scholarly journals Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline

2006 ◽  
Vol 189 (2) ◽  
pp. 124-131 ◽  
Author(s):  
R. M. Post ◽  
L. L. Altshuler ◽  
G. S. Leverich ◽  
M. A. Frye ◽  
W A. Nolen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Antidepressant Drugs ◽  
Patient Treatment ◽  
Adjunctive Treatment ◽  
Prior History ◽  
Rapid Cycling ◽  
Acute Response ◽  
Relative Risks ◽  
Increased Risk

BackgroundFew studies have examined the relative risks of switching into hypomania or mania associated with second-generation antidepressant drugs in bipolar depression.AimsTo examine the relative acute effects of bupropion, sertraline and venlafaxine as adjuncts to mood stabilisers.MethodIn a 10-week trial, participants receiving out-patient treatment for bipolar disorder (stratified for rapid cycling) were randomly treated with a flexible dose of one of the antidepressants, or their respective matching placebos, as adjuncts to mood stabilisers.ResultsA total of 174 adults with bipolar disorder I, II or not otherwise specified, currently in the depressed phase, were included. All three antidepressants were associated with a similar range of acute response (49–53%) and remission (34–41%). There was a significantly increased risk of switches into hypomania or mania in participants treated with venlafaxine compared with bupropion or sertraline.ConclusionsMore caution appears indicated in the use of venlafaxine rather than bupropion or sertraline in the adjunctive treatment of bipolar depression, especially if there is a prior history of rapid cycling.

Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

2018 ◽  
Vol 49 (14) ◽  
pp. 2397-2404 ◽  
Author(s):  
Mu-Hong Chen ◽  
Ju-Wei Hsu ◽  
Kei-Lin Huang ◽  
Tung-Ping Su ◽  
Cheng-Ta Li ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Population Based ◽  
Autism Spectrum ◽  
The Public ◽  
First Degree Relatives ◽  
Relative Risks ◽  
Dependent Relationship ◽  
Increased Risk ◽  
Bipolar Patients

AbstractBackgroundBipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.MethodsAmong the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.ResultsFDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.ConclusionsOur study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

Manic-depressive illness — II: treatment outcome in bipolar disorder subtypes

1992 ◽  
Vol 9 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Patrick McKeon ◽  
Patrick Manley ◽  
Gregory Swanwick
Keyword(s):  
Bipolar Disorder ◽  
Treatment Outcome ◽  
Antidepressant Drugs ◽  
Depressive Illness ◽  
Tricyclic Antidepressant ◽  
Rapid Cycling ◽  
Manic Depressive Illness ◽  
Mood Changes ◽  
Manic Depressive ◽  
Manic Patients

AbstractThe treatment outcome of 100 bipolar disorder patients (B.P.) was examined retrospectively to determine whether bipolar subtypes had a differential prophylactic response to lithium, carbamazepine, neuroleptics and antidepressant drugs when these treatments were given in a predetermined sequence. Sixty-eight per cent of 53 B.P.-I patients with a mania-depression-normothymic-interval (M.D.I.) sequence of mood changes had a good response to lithium, and all but one of the remainder responded with the addition of carbamazepine or an antidepressant. While only 17% of 12 unipolar manic patients achieved prophylaxis with lithium and a further 17% when carbamazepine was added, the other 66% remained normothymic when a neuroleptic was prescribed with lithium. Of the seven rapid cycling patients where depression preceded mania, 28% had a good prophylactic effect with lithium, a further 28% when a tricyclic antidepressant was added and 14% with lithium and carbamazepine. None of the 18 rapid cycling M.D.I. group had a good response to lithium, but 39% stabilised when carbamazepine was added to lithium. Twenty-eight per cent of this group failed completely to respond to any of the treatments used. Neuroleptics increased the severity and duration of depressive phases for all subtypes except the unipolar mania group.

Quetiapine as adjunctive treatment of a case of rapid-cycling bipolar disorder with comorbidity

2003 ◽  
Vol 18 (7) ◽  
pp. 559-560 ◽  
Author(s):  
Paolo Stratta ◽  
Stefano De Cataldo ◽  
Giorgio Mancini ◽  
Daniela Gianfelice ◽  
Osvaldo Rinaldi ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Adjunctive Treatment ◽  
Rapid Cycling

Double-Blind, Randomized, Placebo-Controlled Trials of Ethyl-Eicosapentanoate in the Treatment of Bipolar Depression and Rapid Cycling Bipolar Disorder

2006 ◽  
Vol 60 (9) ◽  
pp. 1020-1022 ◽  
Author(s):  
Paul E. Keck ◽  
Jim Mintz ◽  
Susan L. McElroy ◽  
Marlene P. Freeman ◽  
Trisha Suppes ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Bipolar Depression ◽  
Controlled Trials ◽  
Rapid Cycling ◽  
Double Blind

scholarly journals A History of Cerebrovascular Disease Is Independently Associated with Increased Morbidity and Mortality in Patients with COVID-19: A Cohort Study of 369,563 COVID-19 Cases in the USA

2021 ◽  
pp. 1-9
Author(s):  
Anna M. Nia ◽  
Visish M. Srinivasan ◽  
Miranda K. Hayworth ◽  
Rishi R. Lall ◽  
Peter Kan
Keyword(s):  
Critical Care ◽  
Cerebrovascular Disease ◽  
Morbidity And Mortality ◽  
Prior History ◽  
Care Services ◽  
Relative Risks ◽  
Previous Diagnosis ◽  
Increased Risk ◽  
The Usa ◽  
History Of

<b><i>Objectives:</i></b> We set out to evaluate the risk for severe coronavirus disease 2019 (COVID-19) infection and subsequent cerebrovascular disease (CVD) in the population with a prior diagnosis of CVD within the past 10 years. <b><i>Methods:</i></b> We utilized the TriNetX Analytics Network to query 369,563 CO­VID-19 cases up to December 30, 2020. We created 8 cohorts of patients with COVID-19 diagnosis based on a previous diagnosis of CVD. We measured the odds ratios, relative risks, risk differences for hospitalizations, ICU/critical care services, intubation, mortality, and CVD recurrence within 90 days of COVID-19 diagnosis, compared to a propensity-matched cohort with no prior history of CVD within 90 days of COVID-19 diagnosis. <b><i>Results:</i></b> 369,563 patients had a confirmed diagnosis of COVID-19 with a subset of 22,497 (6.09%) patients with a prior diagnosis of CVD within 10 years. All cohorts with a CVD diagnosis had an increased risk of hospitalization, critical care services, and mortality within 90 days of COVID-19 diagnosis. Additionally, the data demonstrate that any history of CVD is associated with significantly increased odds of subsequent CVD post-COVID-19 compared to a matched control. <b><i>Conclusions:</i></b> CVD, a known complication of CO­VID-19, is more frequent in patients with a prior history of CVD. Patients with any previous diagnosis of CVD are at higher risks of morbidity and mortality from COVID-19 infection. In patients admitted to the ED due to COVID-19 symptoms, these risk factors should be promptly identified as delayed or missed risk stratification and could lead to an ineffective and untimely diagnosis of subsequent CVD, which would lead to protracted hospitalization and poor prognosis.

scholarly journals Bipolar Affective Disorder and Parkinson's Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Birk Engmann
Keyword(s):  
Parkinson’S Disease ◽  
Bipolar Disorder ◽  
Parkinson's Disease ◽  
Bipolar Depression ◽  
Treatment Options ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizer ◽  
Rapid Cycling ◽  
Underlying Mechanisms ◽  
Few Data

Little is known about comorbidities of bipolar disorder such as Parkinson's disease. A case history and a literature survey indicate that bipolar disorder is linked with or influences Parkinson's disease and vice versa. Underlying mechanisms are poorly understood, and, more importantly, no treatment options are established in such double diagnoses. The few data in comorbid Parkinson cases seem to point to a rapid cycling pattern of bipolar symptoms. With regard to therapeutic intervention, the literature supports pramipexole for treatment of both Parkinson and depressive symptoms in bipolar depression. Lithium, the mood stabilizer of choice for treating manic states, is problematical for use in Parkinson patients because of its side effects. Valproate might be an alternative, especially for treatment of rapid cycling.

scholarly journals Autism risk following antidepressant medication during pregnancy

2017 ◽  
Vol 47 (16) ◽  
pp. 2787-2796 ◽  
Author(s):  
A. Viktorin ◽  
R. Uher ◽  
A. Reichenberg ◽  
S. Z. Levine ◽  
S. Sandin
Keyword(s):  
Cox Regression ◽  
Population Sample ◽  
Antidepressant Drugs ◽  
Antidepressant Medication ◽  
Population Based ◽  
Autism Spectrum ◽  
Relative Risks ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression

BackgroundPrevious studies have examined if maternal antidepressant medication during pregnancy increase the risk of autism spectrum disorder (ASD) in the offspring, but the results have been conflicting.MethodsIn a population-based cohort of 179 007 children born in 2006 and 2007 and followed through 2014 when aged 7 and 8, we estimated relative risks (RRs) of ASD and 95% confidence intervals (CIs) from Cox regression in children exposed to any antidepressant medication during pregnancy, and nine specific antidepressant drugs. Analyses were adjusted for potential confounders and were conducted in the full population sample, and in a clinically relevant sub-sample of mothers with at least one diagnosis of depression or anxiety during life.ResultsThe adjusted RR of ASD in children of mothers who used antidepressant medication during pregnancy was estimated at 1.23 (95% CI 0.96–1.57), and at 1.07 (95% CI 0.80–1.43) in women with a history of depression or anxiety. Analyses of specific antidepressants initially revealed increased RRs of offspring ASD confined to citalopram and escitalopram (RR: 1.47; 95% CI 0.92–2.35) and clomipramine (RR: 2.86; 95% CI 1.04–7.82).ConclusionMedication with antidepressants during pregnancy does not appear to be causally associated with an increased risk of ASD in the offspring. Instead, the results suggest that the association is explained by factors related to the underlying susceptibility to psychiatric disorders. Based on these findings, the risk of ASD in the offspring should not be a consideration to withhold treatment with commonly used antidepressant drugs from pregnant women.

scholarly journals Incidence of ischaemic heart disease and stroke among people with psychiatric disorders: retrospective cohort study

2019 ◽  
Vol 217 (2) ◽  
pp. 442-449 ◽  
Author(s):  
Caroline A. Jackson ◽  
Joannes Kerssens ◽  
Kelly Fleetwood ◽  
Daniel J. Smith ◽  
Stewart W. Mercer ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Heart Disease ◽  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Ischaemic Heart Disease ◽  
Sociodemographic Factors ◽  
Deprivation Level ◽  
Relative Risks ◽  
Increased Risk ◽  
Over Time

BackgroundPsychiatric disorders are associated with increased risk of ischaemic heart disease (IHD) and stroke, but it is not known whether the associations or the role of sociodemographic factors have changed over time.AimsTo investigate the association between psychiatric disorders and IHD and stroke, by time period and sociodemographic factors.MethodWe used Scottish population-based records from 1991 to 2015 to create retrospective cohorts with a hospital record for psychiatric disorders of interest (schizophrenia, bipolar disorder or depression) or no record of hospital admission for mental illness. We estimated incidence and relative risks of IHD and stroke in people with versus without psychiatric disorders by calendar year, age, gender and area-based deprivation level.ResultsIn all cohorts, incidence of IHD (645 393 events) and stroke (276 073 events) decreased over time, but relative risks decreased for depression only. In 2015, at the mean age at event onset, relative risks were 2- to 2.5-fold higher in people with versus without a psychiatric disorder. Age at incidence of outcome differed by cohort, gender and socioeconomic status. Relative but not absolute risks were generally higher in women than men. Increasing deprivation conveys a greater absolute risk of IHD for people with bipolar disorder or depression.ConclusionsDespite declines in absolute rates of IHD and stroke, relative risks remain high in those with versus without psychiatric disorders. Cardiovascular disease monitoring and prevention approaches may need to be tailored by psychiatric disorder and cardiovascular outcome, and be targeted, for example, by age and deprivation level.

scholarly journals The case for and against selective serotonin reuptake inhibitors in rapid cycling bipolar disorder

2021 ◽  
Author(s):  
Daniel Semenov ◽  
Jason Quinn
Keyword(s):  
Bipolar Disorder ◽  
Serotonin Receptor ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Bipolar Depression ◽  
Selective Serotonin ◽  
Rapid Cycling ◽  
Community Functioning ◽  
Phase Switching ◽  
Functional Difficulties ◽  
Treatment Refractory

Patients affected by the rapid cycling variant of bipolar disorder often experience significant functional difficulties. Physicians caring for affected patients face many challenges managing the turbulent course of this disorder, complicated at times by psychiatric comorbidities (including substance use disorders), polypharmacy, risk management (of suicidality and aggression), and difficulties with community functioning. There is some controversy about the use of selective serotonin receptor inhibitors (SSRIs) in managing bipolar depression, particularly in the rapid cycling variant. The potential benefit of SSRIs in reducing depressive symptoms must be balanced against the risks of mood phase switching and overall worsening of the rapid cycling course. This case report highlights challenges inherent in the application of SSRIs in a case of treatment-refractory rapid cycling bipolar disorder, and discusses the controversy of their use.

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