Low Dose Risperidone Every 3.8 Hours: Superior Efficacy In Treatment of Bipolar Disorders

Mapping Intimacies ◽

10.21203/rs.3.rs-996418/v1 ◽

2021 ◽

Author(s):

Robert W. Townsend

Keyword(s):

Bipolar Disorder ◽

Failure Rate ◽

Low Dose ◽

Plasma Concentrations ◽

Neural Activation ◽

Low Doses ◽

Therapeutic Benefits ◽

Superior Efficacy ◽

Disorder Treatment ◽

Bipolar Patients

Abstract Background: This paper presents a previously unpublished Bipolar Disorder treatment using low-dose Risperidone that gives superior-efficacy, prevents overmedication, and prevents medication-induced anxiety and irritability. Standardized other Bipolar Disorder treatments have a failure rate of 82% to 87.1%. When dropouts and poor adherence are combined, only 12.9% to 18% of Bipolar patients adhere to medications within three years. Self-defensive providers primarily blame Bipolar patients for treatment failures. When that bias is removed, failure is due to overmedication and anxiety and irritability caused by medications. This paper shows the neurobiochemical processes that cause those problems. Published prescription-guidelines recommend Risperidone in high amounts that intentionally activate its 9-Hydroxyrisperidone metabolite under auspices that it is virtually the same as Risperidone and lasts for 24 hours. In truth, however, the beneficial Risperidone chemical lasts for four hours and 9-Hydroxyrisperidone agonizes Bipolar-toxic Serotonin. Low-dose Risperidone neutralizes 9-Hydroxyrisperidone.Methods: Low doses of Risperidone were calculated to be therapeutic amounts without causing overmedication, anxiety, and irritability. Doses were calculated to metabolize low plasma concentrations of 9-Hydroxyrisperidone that stay below the neural-activation threshold level. Four-hour-duration low doses of Risperidone were administered every 3.8 hours.Results: 3.8-hour dosing sustained steady benefits by overlapping 15-minute efficacy-onset with the 15-minute termination of each previous dose. Steady transitions between doses and five administrations per day gave therapeutic efficacy for 16 hours. Taking dose #5 at bedtime gave improved sleep.Conclusions: Low doses of Risperidone activate its therapeutic benefits while neutralizing Bipolar-toxic Paliperidone. Low-dose Risperidone every 3.8 hours maintains stability with room for adding occasional extra doses to control exacerbations of symptoms. This study provides a new biochemistry-based Bipolar Disorder treatment that is vitally needed because the failure rate of traditional treatments is too high. Traditional treatments and research are guided by commercial drug manufacturers’ recommendations and data. Traditional treatment dropout and non-adherence rates attest to the immediate need for this paper’s new paradigm of analytic neurobiochemistry.

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The two faces of the blade: Stigmatization and internalized stigmatization

European Psychiatry ◽

10.1016/s0924-9338(11)71905-8 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 195-195

Author(s):

M.O. Cam ◽

D. Cuhadar

Keyword(s):

Bipolar Disorder ◽

Psychiatric Treatment ◽

Self Esteem ◽

The Past ◽

People With Mental Illness ◽

The People ◽

Disorder Treatment ◽

Bipolar Patients ◽

Married Female ◽

Stigma Experiences

Stigmatization is a serious problem that felt by 54.6% of bipolar patients. The most dramatic deterministic about attidues of bipolar patients towards their illness is decreased self esteem that occur result of illness. Stigma and internalized stigma experiences of a patient with bipolar disorder will be transferred in this case report.Case31 years old, married, female patient. She is having bipolar disorder treatment for three years. About her diseases she said that “ıt is the worst illness among all of the illness, because mind is the organizatör of the human body, if you loss your mind you can not move your hand or arm”.About public stigma she told that “people afraid because of harming by us, when they see us on street they enter their home, they don’t give permission to touch their child and run away from us. My brothers wife saying me afraid from me and don’t want to be alone with me.” Also patient said that “I’m not having a talk with my neighbour because I feel they won’t take seriously me. I stayed in hospital for 28 day because illness after discharged I didn’t told anyone about staying in psychiatry clinic. In the past I done eveything but now I’m doing nothing. I feel all of the weight of the world on me. I feel myself weak both as physical and mental”ConclusionStigmatized people believe that others will devalue and reject the people with mental illness and experiencing negative outcomes such as demoralization, decreased self esteem, impaired social adaptaion, unemployment, decreased psychiatric treatment adherence.

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Psychoeducation in Bipolar Disorder: A Clinical Perspective

European Psychiatry ◽

10.1016/s0924-9338(09)70835-1 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

L.C. Castro ◽

T. Rodrigues ◽

J. Pereira ◽

I. Coelho ◽

H. Maia ◽

...

Keyword(s):

Bipolar Disorder ◽

Bipolar Disorders ◽

Psychosocial Interventions ◽

Clinical Perspective ◽

Prodromal Symptoms ◽

Disorder Treatment ◽

Bipolar Patients ◽

The Impact ◽

Relapse Rates

Background:Bipolar disorder is a chronic, recurrent and debilitating mood disorder with a major impact on several aspects of everyday life. Although pharmacotherapy plays a central role in bipolar disorder treatment, psychosocial interventions are essential to a more complete and successful treatment.Aims:To present a psychoeducation program for bipolar patients runned in a Portuguese psychiatric hospital - Hospital de Magalhães Lemos, Oporto. To review the impact of psychoeducative measures on bipolar patients.Methods:A psychoeducative program for bipolar patients was developed and adapted, based on the Barcelona Bipolar Disorders Program"s experience. The psychoeducative program was applied to bipolar patients as an adjuvant of maintenance treatment.Results:Fifteen sessions were runned during 15 weeks. Twelve patients were recruited to integrate the psychoeducative group. The sessions addressed several topics including information about the illness, early detection of prodromal symptoms and symptoms management, stress management and the importance of maintaining routines.Conclusions:The best treatment available for patients with bipolar disorder includes, along with the pharmacological treatment, psychosocial interventions aimed to target issues as early identification of prodromal symptoms, coping skills, medication adherence and understanding of the disorder. This broader approach of bipolar disorder treatment has proved to be efficient in reducing relapse rates, and improving patients’ feelings of self-efficacy and quality of life.

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Pharmacologic Treatment of Bipolar Disorder

CNS Spectrums ◽

10.1017/s1092852900027772 ◽

2010 ◽

Vol 15 (S3) ◽

pp. 10-13 ◽

Cited By ~ 1

Author(s):

Claudia Baldassano

Keyword(s):

Bipolar Disorder ◽

Bipolar Depression ◽

Mood Stabilizers ◽

Controlled Trials ◽

United States Food ◽

Mortality Ratio ◽

States Food ◽

Disorder Treatment ◽

Standardized Mortality Ratios ◽

Bipolar Patients

Regarding the treatment of patients with bipolar disorder, positive findings have shown that patients engaged in treatment may live longer. Angst and Sellaro studied standardized mortality ratios for patients with bipolar disorder and found a significant reduction in mortality ratio in our bipolar patients who were actively in treatment (Slide 1). Data from the Collaborative Depression Study by Judd and colleagues showed that bipolar patients are quite symptomatic. Judd and colleagues followed bipolar patients over a 13-year period and found that these patients were symptomatic ~50% of the study period. What were these patients most likely to be symptomatic with: bipolar depression (Slide 2). Thus, it is important to focus on bipolar depression and examine placebo-controlled trials that were adequately powered in its treatment.Over the last decade, there have been positive trials studying lamotrigine, quetiapine, olanzapine, and olanzapine-fluoxetine combination. Two of these medications are United States Food and Drug Administration—approved in bipolar disorder treatment: quetiapine and olanzapine-fluoxetine. There are a number of negative trials in bipolar depression, including a number of antidepressant monotherapy trials and antidepressants in combination with mood stabilizers (Slide 3). However, what is the most frequent pharmacotherapy treatment used for bipolar depression? It is the use of antidepressants alone; antidepressant monotherapy is twice as commonly prescribed as mood stabilizers (Slide 4). Thus, it is necessary for clinicians to possess knowledge of the evidence and results from both positive and negative antidepressant trials for bipolar disorder.

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Pharmacokinetics, tolerability and cycle control of three transdermal contraceptive delivery systems containing different doses of ethinylestradiol and levonorgestrel

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci.2011.004 ◽

2011 ◽

Vol 6 (2) ◽

Cited By ~ 2

Author(s):

Frank Z. Stanczyk ◽

Arkady Rubin ◽

Lisa Flood ◽

Marie Foegh

Keyword(s):

Randomized Trials ◽

Low Dose ◽

Phase 1 ◽

Plasma Concentrations ◽

Delivery Systems ◽

Low Doses ◽

Plasma Drug ◽

Open Label ◽

Phase 3 ◽

Different Doses

AbstractThe only available contraceptive patch, Ortho EvraThree transdermal contraceptive delivery systems (TCDS) containing low doses of ethinylestradiol (EE) and levonorgestrel (LNG) were evaluated in two open-label randomized trials. In a phase 1, two-period, cross-over trial, AG200-12.5 and AG200LE were compared with a 150 μg LNG/30 μg EE oral contraceptive (OC) (LevlenIn Study 1, mean steady-state plasma concentrations (All three patches exhibited excellent safety and wearability profiles while maintaining plasma drug levels required for ovulation suppression and adequate cycle control. A slight increase in the EE dose in AG200-15 still places this TCDS within the range of low-dose OCs, with EE exposure much lower than reported for Ortho Evra. AG200-15 was selected for further testing in phase 3 studies.

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Subjective experience of bipolar disorder, treatment adherence and stigma

PsycEXTRA Dataset ◽

10.1037/e500392011-007 ◽

2009 ◽

Author(s):

Martha Sajatovic ◽

William J. Meyer ◽

Douglas Smith ◽

Elizabeth Singer ◽

Kristin A. Cassidy ◽

...

Keyword(s):

Bipolar Disorder ◽

Treatment Adherence ◽

Subjective Experience ◽

Disorder Treatment

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AB1335-HPR HEALTH PROFESSIONALS’ PERSPECTIVE ON THE BENEFITS AND RISKS OF LOW-DOSE GLUCOCORTICOIDS IN RHEUMATOID ARTHRITIS – AN INTERNATIONAL SURVEY OF 444 HEALTH PROFESSIONALS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3277 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1955.1-1956

Author(s):

T. Santiago ◽

M. Voshaar ◽

M. De Wit ◽

P. Carvalho ◽

M. Boers ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Adverse Events ◽

Health Professionals ◽

Patient Perspective ◽

Online Survey ◽

Low Dose ◽

Low Doses ◽

Research Support ◽

Serious Adverse Events ◽

Patient Organizations

Background:The Glucocorticoid Low-dose Outcome in Rheumatoid Arthritis Study (GLORIA) is an international investigator-initiated pragmatic randomized trial designed to study the effects of low-dose glucocorticoids (GCs) in elderly patients with Rheumatoid Arthritis (RA).The research team is also committed to promote a better understanding of the risks and benefits of these drugs among health professionals and patients. In order to achieve these goals, it is important to assess the current ideas and concerns of patients regarding GCs.Objectives:To evaluate the current patient perspective on the efficacy and risks of GCs in RA patients who are or have been treated with GCs.Methods:Patients with RA completed an online survey (with 5 closed questions regarding efficacy and safety) presented in their native language. RA patients were recruited through a variety of patient organizations representing three continents. Patients were invited to participate through national patient organizations. In the USA, patients were also invited to participate through MediGuard.org. Participants were asked for their level of agreement on a 5-point Likert scale.Results:1344 RA patients with exposure to GCs, from Brazil, USA, UK, Portugal, Netherlands, Germany and 24 other countries** participated: 89% female, mean age (SD) 52 (14) years and mean disease duration 13 (11) years. The majority of participants (84%) had ≥10 years of education. The duration of GCs exposure was 1.6 (4.2) years. The majority of participants had read articles or pamphlets on the benefits or harms of GC therapy.Regarding GCs efficacy (table 1), high levels of endorsement were found: about 2/3 of patients considered that GCs as very useful in their case, more than half considered that GCs were effective even at low doses, and agreed that GC improved RA symptoms within days.Regarding safety (table 1), 1/3 of the participants reported having suffered some form of serious adverse events (AEs) due to GCs, and 9% perceived this as “life-threatening. Adverse events had a serious impact on quality of life, according to about 1/3 of the respondents.Conclusion:Patients with RA exposed to GC report a strong conviction that GCs are very useful and effective for the treatment of their RA, even at low doses. This is accompanied by an important prevalence of serious AEs. Understanding the patient perspective can improve shared decision-making between patient and rheumatologist.Funding statement:This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 634886.Disclosure of Interests:Tânia Santiago: None declared, Marieke Voshaar Grant/research support from: part of phd research, Speakers bureau: conducting a workshop (Pfizer), Maarten de Wit Grant/research support from: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Consultant of: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Speakers bureau: Dr. de Wit reports personal fees from Ely Lilly, 2019, personal fees from Celgene, 2019, personal fees from Pfizer, 2019, personal fees from Janssen-Cilag, 2017, outside the submitted work., Pedro Carvalho: None declared, Maarten Boers: None declared, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha, Frank Buttgereit Grant/research support from: Amgen, BMS, Celgene, Generic Assays, GSK, Hexal, Horizon, Lilly, medac, Mundipharma, Novartis, Pfizer, Roche, and Sanofi., José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis

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Patients’ adherence to smartphone apps in the management of bipolar disorder: a systematic review

International Journal of Bipolar Disorders ◽

10.1186/s40345-021-00224-6 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Marie-Camille Patoz ◽

Diego Hidalgo-Mazzei ◽

Bruno Pereira ◽

Olivier Blanc ◽

Ingrid de Chazeron ◽

...

Keyword(s):

Systematic Review ◽

Bipolar Disorder ◽

Mobile Health ◽

Smartphone Apps ◽

Exclusion Criteria ◽

Future Studies ◽

Health Apps ◽

Definition Of ◽

Bipolar Patients ◽

Digital Or

Abstract Background Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies. Methods A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: "bipolar disorder" or "mood disorder" or “bipolar” combined with “digital” or “mobile” or “phone” or “smartphone” or “mHealth” or “ehealth” or "mobile health" or “app” or “mobile-health”. Results Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%. Conclusion The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools.

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Response Processes to Looming Appetitive and Aversive Cues in Euthymic Bipolar Patients and Their First-Degree Relatives: An Exploratory Study

Indian Journal of Psychological Medicine ◽

10.1177/0253717620975285 ◽

2020 ◽

pp. 025371762097528

Author(s):

Velprashanth Venkatesan ◽

Christoday R J Khess ◽

Umesh Shreekantiah ◽

Nishant Goyal ◽

K. K. Kshitiz

Keyword(s):

Bipolar Disorder ◽

Healthy Controls ◽

Sensitivity To Reward ◽

Bipolar Group ◽

First Degree Relatives ◽

Vulnerability Model ◽

Increased Sensitivity ◽

Appetitive Cues ◽

Spectrum Disorders ◽

Bipolar Patients

Background: Patients with bipolar disorder demonstrate increased sensitivity to appetitive/rewarding stimuli even during euthymia. On presentation of arousing pictures, they show a peculiar response, suggesting heightened vigilance. While responding to looming arousing cues, studies show subjects with anxiety spectrum disorders exhibit increased reaction time (RT), explained by the “looming-vulnerability model.” This study aimed to investigate the responses to looming arousing cues in euthymic bipolar patients and their first-degree relatives, as compared to healthy controls. Method: A looming appetitive and aversive cue paradigm was designed for assessing the RT of patients to process appetitive and aversive cues. The behavioral inhibition/activation and sensitivity to reward/punishment amongst the groups were also assessed. Results: The bipolar group showed significantly longer RT to process appetitive cues irrespective of the looming condition. Aversive cues elicited significantly longer RT in both the bipolar group and in first-degree relatives, but only when presented with the looming condition. Significant looming bias was elicited in the bipolar group which suggested a particular cognitive style to looming cues. A composite measure of RT along with sensitivity to reward/punishment distinguishes the bipolar group and their first-degree relatives from the healthy controls. Conclusion: The looming vulnerability model may provide important insights for future exploration of cognitive endophenotypes in bipolar disorder.

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