scholarly journals Thyroid Functions and Bipolar Affective Disorder

2011 ◽  
Vol 2011 ◽  
pp. 1-13 ◽  
Author(s):  
Subho Chakrabarti
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Clinical Course ◽  
Lithium Treatment ◽  
Bipolar Affective Disorder ◽  
High Dose ◽  
Careful Monitoring ◽  
Genetic Studies ◽  
Treatment Refractory ◽  
Hpt Axis

Accumulating evidence suggests that hypothalamo-pituitary-thyroid (HPT) axis dysfunction is relevant to the pathophysiology and clinical course of bipolar affective disorder. Hypothyroidism, either overt or more commonly subclinical, appears to the commonest abnormality found in bipolar disorder. The prevalence of thyroid dysfunction is also likely to be greater among patients with rapid cycling and other refractory forms of the disorder. Lithium-treatment has potent antithyroid effects and can induce hypothyroidism or exacerbate a preexisting hypothyroid state. Even minor perturbations of the HPT axis may affect the outcome of bipolar disorder, necessitating careful monitoring of thyroid functions of patients on treatment. Supplementation with high dose thyroxine can be considered in some patients with treatment-refractory bipolar disorder. Neurotransmitter, neuroimaging, and genetic studies have begun to provide clues, which could lead to an improved understanding of the thyroid-bipolar disorder connection, and more optimal ways of managing this potentially disabling condition.

Mania with Bupropion: A Dose-Related Phenomenon?

2000 ◽  
Vol 34 (5) ◽  
pp. 619-621 ◽  
Author(s):  
Jessica L Goren ◽  
Gary M Levin
Keyword(s):  
Affective Disorder ◽  
Bipolar Depression ◽  
Bipolar Affective Disorder ◽  
Antidepressant Drug ◽  
Manic Episode ◽  
Total Daily Dose ◽  
High Dose ◽  
Related Phenomenon ◽  
Increased Risk ◽  
Daily Dose

OBJECTIVE: To report a case in which bipolar depression was resistant to usual therapies, requiring dosages of bupropion >450 mg/d and to review the literature on mania associated with bupropion and propose a potential theory of a dose-related threshold associated with bupropion and mania. CASE SUMMARY: A 44-year-old white man with a 25-year history of bipolar affective disorder presented with depression resistant to usual therapies. Bupropion therapy was initiated and the dosage was titrated to 600 mg/d. After exceeding the maximum recommended daily dose (450 mg/d), he experienced a manic episode attrib uted to high-dose bupropion. DISCUSSION: Due to increased risk of seizures, current prescribing guidelines state that the total daily dose of bupropion is not to exceed 450 mg/d. Since bupropion is the agent least likely to cause a manic switch in bipolar disorder, this agent seemed a logical choice to treat the patient's depression. Due to a lack of response, the bupropion dosage was titrated to a maximum of 600 mg/d. Since the patient did not switch into mania until the dosage exceeded 450 mg/d, we speculate that this adverse reaction is a dose-related phenomenon. Scientific literature supports this theory. CONCLUSIONS: A switch into mania is a potential risk associated with antidepressant drug use in bipolar affective disorder. Bupropion is believed to be associated with a decreased risk compared with other antidepressant therapies. However, our case report as well as others support the theory that this decreased risk may be due to dosages not exceeding the recommended daily dose (450 mg/d). Doses of bupropion >450 mg/d should be used with caution in depressed patients with bipolar affective disorder.

scholarly journals Neurocysticercosis presenting as bipolar disorder: a case report

2021 ◽  
Vol 34 (6) ◽  
pp. e100663
Author(s):  
Surbhi Batra ◽  
Sumit Kumar ◽  
Lokesh Singh Shekhawat
Keyword(s):  
Bipolar Disorder ◽  
Case Report ◽  
Depressive Symptoms ◽  
Affective Disorder ◽  
Postpartum Period ◽  
Bipolar Affective Disorder ◽  
Taenia Solium ◽  
Manic Episode ◽  
Symptoms And Signs ◽  
Rule Out

Neurocysticercosis is the most common neuro-parasitosis caused by the larval stage of Taenia solium. The most common manifestations include seizures and hydrocephalus. Psychiatric abnormalities are relatively rare but depressive symptoms are frequent in patients with neurocysticercosis. However, mania as a presentation is relatively rare. Pregnancy and the postpartum period are relatively vulnerable times and they can lead to reactivation of existing neurocysterci lesions. We are discussing the case of a 23-year-old female patient with neurocysticercosis leading to the reactivation of lesions in the peripartum and postpartum period leading to bipolar affective disorder. Improvement in the patient was seen with a combination of antipsychotics, antihelmintics, antiepileptics and steroids, along with improved radiological signs of neurocysterci lesions. Although neurocysticercosis is a common illness, its prevalence presenting as a manic episode is merely 2.6% and, hence, missed easily. Therefore, it is important to rule out organic aetiology in patients even with a classic presentation of bipolar affective disorder and those having any other neurological symptoms and signs.

Depot Antipsychotics in the Prophylaxis of Bipolar Affective Disorder

1994 ◽  
Vol 165 (6) ◽  
pp. 827-829 ◽  
Author(s):  
R. Littlejohn ◽  
F. Leslie ◽  
J. Cookson
Keyword(s):  
Bipolar Disorder ◽  
British Journal ◽  
Affective Disorder ◽  
Antipsychotic Drugs ◽  
Prophylactic Treatment ◽  
Bipolar Affective Disorder ◽  
Manic Depressive ◽  
Depot Antipsychotic ◽  
Depot Antipsychotics ◽  
Depot Medication

BackgroundThe efficacy of depot antipsychotic drugs in the prophylaxis of bipolar affective disorder was investigated.MethodLife charts were constructed for 18 outpatients with bipolar disorder receiving prophylactic treatment with depot medication. The durations of affective episodes were compared during periods on or off medication.ResultsThe subjects suffered fewer relapses and spent significantly less time in hospital (P = 0.001) for treatment of manic, depressive and mixed affective illness during treatment with depot antipsychotics.ConclusionsDepot antipsychotic medication may be a useful prophylactic treatment for certain patients with bipolar affective disorder.British Journal of Psychiatry (1994), 165, 827–829

Cognitive impairment, clinical course and treatment history in out-patients with bipolar affective disorder: relationship to tardive dyskinesia

1989 ◽  
Vol 19 (4) ◽  
pp. 897-902 ◽  
Author(s):  
John L. Waddington ◽  
Katherine Brown ◽  
Jane O'Neill ◽  
Patrick McKeon ◽  
Anthony Kinsella
Keyword(s):  
Tardive Dyskinesia ◽  
Affective Disorder ◽  
Cognitive Flexibility ◽  
Clinical Course ◽  
Bipolar Affective Disorder ◽  
Involuntary Movements ◽  
Impaired Performance ◽  
Treatment History ◽  
Individual Vulnerability ◽  
History Of

SYNOPSISClinical, neuropsychological and psychopharmacological characteristics were investigated for their ability to distinguish individuals with and without involuntary movements (tardive dyskinesia), among a population of 40 out-patients with bipolar affective disorder and a history of exposure to neuroleptics and lithium. Impaired performance on a test of cognitive flexibility bore the primary association with both the presence and the severity of involuntary movements. The additional relationships identified emphasized further that individual vulnerability to involuntary movements appeared to be associated not with greater duration or dosage of treatment, but with features of the bipolar illness, including number and type of affective episodes, for which that treatment was prescribed.

Bipolar affective disorder

2017 ◽  
Author(s):  
Tom Burns ◽  
Mike Firn
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Therapeutic Relationship ◽  
Bipolar Affective Disorder ◽  
Psychosocial Interventions ◽  
Mood Stabilizers ◽  
Psychotic Illness ◽  
Early Admission ◽  
Outreach Workers

This chapter deals with the other major psychotic illness, bipolar affective disorder. Bipolar disorder poses a difficult question for outreach workers, as patients are often well recovered between episodes—so should persisting outreach be provided? We report very good results in severe bipolar disorder where continuity of care has paid off. The chapter also deals with theories of causation and classification. The section on treatment identifies the importance of early admission in hypomania, the use of mood stabilizers, and the value of identifying and agreeing on relapse signatures. It also confirms the value of working hard to strengthen the therapeutic relationship and of psychosocial interventions such as psycho-education. Long-term work with these patients brings home just how persistent and disabling the depressive phases can be.

scholarly journals Impulsivity as a Clinical Marker for Bipolar Affective Disorder

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Omar ◽  
A N Elbatrawy ◽  
W M Sabry ◽  
H A Elkholy ◽  
W A Farrag
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Behavioral Problems ◽  
Psychosocial Functioning ◽  
Bipolar Affective Disorder ◽  
Bipolar Disorders ◽  
First Degree Relatives ◽  
Adult Psychiatry ◽  
Healthy Functioning ◽  
Substantial Morbidity

Abstract Background Bipolar disorder is one of the world’s 10 most disabling conditions, taking away years of healthy functioning from individuals, all bipolar disorders are chronically recurring illnesses associated with substantial morbidity and mortality. Impulsivity considered an integral part of bipolar disorder. Operationalized as a predisposition to action without reflection or regard for consequences. Potential consequences of this increased impulsivity include substance abuse, suicidal attempts, and other serious behavioral problems. Aim of the Study The aim of the current study was to measure impulsivity in both BD euthymic patients and in healthy first-degree relatives of BD patients. And to assess the functional implications of impulsiveness, on psychosocial functioning and in bipolar disorder patients, their first-degree relatives. Patients and Methods A convenient sample of 50 patients; diagnosed with bipolar affective disorder according to DSM-IV diagnostic criteria were selected from the general adult psychiatry clinics and a convenient sample of 50 healthy first degree relatives of BD patients. Results We concluded by the end of this study that both cases and relatives have high overall impulsivity, and cases have higher impulsivity in comparison to relatives. Conclusion We suggest that impulsivity may be a potentially valuable candidate endophenotype for bipolar disorder.

scholarly journals Uncovering neurodevelopmental features in bipolar affective disorder

2019 ◽  
Vol 215 (01) ◽  
pp. 383-385 ◽  
Author(s):  
Isabel Valli ◽  
Chiara Fabbri ◽  
Allan H. Young
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Clinical Features ◽  
Neurodevelopmental Disorder ◽  
Bipolar Affective Disorder ◽  
Cognitive Profiles ◽  
Potential Utility ◽  
Cluster Analytic

SummarySchizophrenia and bipolar disorder are genetically related and their clinical features overlap. Schizophrenia is conceptualised as a neurodevelopmental disorder but the evidence for bipolar disorder is less clear. Cluster-analytic approaches reveal different cognitive profiles within bipolar disorder, possibly reflective of differing neurodevelopmental loads, which are also suggested by recent genetic and neuroimaging studies. Such studies suggest the potential utility of further clinical subcategories in bipolar disorder based on neurodevelopmental load.Declaration of interestNone.

scholarly journals Incidence of bipolar affective disorder in three UK cities

2005 ◽  
Vol 186 (2) ◽  
pp. 126-131 ◽  
Author(s):  
Tuhina Lloyd ◽  
Noel Kennedy ◽  
Paul Fearon ◽  
James Kirkbride ◽  
Rosemarie Mallett ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Ethnic Groups ◽  
Bipolar Affective Disorder ◽  
Incidence Rates ◽  
First Episode ◽  
Minority Ethnic Groups ◽  
Incidence Studies ◽  
Significant Difference ◽  
Minority Ethnic

BackgroundThere has been a relative dearth of epidemiological research into bipolar affective disorder. Furthermore, incidence studies of bipolar disorder have been predominantly retrospective and most only included hospital admission cases.AimsTo determine the incidence of operationally defined bipolar disorder in three areas of the UK and to investigate any differences in gender and ethnicity.MethodAll patients who contacted mental health services with first-episode psychosis or non-psychotic mania between September 1997 and August 1999 were identified and diagnosed according to ICD–10 criteria. Incidence rates of bipolar affective disorder were standardised for age and stratified by gender and ethnic group across the three areas.ResultsThe incidence rate per 100 000 per year in south-east London was over twice that in Nottingham and Bristol. There was no significant difference in the rates of disorder in men and women. Incidence rates of bipolar disorder in the combined Black and minority ethnic groups in all three areas were significantly higher than those of the comparison White groups.ConclusionsThe incidence of bipolar disorder was higher in south-east London than in the other two areas, and was higher among Black and minority ethnic groups than in the White population.

Multisystem Atrophy Made Worse by Lithium Treatment in a Hospice Patient

2012 ◽  
Vol 29 (7) ◽  
pp. 570-573 ◽  
Author(s):  
Ellen Babinsky ◽  
Richard S. Levene
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Clinical Course ◽  
Lithium Treatment ◽  
Unknown Etiology ◽  
Lithium Toxicity ◽  
Adult Onset ◽  
Presenting Symptoms ◽  
Multisystem Atrophy ◽  
Hospice Patient

Multisystem atrophy is a neurologic condition defined as an adult-onset, progressive, neurodegenerative disease of unknown etiology. It carries a multisystem clinical course, including autonomic, urogenital, cerebellar, and parkinsonian features. Lithium toxicity, classically manifesting as increased thirst, polyuria, gastric distress, weight gain, tremor, fatigue, and mild cognitive impairment, can present in a similar manner. 1 We would like to present a patient diagnosed with progressive neurologic features typical of multisystem atrophy that also had bipolar disorder and had been taking lithium for many years. Despite normal lithium levels, it appeared as though a subclinical lithium toxicity was manifesting in the patient, and once lithium was discontinued, the patient was discharged from hospice with significant improvement in his presenting symptoms.

Cytogenetic abnormalities on chromosome 18 associated with bipolar affective disorder or schizophrenia

1997 ◽  
Vol 170 (3) ◽  
pp. 278-280 ◽  
Author(s):  
Ole Mors ◽  
Henrik Ewald ◽  
Douglas Blackwood ◽  
Walter Muir
Keyword(s):  
Bipolar Disorder ◽  
Affective Disorder ◽  
Human Genetics ◽  
Bipolar Affective Disorder ◽  
Chromosome Abnormalities ◽  
Cross Linking ◽  
Chromosome 18 ◽  
Karyotype Abnormality

BackgroundA few recent linkage studies have shown a possible locus for bipolar disorder on chromosome 18. Cytogenetic studies may assist in the further localisation of susceptibility loci on this chromosome.MethodA search was made for abnormalities of chromosome 18 in two separate large cytogenetic databases. In Denmark detection of mental illness in subjects with chromosome abnormalities was done by cross-linking the two separate register of psychiatric and chromosome disorders. In Scotland the Cytogenetic Registry of the MRC Human Genetics Unit undertakes long-term clinical follow-up of all cases with chromosome abnormalities.ResultsCross-linking the two Danish register's revealed a family with the rare karyotype abnormality inv(18) (p11.3;q21.1) with one inversion carrier who also suffered from bipolar disorder. In this family there were two other cases of bipolar disorder, but the karyotype of these cases could not be established. One family in Scotland showed a case of schizophrenia in a carrier of inv(18) with the same breakpoints as the Danish family.ConclusionsWe suggest further studies of the 18p11.3 and 18q21.1 regions in order to identify genes involved in bipolar affective disorder and schizophrenia.

Sign in / Sign up

Export Citation Format

Share Document