Pharmacotherapy of bipolar disorder: impact on neurocognition

2017 ◽  
Author(s):  
Vicent Balanzá-Martínez ◽  
Sofia Brissos ◽  
Maria Lacruz ◽  
Rafael Tabarés-Seisdedos
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Side Effects ◽  
Cognitive Deficits ◽  
Clinical Factors ◽  
Neurocognitive Dysfunction ◽  
Quality Research ◽  
Human Data ◽  
Core Feature ◽  
Potential Impact

Neurocognitive dysfunction is a core feature of bipolar disorder (BD), which may be further compounded by several clinical factors, such as medications. There is growing interest on the potential impact of pharmacotherapy (lithium, anticonvulsants, antipsychotics, and other) on neurocognition. This chapter summarizes a critical, descriptive update of the literature, mostly focused on human data. Based on current studies, medication-associated neurocognitive side effects cannot be clearly distinguished from those intrinsic to BD. Moreover, available research is limited by several methodological flaws. We suggest some likely profitable directions to move the field forward, as well as several recommendations to manage cognitive deficits in clinical practice. The neurocognitive impact of medications used to treat BD clearly warrants further, higher-quality research.

scholarly journals Lithium, an old friend and a forgotten enemy

2020 ◽  
Vol 66 (12) ◽  
pp. 1625-1627
Author(s):  
Cátia Figueiredo ◽  
Joana Lemos
Keyword(s):  
Bipolar Disorder ◽  
Clinical Practice ◽  
Side Effects ◽  
Nephrogenic Diabetes Insipidus ◽  
Urine Osmolality ◽  
Organ Damage ◽  
Daily Basis ◽  
Case Description ◽  
Clinical Recovery ◽  
The Past

SUMMARY INTRODUCTION: Nephrogenic diabetes insipidus (DI) is a polyuric and polydipsic syndrome and can have multiple causing factors. CASE DESCRIPTION: A 69-year-old woman with bipolar disorder medicated with lithium 400mg for 12 years on a daily basis. The patient was admitted, after psychiatric decompensation, with hypernatremia unresponsive to hypotonic iv fluids. The diagnosis of DI was made with high plasmatic osmolality measurement, low urine osmolality, and high levels of antidiuretic hormone. Full clinical recovery was possible with lithium suspension, hydration, and chlorthalidone. DISCUSSION: Although frequently used in the past, Lithium (Li) is nowadays rarely used in clinical practice for prolonged treatments because of its potentially devastating side effects. Clinicians must be aware of those side effects in order to prevent organ damage, mainly in patients with severe bipolar disease and precarious response to alternative treatments.

Lithium and carbamazepine in bipolar disorder

2000 ◽  
Vol 12 (3) ◽  
pp. 120-121 ◽  
Author(s):  
P. Moleman ◽  
E.G.Th.M. Hartong ◽  
C.A.L. Hoogduin ◽  
T.G. Broekman ◽  
W.A. Nolen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Side Effects ◽  
Alternative Treatments ◽  
First Choice

AbstractLithium is considered first choice in the prevention of prospective episodes in patients with bipolar disorder. However, efficacy is not satisfactory in all patients and side effects sometimes prevent the use of lithium. It is argued that efficacy in clinical practice may be less impressive than anticipated from clinical trials, and alternative treatments are beinu advocated increasingly for that reason, such as the anticonvulsants, carbamazepine and valproate.

scholarly journals Conducting clinical studies targeting cognition in psychiatry: guiding principles and design

CNS Spectrums ◽  
2018 ◽  
Vol 24 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Tamsyn E. Van Rheenen ◽  
Kathryn E. Lewandowski ◽  
Jessica M. Lipschitz ◽  
Katherine E. Burdick
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Deficits ◽  
Trial Design ◽  
Functional Disability ◽  
Standard Of Care ◽  
Consensus Guidelines ◽  
Major Depressive ◽  
Core Feature ◽  
Important Symptom

Cognitive dysfunction is common in many psychiatric disorders. While it has long been described as a core feature in schizophrenia, more recent data suggest qualitatively similar impairments in patients with bipolar disorder and major depressive disorder. There is compelling evidence to suggest that cognitive impairment contributes directly to functional disability and reduced quality of like across these disorders. As current treatments focus heavily on “primary” symptoms of mood and psychosis, the standard of care typically leaves cognitive deficits unmanaged. With this in mind, the field has recently begun to consider intervening directly on this important symptom domain, with several ongoing trials in schizophrenia. Fewer studies have targeted cognition in bipolar disorder and still fewer in MDD. With progress toward considering this domain as a target for treatment comes the need for consensus guidelines and methodological recommendations on cognitive trial design. In this manuscript, we first summarize the work conducted to date in this area for schizophrenia and for bipolar disorder. We then begin to address these same issues in MDD and emphasize the need for additional work in this area.

Recent Advances in the Rational Drug Design Based on Multi-target Ligands

2020 ◽  
Vol 27 (28) ◽  
pp. 4720-4740 ◽  
Author(s):  
Ting Yang ◽  
Xin Sui ◽  
Bing Yu ◽  
Youqing Shen ◽  
Hailin Cong
Keyword(s):  
Drug Resistance ◽  
Clinical Practice ◽  
Side Effects ◽  
Drug Design ◽  
Rational Drug Design ◽  
Health Conditions ◽  
Pharmacokinetic Parameters ◽  
Single Target ◽  
Rational Drug ◽  
Huge Challenge

Multi-target drugs have gained considerable attention in the last decade owing to their advantages in the treatment of complex diseases and health conditions linked to drug resistance. Single-target drugs, although highly selective, may not necessarily have better efficacy or fewer side effects. Therefore, more attention is being paid to developing drugs that work on multiple targets at the same time, but developing such drugs is a huge challenge for medicinal chemists. Each target must have sufficient activity and have sufficiently characterized pharmacokinetic parameters. Multi-target drugs, which have long been known and effectively used in clinical practice, are briefly discussed in the present article. In addition, in this review, we will discuss the possible applications of multi-target ligands to guide the repositioning of prospective drugs.

Development of a brief questionnaire (ICQ-S) to monitor inhaled corticosteroid side-effects in clinical practice

Allergy ◽  
2014 ◽  
Vol 69 (3) ◽  
pp. 372-379 ◽  
Author(s):  
J. M. Foster ◽  
S. Schokker ◽  
R. Sanderman ◽  
D. S. Postma ◽  
T. van der Molen
Keyword(s):  
Clinical Practice ◽  
Side Effects ◽  
Inhaled Corticosteroid

scholarly journals Cognitive behaviour therapy meets psychopharmacotherapy

2010 ◽  
Vol 3 (4) ◽  
pp. 117-131
Author(s):  
David Veale ◽  
Anna Stout
Keyword(s):  
Bipolar Disorder ◽  
Side Effects ◽  
Emotional Disorders ◽  
Cognitive Behaviour Therapy ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Underlying Disorder

AbstractThis article provides an overview of the role of psychopharmacotherapy in common emotional disorders for cognitive behaviour therapists. We consider some of the philosophical difference between CBT and medication, when medication might interfere with CBT, when it may enhance outcome and when it might be safely discontinued. We highlight how to differentiate side-effects and symptoms of discontinuation of antidepressants from that of the underlying disorder. The scope of this article is confined to common emotional disorders and does not discuss the interaction of CBT with medication in, e.g. schizophrenia, bipolar disorder or dementia.

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