaches

Over the past two decades, adjunctive psychosocial treatments for bipolar disorder have been shown to hasten recovery, reduce relapse, and improve patients’ medication adherence, functioning, and quality of life. This chapter reviews four of the most widely studied psychosocial approaches for bipolar disorder: psychoeducation, cognitive-behavioral therapy (CBT), family-focused treatment (FFT), and interpersonal and social rhythm therapy (IPSRT). Core treatment strategies for each modality are presented, and key outcome studies are reviewed. The role of psychosocial treatment in pediatric bipolar disorder and in the prevention of bipolar disorder in youth at high risk for bipolar disorder is also presented. Suggestions for future research and the critical need for dissemination are also briefly discussed.

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