1
|
Cheng G, Singh S, Garabet C, Ard M. Fifty-Nine-Year-Old Woman With Concurrent Administration of Cobicistat and Dexamethasone Potentially Leading to Mania: A Case Report. J Clin Psychopharmacol 2024; 44:330-331. [PMID: 38587363 DOI: 10.1097/jcp.0000000000001842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
| | | | | | - Mark Ard
- Department of Psychiatry VA Loma Linda Health Care System Loma Linda, CA
| |
Collapse
|
2
|
Dormegny-Jeanjean LC, Mainberger OAE, de Crespin de Billy C, Obrecht A, Danila V, Erb A, Arcay HM, Weibel S, Blanc F, Meyer G, Tomsa M, Bertschy G, Duval F, Foucher JR. Safety and tolerance of combination of monoamine oxidase inhibitors and direct dopamine agonists in adults and older adults with highly resistant depression. Encephale 2024; 50:137-142. [PMID: 37005193 DOI: 10.1016/j.encep.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/09/2023] [Accepted: 01/27/2023] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Dopamine (DA) is likely to be involved in some depressive dimensions, such as anhedonia and amotivation, which account for a part of treatment-resistant forms. Monoamine oxidase inhibitors (MAOI) and direct D2 and D3 receptors agonists (D2/3r-dAG) are known to help, but we lack safety data about their combined usage. We report on safety and tolerance of the MAOI+D2r-dAG combination in a clinical series. METHOD All patients referred to our recourse center for depression between 2013 and 2021 were screened to select those who did receive the combo. Data were extracted from clinical files. RESULTS Sixteen patients of 60±17 years of age (8 women, 7 with age>65years, all suffered from treatment resistant depression, 7 with bipolar disorder) received the combo. There were no life-threatening adverse effects (AE). However, AE were reported by 14 patients (88%) most of which were mild and consisted of insomnia, nausea, nervousness, confusion, impulse control disorder and/or "sleep attacks". One patient presented a serious AE requiring a short hospitalization for confusion. Intolerance led to failure to introduce treatment in two patients (13%). The retrospective non-interventional design, the variety of molecules, and the modest sample size limited the scope of these results. CONCLUSION There was no life-threatening safety issue in combining MAOI and D2/3r-dAG, especially regarding cardiovascular side effects. The systematic screening of AE might account for their frequency, but these precluded the treatment in only two patients. Comparative studies are needed to assess the efficacy of this new combination.
Collapse
Affiliation(s)
- L C Dormegny-Jeanjean
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France.
| | - O A E Mainberger
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - C de Crespin de Billy
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - A Obrecht
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - V Danila
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - A Erb
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - H M Arcay
- CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| | - S Weibel
- Department of Psychiatry and Mental Health-University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France; Inserm UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, 67000 Strasbourg, France
| | - F Blanc
- CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France; Geriatrics Department and Expert Center for Neurocognitive Disorders, University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France
| | - G Meyer
- Pharmacopsy Alsace, Clinical Pharmacy Department, Établissement Public de Santé Alsace Nord, Brumath, France; Pharmacy Department, University Hospital of Strasbourg, 67000 Strasbourg, France
| | - M Tomsa
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - G Bertschy
- Department of Psychiatry and Mental Health-University Hospital of Strasbourg, University of Strasbourg, 67000 Strasbourg, France; Inserm UMR 1114, Physiopathology and Cognitive Psychopathology of Schizophrenia, University of Strasbourg, 67000 Strasbourg, France
| | - F Duval
- Department of Psychiatry "pole 8/9", Rouffach Psychiatric Hospital, 68250 Rouffach, France
| | - J R Foucher
- Non-Invasive neuroModulation Center of Strasbourg (CEMNIS), University Hospital of Strasbourg, 67000 Strasbourg, France; CNRS UMR 7357 iCube, neurophysiology, FMTS, University of Strasbourg, 67000 Strasbourg, France
| |
Collapse
|
3
|
Tural Hesapcioglu S, Kasak M, Abursu H, Kafali S, Ceylan MF, Akyol M. A systematic review and network meta-analysis on comparative efficacy, acceptability, and safety of treatments in acute bipolar mania in youths. J Affect Disord 2024; 349:438-451. [PMID: 38211745 DOI: 10.1016/j.jad.2024.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/20/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND The evidence of treatment options' efficacy on acute bipolar manic episodes is relatively less in youths than adults. We aimed to compare and rank the drug's efficacy, acceptability, tolerability, and safety for acute mania in children and adolescents. METHOD We systematically reviewed the double-blinded, randomized controlled trials (RCTs) comparing drugs or placebo for acute manic episodes of bipolar disorder in children and adolescents using PRISMA guidelines. We searched PubMed/MEDLINE, EMBASE, Web of Science, EBSCO, Scopus, the Cochrane Central Register of Controlled Trials, and https://clinicaltrials.gov from inception until November 20, 2022. Response to treatment was the primary outcome, and random-effects network meta-analyses were conducted (PROSPERO 2022: CRD42022367455). RESULTS Of 10,134 citations, we included 15 RCTs, including 2372 patients (47 % female), 15 psychotropic drugs, and the placebo. Risperidone 0.5-2.5 mg/day, aripiprazole 30 mg/day olanzapine, quetiapine 400 mg/day, quetiapine 600 mg/day, asenapine 5 mg/day, asenapine 10 mg, ziprasidone, and aripiprazole 10 mg were found to be effective (in comparison with placebo) in children and adolescents, respectively (τ2 = 0.0072, I2 = 10.2 %). The tolerability of aripiprazole 30 mg/day was lower than risperidone 0.5-2.5 mg/day and olanzapine. Oxcarbazepine had the highest discontinuation due to the adverse effects risk ratio. LIMITATIONS Efficacy ranking of the treatments could be performed by evaluating relatively few RCT results, and only monotherapies were considered. CONCLUSIONS Efficacy, acceptability, tolerability, and safety are changing with the doses of antipsychotics for children and adolescents with acute bipolar manic episodes. Drug selection and optimum dosage should be carefully adjusted in children and adolescents.
Collapse
Affiliation(s)
- Selma Tural Hesapcioglu
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Meryem Kasak
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Helin Abursu
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Seda Kafali
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Mehmet Fatih Ceylan
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Mesut Akyol
- Ankara Yildirim Beyazit University, Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
| |
Collapse
|
4
|
Kishi T, Citrome L, Sakuma K, Iwata N. A comparison of recurrence rates after discontinuation of second-generation antipsychotic long-acting injectable versus corresponding oral antipsychotic in the maintenance treatment of bipolar disorder: A systematic review. Psychiatry Res 2024; 333:115761. [PMID: 38301289 DOI: 10.1016/j.psychres.2024.115761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
It has been previously reported that among patients with schizophrenia that long-acting injectable (LAI) antipsychotic formulations can delay time to relapse longer when compared to their oral equivalents when patients discontinue therapy. Unanswered is whether this same pattern would be observed for patients with bipolar disorder receiving maintenance treatment. A systematic review was undertaken to identify relevant studies of LAI antipsychotics in maintenance treatment of bipolar disorder, employing a placebo-controlled randomized withdrawal design, and where equivalent studies using the corresponding oral formulation were also available. We found five studies [one aripiprazole monohydrate once monthly (AOM) study, one oral aripiprazole (OARI) study, two 2 weeks risperidone-LAI (RIS-LAI) studies, and one oral paliperidone (OPAL) study]. Numerically lower recurrence rates at 2, 4, 6, 8, 12, 16, 20, and 26 weeks were observed when AOM was discontinued when compared with discontinuation from OARI. Numerically lower recurrence rates at 2, 4, 6, 8, and 16 weeks were observed when RIS-LAI was discontinued when compared with discontinuation from OPAL. These results can be interpreted as a substantial delay in time to recurrence with a LAI antipsychotics formulation compared to the oral equivalent when medication is discontinued in patients with mania who had been stabilized on LAI antipsychotics or corresponding oral antipsychotics.
Collapse
Affiliation(s)
- Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
| | - Leslie Citrome
- Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, NY, United States
| | - Kenji Sakuma
- Department of Psychiatry, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan
| |
Collapse
|
5
|
Nagano M, Susuta Y, Masui H, Watanabe Y, Watanabe K. Efficacy and Safety of Valbenazine in Japanese Patients With Tardive Dyskinesia and Schizophrenia/Schizoaffective Disorder or Bipolar Disorder/Depressive Disorder: Primary Results and Post Hoc Analyses of the J-KINECT Study. J Clin Psychopharmacol 2024; 44:107-116. [PMID: 38421921 DOI: 10.1097/jcp.0000000000001811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE This post hoc analysis investigated whether a patient's underlying psychiatric disease (schizophrenia/schizoaffective disorder [SCHZ] or bipolar disorder/depressive disorder [MOOD]) influenced the efficacy or safety of valbenazine for tardive dyskinesia (TD) in an Asian population. METHODS We analyzed data from J-KINECT, a multicenter, phase II/III, randomized, double-blind study, which consisted of a 6-week placebo-controlled period followed by a 42-week extension where Japanese patients with TD received once-daily 40- or 80-mg valbenazine. We compared the change from baseline in Abnormal Involuntary Movement Scale total score and Clinical Global Impression of TD score between patients with SCHZ and those with MOOD, and incidence of treatment-emergent adverse events. RESULTS Of 256 patients included in the placebo-controlled period, 211 continued to the long-term extension. The mean change from baseline in Abnormal Involuntary Movement Scale total score at week 6 (95% confidence interval) was -1.8 (-3.2 to -0.5) and -3.3 (-4.7 to -1.9) in the valbenazine 40- and 80-mg groups, respectively (SCHZ group), and -2.4 (-3.9 to -0.9) and -3.5 (-5.1 to -1.9) in the valbenazine 40- and 80-mg groups, respectively (MOOD group), demonstrating improvement at either dose level over placebo, regardless of the underlying disease. These results were maintained to week 48, and improvements of Clinical Global Impression of TD scores were similar. There were no notable differences in the incidence of serious or fatal treatment-emergent adverse events by underlying disease; differences in the incidence of worsening schizophrenia and depression were attributed to underlying disease progression. CONCLUSIONS Safety and efficacy of long-term valbenazine therapy for TD did not vary according to underlying psychiatric disease.
Collapse
Affiliation(s)
- Mieko Nagano
- From the Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Japan
| | - Yutaka Susuta
- From the Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Japan
| | - Hideaki Masui
- From the Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Japan
| | - Yumi Watanabe
- From the Ikuyaku, Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Japan
| | - Koichiro Watanabe
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| |
Collapse
|
6
|
McElroy SL, Guerdjikova AI, Blom TJ, Mori N, Romo-Nava F. Liraglutide in Obese or Overweight Individuals With Stable Bipolar Disorder. J Clin Psychopharmacol 2024; 44:89-95. [PMID: 38227621 DOI: 10.1097/jcp.0000000000001803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Obesity is common among persons with bipolar disorder (BD). Liraglutide 3.0 mg/d subcutaneous injection is indicated for chronic weight management and associated with minimal adverse neuropsychiatric effects. This study evaluated whether liraglutide 3 mg/d reduced body weight, improved metabolic factors and eating psychopathology, and was safe and well tolerated in persons with stable BD who were obese (body mass index [BMI] >30 kg/m 2 ) or overweight (BMI ≥27 kg/m 2 ) with at least one weight-related comorbidity. METHODS This was a 40-week, randomized (1:1 ratio), placebo-controlled, double-blind, parallel-group, 2-arm clinical trial of liraglutide targeted to 3.0 mg/d (in combination with a reduced-calorie diet and increased physical activity) in 60 participants with stable BD who were obese or overweight. Primary outcome was percent change in body weight from baseline to study end. Secondary outcomes included percentage of patients who lost ≥5% of baseline body weight, and changes in metabolic variables and measures of eating psychopathology. RESULTS There were no significant baseline differences between the 29 liraglutide recipients and the 31 placebo recipients, except that liraglutide recipients had higher levels of binge eating and lower levels of high-density lipoprotein cholesterol. Compared with placebo, liraglutide was associated with significantly greater reductions in percent change in body weight, percentage of participants who lost at least 5% of body weight, and reductions in weight, BMI, hemoglobin A 1c levels, binge eating, and hunger. Liraglutide was well tolerated. CONCLUSIONS Liraglutide 3 mg/d may be efficacious and safe for weight loss in individuals with stable BD and obesity or overweight. TRIAL REGISTRATION ClinicalTrials.gov (NCT03158805).
Collapse
|
7
|
Shuy YK, Santharan S, Chew QH, Lin SK, Ouyang WC, Chen CK, Park SC, Jang OJ, Park JH, Chee KY, Ding KS, Chong J, Zhang L, Li K, Zhu X, Jatchavala C, Pariwatcharakul P, Kallivayalil RA, Grover S, Avasthi A, Ansari M, Maramis MM, Aung PP, Tan CH, Xiang YT, Chong MY, Park YC, Kato TA, Shinfuku N, Baldessarini RJ, Sim K. Pharmacoepidemiology and Clinical Correlates of Lithium Treatment for Bipolar Disorder in Asia. J Clin Psychopharmacol 2024; 44:117-123. [PMID: 38230861 DOI: 10.1097/jcp.0000000000001813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND As clinical practices with lithium salts for patients diagnosed with bipolar disorder (BD) are poorly documented in Asia, we studied the prevalence and clinical correlates of lithium use there to support international comparisons. METHODS We conducted a cross-sectional study of use and dosing of lithium salts for BD patients across 13 Asian sites and evaluated bivariate relationships of lithium treatment with clinical correlates followed by multivariate logistic regression modeling. RESULTS In a total of 2139 BD participants (52.3% women) of mean age 42.4 years, lithium salts were prescribed in 27.3% of cases overall, varying among regions from 3.20% to 59.5%. Associated with lithium treatment were male sex, presence of euthymia or mild depression, and a history of seasonal mood change. Other mood stabilizers usually were given with lithium, often at relatively high doses. Lithium use was associated with newly emerging and dose-dependent risk of tremors as well as risk of hypothyroidism. We found no significant differences in rates of clinical remission or of suicidal behavior if treatment included lithium or not. CONCLUSIONS Study findings clarify current prevalence, dosing, and clinical correlates of lithium treatment for BD in Asia. This information should support clinical decision-making regarding treatment of BD patients and international comparisons of therapeutic practices.
Collapse
Affiliation(s)
- Yao Kang Shuy
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Sanjana Santharan
- Department of Emergency and Crisis Care, Institute of Mental Health, Singapore
| | - Qian Hui Chew
- Research Division, Institute of Mental Health, Singapore
| | | | | | - Chih-Ken Chen
- Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | | | - Ok-Jin Jang
- Department of Psychiatry, Bugok National Hospital, Changnyong, South Korea
| | - Jun Hyuk Park
- Jeju National University Hospital, Jeju University School of Medicine, Jeju, South Korea
| | - Kok-Yoon Chee
- Department of Psychiatry and Mental Health, Tunku Abdul Rahman Institute of Neurosciences, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Kwong Sen Ding
- Department of Psychiatry, Hospital Bahagia Ulu Kinta, Tanjung Rambutan, Perak Darul Ridzwan, Malasia
| | - Jamaline Chong
- Hospital Permai Johor Bahru, Ministry of Health, Johor Bahru, Malaysia
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China
| | - Keqing Li
- Hebei Provincial Mental Health Center, Baoding, Hebei, China
| | - Xiaomin Zhu
- Department of Psychiatry, Suzhou Guangji Hospital, the Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Chonnakarn Jatchavala
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Pornjira Pariwatcharakul
- Department of Psychiatry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Roy A Kallivayalil
- Department of Psychiatry, Pushpagiri Institute of Medical Sciences, Tiruvalla, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Moin Ansari
- Department of Psychiatry, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Margarita M Maramis
- Department of Psychiatry, Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Surabaya, Indonesia
| | - Paing Phyo Aung
- Mental Health Hospital, Yangon University of Medicine, Yangon, Myanmar
| | - Chay Hoon Tan
- Department of Pharmacology, National University of Singapore, Singapore
| | | | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Yong Chon Park
- Department of Neuropsychiatry, Hanyang University Guri Hospital, Guri, South Korea
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University Fukuoka, Japan
| | - Naotaka Shinfuku
- School of Human Sciences, Seinan Gakuin University, Fukuoka, Japan
| | | | - Kang Sim
- West Region, Institute of Mental Health, Singapore
| |
Collapse
|
8
|
Jumaili WA, Gburi NA, Jain S. Weight Loss Medication Phentermine-Induced Hypomania in Bipolar Depression. Prim Care Companion CNS Disord 2024; 26:23cr03624. [PMID: 38395144 DOI: 10.4088/pcc.23cr03624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Wisam Al Jumaili
- Texas Tech University Health Science Center at Permian Basin, Odessa, Texas
- Corresponding Author: Wisam Al Jumaili, MD, 2301 W Michigan Ave, Midland, TX 79707
| | | | - Shailesh Jain
- Texas Tech University Health Science Center at Permian Basin, Odessa, Texas
| |
Collapse
|
9
|
Nuñez NA, Coombes BJ, Beaupre LM, Ozerdem A, Resendez MG, Romo-Nava F, Bond DJ, Veldic M, Singh B, Moore KM, Betcher HK, Kung S, Prieto ML, Fuentes M, Ercis M, Miola A, Sanchez Ruiz JA, Jenkins G, Batzler A, Leung JG, Cuellar-Barboza A, Tye SJ, McElroy SL, Biernacka JM, Frye MA. Pharmacogenomic overlap between antidepressant treatment response in major depression & antidepressant associated treatment emergent mania in bipolar disorder. Transl Psychiatry 2024; 14:93. [PMID: 38351009 PMCID: PMC10864308 DOI: 10.1038/s41398-024-02798-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
There is increasing interest in individualizing treatment selection for more than 25 regulatory approved treatments for major depressive disorder (MDD). Despite an inconclusive efficacy evidence base, antidepressants (ADs) are prescribed for the depressive phase of bipolar disorder (BD) with oftentimes, an inadequate treatment response and or clinical concern for mood destabilization. This study explored the relationship between antidepressant response in MDD and antidepressant-associated treatment emergent mania (TEM) in BD. We conducted a genome-wide association study (GWAS) and polygenic score analysis of TEM and tested its association in a subset of BD-type I patients treated with SSRIs or SNRIs. Our results did not identify any genome-wide significant variants although, we found that a higher polygenic score (PGS) for antidepressant response in MDD was associated with higher odds of TEM in BD. Future studies with larger transdiagnostic depressed cohorts treated with antidepressants are encouraged to identify a neurobiological mechanism associated with a spectrum of depression improvement from response to emergent mania.
Collapse
Affiliation(s)
- Nicolas A Nuñez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Manuel Gardea Resendez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - David J Bond
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Katherine M Moore
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hannah K Betcher
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Simon Kung
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Miguel L Prieto
- Department of Psychiatry, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Manuel Fuentes
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Mete Ercis
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Alessandro Miola
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Gregory Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | - Susannah J Tye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia
| | - Susan L McElroy
- Lindner Center of HOPE/University of Cincinnati, Cincinnati, OH, USA
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
10
|
Vgontzas AN, Paschalidou A, Simos PG, Anastasaki M, Zografaki A, Volikos E, Koutra K, Basta M. Impact of long-acting injectable antipsychotics vs. oral medication on relapses of patients with psychosis and bipolar disorder. Psychiatry Res 2024; 332:115676. [PMID: 38176166 DOI: 10.1016/j.psychres.2023.115676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024]
Abstract
Relapse associated with multiple hospital readmissions of patients with chronic and severe mental disorders, such as psychosis and bipolar disorder, is frequently associated with non-adherence to treatment. The primary aim of the study was to compare the effectiveness of long-acting injectable (LAI) treatment, vs. oral medication in reducing readmissions of patients with psychotic or bipolar disorder in a community sample of 164 patients with psychosis and 29 patients with bipolar disorder (n = 193), with poor adherence to oral medication. The mean follow up period was 5.6 years and the number of readmissions were compared for an equal-length period of oral treatment preceding the onset of LAI administration. We observed a significant decrease of 45.2 % in total hospital readmissions after receiving LAIs treatment. The effect was significant both for patients with a pre-LAI treatment history of predominantly voluntary hospitalizations and with predominantly involuntary admissions. In addition, we observed equal effectiveness of first- vs. second-generation LAIs in reducing total hospital readmissions regardless of type of pre-treatment admission history (voluntary vs. involuntary). LAIs appear to be effective in reducing both voluntary and involuntary hospital readmissions in patients with psychosis and bipolar disorder with a history of poor adherence to treatment.
Collapse
Affiliation(s)
- Alexandros N Vgontzas
- Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Sleep Research and Treatment Center Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
| | - Anna Paschalidou
- Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece
| | - Panagiotis G Simos
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete 71110, Greece; Institute of Computer Science, Foundation of Research and Technology, Heraklion, Greece
| | - Maria Anastasaki
- Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece
| | - Avgi Zografaki
- Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece
| | - Emmanouil Volikos
- Mobile Mental Health Unit of Heraklion, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete 71110, Greece
| | - Katerina Koutra
- Department of Psychology, School of Social Sciences, University of Crete, Gallos Campus, Rethymnon, Crete 74100, Greece
| | - Maria Basta
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Voutes, Heraklion, Crete 71003, Greece; Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete 71110, Greece
| |
Collapse
|
11
|
Karlin DM, Nelson LA, Campbell AR. Dexmedetomidine Sublingual Film: A New Treatment to Reduce Agitation in Schizophrenia and Bipolar Disorders. Ann Pharmacother 2024; 58:54-64. [PMID: 37119212 DOI: 10.1177/10600280231171179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
OBJECTIVE The objective of this study was to review the available literature for dexmedetomidine sublingual film use in the treatment of acute agitation associated with schizophrenia and bipolar disorders. DATA SOURCES A literature search of PubMed (January 2017-March 2023) and EMBASE (January 2017-March 2023) was performed using the terms: Igalmi, dexmedetomidine, schizophrenia, bipolar disorder, and agitation. Additional information sources include ClinicalTrials.gov, scientific posters, and articles identified through review of references from clinical trials publications. STUDY SELECTION AND DATA EXTRACTION Relevant English-language articles conducted in humans were considered, with a preference for phase 3 clinical trials. Trial analyses and articles discussing pharmacology, pharmacokinetics, efficacy, and safety were also evaluated. DATA SYNTHESIS Dexmedetomidine sublingual film was evaluated for use in schizophrenia in the SERENITY 1 pivotal trial and for bipolar disorders in the SERENITY 2 pivotal trial. Both studies found treatment of mild to moderate agitation with dexmedetomidine sublingual film 180 and 120 μg to be superior to placebo in reducing the severity of agitation. Treatment effect was seen as early as 20 minutes. Somnolence was the most common adverse effect in both studies. Cardiovascular adverse effects were mild and transient in most cases. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Dexmedetomidine sublingual film is a new and novel treatment for agitation and gives clinicians an alternative to antipsychotic and benzodiazepine use. It has advantageous properties including its noninvasive route of administration, fast absorption, and rapid onset of effect. Cost may limit its use. CONCLUSION Dexmedetomidine sublingual film provides an alternative approach to treatment of acute agitation in adults with schizophrenia and bipolar disorders based on both mechanism of action and route of administration.
Collapse
Affiliation(s)
- Danielle M Karlin
- Department of Pharmacy, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Leigh Anne Nelson
- Department of Pharmacy, School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Austin R Campbell
- Department of Pharmacy, School of Pharmacy at MU, University of Missouri-Kansas City, Columbia, MO, USA
| |
Collapse
|
12
|
Huybrechts KF, Olfson M. Evaluating the Liability of Antidepressants to Induce Mania in Children and Adolescents With Depression. JAMA Psychiatry 2024; 81:13-14. [PMID: 37755866 DOI: 10.1001/jamapsychiatry.2023.3525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Affiliation(s)
- Krista F Huybrechts
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mark Olfson
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York
- New York State Psychiatric Institute, New York
| |
Collapse
|
13
|
Batten J, Gorrepati V, Smith T, Spelber D, Almeida J. Disulfiram-induced mania: A case report. Bipolar Disord 2023; 25:701-702. [PMID: 37919814 DOI: 10.1111/bdi.13391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Affiliation(s)
- Jessica Batten
- Department of Psychiatry and Behavioral Sciences at Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Vijay Gorrepati
- Department of Psychiatry and Behavioral Sciences at Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - Tawny Smith
- Department of Psychiatry and Behavioral Sciences at Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - David Spelber
- Mood Treatment Center, Integral Care, Austin, Texas, USA
| | - Jorge Almeida
- Department of Psychiatry and Behavioral Sciences at Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| |
Collapse
|
14
|
Hamsa A, Karumandampalayam Shanmugaramasamy K, Kariyarambath P, Kathirvel S. Quetiapine Fumarate: A Review of Analytical Methods. J Chromatogr Sci 2023; 61:892-906. [PMID: 36519755 DOI: 10.1093/chromsci/bmac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Indexed: 11/11/2023]
Abstract
Atypical antipsychotics are newer second-generation antipsychotics with weak dopamine type 2 blocking but potent 5-HT2 antagonistic activity. They are considered first-line treatments for schizophrenia and gradually replace typical antipsychotics. Extrapyramidal side effects are minimal, and they tend to improve impaired cognitive function in psychotics. Quetiapine fumarate is an atypical antipsychotic drug used to treat schizophrenia, mania and depression in people with bipolar disorder combined with other drugs or alone. Quetiapine was developed in 1985 and approved for medical use in the USA in 1997. Thorough computer-aided literature, surveys revealed that numerous analytical methods were reported over the years. The present study reviews analytical methods with their validation parameters published during the last 22 years (1999-2021) either as a single entity or combination in dosage form, and determination from biological samples. Novel strategies for increasing separation quality, such as QbD analysis and green spectroscopy, were discovered during the evaluation, and this review can be utilized for further research reference.
Collapse
Affiliation(s)
- Ahsaana Hamsa
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala 673602, India
| | | | - Praseetha Kariyarambath
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala 673602, India
| | - Singaram Kathirvel
- Department of Pharmaceutical Analysis, National College of Pharmacy, Manassery, Mukkam Post, Kozhikode, Kerala 673602, India
| |
Collapse
|
15
|
Jefsen OH, Rohde C, Østergaard SD. Revisiting the association between treatment with antidepressants and mania: A nationwide within-individual study of 3554 patients with bipolar disorder. Bipolar Disord 2023; 25:583-591. [PMID: 37308316 DOI: 10.1111/bdi.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Antidepressants are commonly used "off-label" for bipolar depression, despite concerns over the risk of potential treatment-emergent mania (or "manic switch"). Treatment-emergent mania is difficult to study with adequate power in clinical trials as it requires a large group of participants and long follow-up. Therefore, naturalistic register-based studies have been applied to assess this phenomenon. Here, we aimed to replicate previous findings and address key methodological limitations that were not previously taken into account. METHODS We utilized data from nationwide Danish health registries to identify patients with bipolar disorder treated with an antidepressant, either with or without concomitant treatment with a mood stabilizer (drug treatment proxied via redeemed prescriptions). We plotted the incidence of manic and depressive episodes relative to the initiation of antidepressant treatment and compared the incidence of mania in the period prior to and following initiation of antidepressant treatment (within-individual design). RESULTS In 3554 patients with bipolar disorder initiating treatment with an antidepressant, the number of manic episodes peaked approximately 3 months prior to initiation of antidepressant treatment, and the number of depressive episodes peaked around the initiation of antidepressant prescription. This temporal pattern suggests that antidepressants were used to treat post-manic depression. CONCLUSION Within-individual designs do not control sufficiently for confounding by indication, when the treatment indication is time-varying. Thus, results from prior within-individual studies of antidepressant treatment in the context of bipolar disorder may be invalid due to time-varying confounding by indication.
Collapse
Affiliation(s)
- Oskar Hougaard Jefsen
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus N, Denmark
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus N, Denmark
| | - Christopher Rohde
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus N, Denmark
| | - Søren Dinesen Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus N, Denmark
| |
Collapse
|
16
|
Uppalapati S, Cheng A, Mian T. A Case of COVID-19-Induced Mania. Prim Care Companion CNS Disord 2023; 25:23cr03533. [PMID: 37857288 DOI: 10.4088/pcc.23cr03533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Affiliation(s)
- Swetha Uppalapati
- Community Health Network Psychiatry Residency, Indianapolis, Indiana
- Corresponding Author: Swetha Uppalapati, DO, Community Health Network, 7150 Clearvista Dr, Indianapolis, IN 46256
| | - Alison Cheng
- Community Health Network Psychiatry Residency, Indianapolis, Indiana
| | - Taimur Mian
- Community Health Network Psychiatry Residency, Indianapolis, Indiana
| |
Collapse
|
17
|
Bartoli F, Callovini T, Cavaleri D, Crocamo C, Riboldi I, Aguglia A, De Fazio P, Martinotti G, D'Agostino A, Ostuzzi G, Barbui C, Carrà G. Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study. Eur Arch Psychiatry Clin Neurosci 2023; 273:1579-1586. [PMID: 36436121 DOI: 10.1007/s00406-022-01522-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 11/15/2022] [Indexed: 11/28/2022]
Abstract
Long-acting injectable (LAI) antipsychotics are often used for the long-term management also of bipolar disorder (BD). Nonetheless, evidence on their effect on pragmatic outcomes such as hospitalization risk in BD is inconsistent. We carried out a mirror-image study comparing rates and number of days of hospitalization, one year before and after the initiation of LAI treatment, in a sample of subjects with BD. Participants were selected from the STAR Network Depot Study, a pragmatic, observational, multicenter research involving a cohort of inpatients and outpatients consecutively started on LAI treatment. Variations in rates and in total number of days of hospitalization between the 12 months before and those after treatment initiation were analyzed. Among 461 individuals screened for eligibility, we included 71 adults with BD, initiated either on first- (FGA) or second-generation (SGA) LAIs. We found a significant decrease in terms of 12-month hospitalization rates (p < 0.001) and number of days (p < 0.001) after LAI initiation, without any effect by age, gender, alcohol/substance use disorders, and symptom severity. Subgroup analyses based on antipsychotic class, history of LAI treatment, and concomitant oral medications, confirmed the decreasing trend on both hospitalization rates and number of days. However, these reductions were not significant among participants who continued this treatment for less than 6 months. Comprehensively, this study supports the role of LAIs as effective maintenance treatment options for BD. Further research is needed to identify clinical characteristics of people with BD who would most benefit from long-acting formulations of antipsychotics.
Collapse
Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
| | - Tommaso Callovini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, University 'Gabriele d'Annunzio' of Chieti, Pescara, Chieti, Italy
| | | | - Giovanni Ostuzzi
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, University of Verona, Verona, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Division of Psychiatry, University College London, London, UK
| |
Collapse
|
18
|
Hsu JW, Chen LC, Tsai SJ, Huang KL, Bai YM, Su TP, Chen TJ, Chen MH. Disease progression to bipolar disorder among adolescents and young adults with antidepressant-resistant and antidepressant-responsive depression: Does antidepressant class matter? Eur Neuropsychopharmacol 2023; 74:22-29. [PMID: 37247462 DOI: 10.1016/j.euroneuro.2023.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023]
Abstract
Studies have demonstrated a positive relationship between antidepressant resistance and the progression of bipolar disorder. However, the influence of antidepressant classes such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) in this context has yet to be investigated. A total of 5,285 adolescents and young adults with antidepressant-resistant depression and 21,140 with antidepressant-responsive depression were recruited in the present study. The antidepressant-resistant depression group was divided into two subgroups: only resistant to SSRIs (n = 2,242, 42.4%) and additionally resistant to non-SSRIs (n = 3,043, 57.6%) groups. The status of bipolar disorder progression was monitored from the date of depression diagnosis to the end of 2011. Patients with antidepressant-resistant depression were more likely to develop bipolar disorder during the follow-up (hazard ratio [HR]: 2.88, 95% confidence interval [CI]: 2.67-3.09) than those with antidepressant-responsive depression. Furthermore, the group that was additionally resistant to non-SSRIs were at the highest risk of bipolar disorder (HR: 3.02, 95% CI: 2.76-3.29), followed by the group that was only resistant to SSRIs (2.70, 2.44-2.98). Adolescents and young adults with antidepressant-resistant depression, especially those who responded poorly to both SSRIs and SNRIs, were at increased risk of subsequent bipolar disorder compared with those with antidepressant-responsive depression. Further studies are warranted to elucidate the molecular pathomechanisms underlying the resistance to SSRIs and SNRIs and subsequent bipolar disorder.
Collapse
Affiliation(s)
- Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
19
|
Suppes T, Durgam S, Kozauer SG, Chen R, Lakkis HD, Davis RE, Satlin A, Vanover KE, Mates S, McIntyre RS, Tohen M. Adjunctive lumateperone (ITI-007) in the treatment of bipolar depression: Results from a randomized placebo-controlled clinical trial. Bipolar Disord 2023; 25:478-488. [PMID: 36779257 DOI: 10.1111/bdi.13310] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE This phase 3, randomized, double-blind, placebo-controlled study (NCT02600507) evaluated the efficacy and safety of lumateperone adjunctive therapy to lithium or valproate in patients with bipolar depression. METHODS Patients (18-75 years) with bipolar I or bipolar II disorder experiencing a major depressive episode (MDE), with inadequate therapeutic response to lithium or valproate, were randomized 1:1:1 to 6 weeks adjunctive therapy with lumateperone 28 mg (n = 176), lumateperone 42 mg (n = 177), or placebo (n = 176). The primary and key secondary efficacy endpoints were change from baseline to Day 43 in Montgomery-Åsberg Depression Rating Scale (MADRS) Total score and the Clinical Global Impression Scale-Bipolar Version-Severity Scale (CGI-BP-S) depression subscore. Safety assessments included adverse events, laboratory evaluations, vital signs, extrapyramidal symptoms (EPS), and suicidality. RESULTS Patients treated with adjunctive lumateperone 42 mg showed significantly greater improvement compared with adjunctive placebo in MADRS Total score (LS mean difference vs placebo [LSMD], -2.4; p = 0.02) and CGI-BP-S depression subscore (LSMD, -0.3; p = 0.01), while adjunctive lumateperone 28 mg showed numerical improvement in MADRS Total score (LSMD, -1.7; p = 0.10) and improvement in the CGI-BP-S depression subscore (LSMD, -0.3; p = 0.04). Adjunctive lumateperone treatment was well tolerated; treatment-emergent adverse events reported at rates >5% and twice placebo for lumateperone 42 mg were somnolence (11.3%), dizziness (10.7%), and nausea (8.5%), with minimal risk of EPS, metabolic abnormalities, or increased prolactin. CONCLUSIONS Lumateperone 42-mg treatment adjunctive to lithium or valproate significantly improved depression symptoms and was generally well tolerated in patients with MDEs associated with either bipolar I or bipolar II disorder.
Collapse
Affiliation(s)
- Trisha Suppes
- Stanford University School of Medicine, Stanford, California, USA
- US Department of Veterans Affairs Palo Alto Healthcare System, Palo Alto, California, USA
| | - Suresh Durgam
- Intra-Cellular Therapies, Inc, New York City, New York, USA
| | | | - Richard Chen
- Intra-Cellular Therapies, Inc, New York City, New York, USA
| | | | - Robert E Davis
- Intra-Cellular Therapies, Inc, New York City, New York, USA
| | - Andrew Satlin
- Intra-Cellular Therapies, Inc, New York City, New York, USA
| | | | - Sharon Mates
- Intra-Cellular Therapies, Inc, New York City, New York, USA
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada
| | - Mauricio Tohen
- Department of Psychiatry & Behavioral Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| |
Collapse
|
20
|
Nuñez NA, Coombes BJ, Melhuish Beaupre L, Romo-Nava F, Gardea-Resendez M, Ozerdem A, Veldic M, Singh B, Sanchez Ruiz JA, Cuellar-Barboza A, Leung JG, Prieto ML, McElroy SL, Biernacka JM, Frye MA. Antidepressant-Associated Treatment Emergent Mania: A Meta-Analysis to Guide Risk Modeling Pharmacogenomic Targets of Potential Clinical Value. J Clin Psychopharmacol 2023; 43:428-433. [PMID: 37683232 PMCID: PMC10476595 DOI: 10.1097/jcp.0000000000001747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/09/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND The purpose of this study was to review the association between the SLC6A4 5-HTTLPR polymorphism and antidepressant (AD)-associated treatment emergent mania (TEM) in bipolar disorder alongside starting a discussion on the merits of developing risk stratification models to guide when not to provide AD treatment for bipolar depression. METHODS Studies that examined the association between clinical and genetic risk factors, specifically monoaminergic transporter genetic variation, and TEM were identified. A meta-analysis was performed using the odds ratio to estimate the effect size under the Der-Simonian and Laird model. RESULTS Seven studies, referencing the SLC6A4 5-HTTLPR polymorphism and TEM (total N = 1578; TEM+ =594, TEM- = 984), of 142 identified articles were included. The time duration between the start of the AD to emergence of TEM ranged from 4 to 12 weeks. There was a nominally significant association between the s allele of the 5-HTTLPR polymorphism and TEM (odds ratio, 1.434; 95% confidence interval, 1.001-2.055; P = 0.0493; I2 = 52%). No studies have investigated norepinephrine or dopamine transporters. CONCLUSION Although the serotonin transporter genetic variation is commercially available in pharmacogenomic decision support tools, greater efforts, more broadly, should focus on complete genome-wide approaches to determine genetic variants that may contribute to TEM. Moreover, these data are exemplary to the merits of developing risk stratification models, which include both clinical and biological risk factors, to guide when not to use ADs in bipolar disorder. Future studies will need to validate new risk models that best inform the development of personalized medicine best practices treating bipolar depression.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marin Veldic
- From the Departments of Psychiatry and Psychology
| | | | | | | | | | - Miguel L. Prieto
- Department of Psychiatry, Faculty of Medicine, Universidad de Los Andes, Santiago, Chile
| | - Susan L. McElroy
- Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Joanna M. Biernacka
- From the Departments of Psychiatry and Psychology
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Mark A. Frye
- From the Departments of Psychiatry and Psychology
| |
Collapse
|
21
|
Duce HL, Duff CJ, Zaidi S, Parfitt C, Heald AH, Fryer AA. Evaluation of thyroid function monitoring in people treated with lithium: Advice based on real-world data. Bipolar Disord 2023; 25:402-409. [PMID: 36645255 DOI: 10.1111/bdi.13298] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Blood test monitoring is essential for the management of lithium treatment and National Institute for Health and Care Excellence guidance recommends 6-monthly serum testing of thyroid function. We examined conformity to these guidelines and the impact of monitoring outside these intervals. METHODS We extracted serum lithium and thyroid hormone results at one centre between January 2009 and December 2020. We identified 266 patients who started lithium during this period with no history of thyroid abnormality within the previous 2 years and were at risk of developing thyroid abnormalities. We examined the interval between tests, time between onset of lithium testing and first thyroid-stimulating hormone (TSH) outside the laboratory reference range and assessed impact of testing outside recommended 6-monthly intervals. RESULTS The most common testing frequency was 3 months (±1 month), accounting for 17.3% of test intervals. Kaplan-Meier analysis showed that most thyroid dysfunction manifests within 3 years (proportion with abnormal TSH at 3 years = 91.4%, 19.9% of total patients). In the first 3 months after commencing lithium therapy, eight patients developed subclinical hypothyroidism and had clinical follow-up data available. Of these, half spontaneously normalized without clinical intervention. In the remaining patients, thyroxine replacement was only initiated after multiple occasions of subclinical hypothyroidism (median = 2 years after initiating lithium, range: 6 months to 3 years). CONCLUSION The peak interval at 3 months suggests that thyroid function is frequently checked at the same time as serum lithium, indicating too frequent testing. Our data support the recommended 6-monthly testing interval and highlight poor adherence to it.
Collapse
Affiliation(s)
- Helen L Duce
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Christopher J Duff
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- School of Medicine, Keele University, Keele, UK
| | - Syed Zaidi
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Ceri Parfitt
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Adrian H Heald
- Department of Diabetes and Endocrinology, Salford Royal NHS Foundation Trust, Salford, UK
- The School of Medicine and Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | | |
Collapse
|
22
|
Wu J, Kwan AT, Rhee TG, Ho R, d'Andrea G, Martinotti G, Teopiz KM, Ceban F, McIntyre RS. A narrative review of non-racemic amisulpride (SEP-4199) for treatment of depressive symptoms in bipolar disorder and LB-102 for treatment of schizophrenia. Expert Rev Clin Pharmacol 2023; 16:1085-1092. [PMID: 37864424 DOI: 10.1080/17512433.2023.2274538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/19/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION The challenges posed by treatment-resistant schizophrenia and depressive symptoms have led to ongoing difficulties despite the availability of antipsychotics and antidepressants. This review addresses the potential of amisulpride analogs, particularly SEP-4199, in addressing these challenges through enhanced efficacy and reduced side effects. AREAS COVERED This review focuses on the pharmacological profile of amisulpride analogs, exemplified by LB-102 and its derivative SEP-4199. PubMed gathered articles (up to 10 March 2023) on 'amisulpride,' 'schizophrenia,' 'bipolar disorder,' and 'major depressive disorder;' ClinicalTrials.gov tracked SEP-4199 and LB-102 trials. LB-102, a newly identified N-methylated analog of amisulpride, exhibits enhanced lipophilicity at lower doses, as demonstrated in a phase 1 study, indicating significant promise for therapeutic applications. The discovery of SEP-4199, a non-racemic analog composed of R- and S-enantiomers in an 85:15 ratio, is discussed, emphasizing its potential to enhance antidepressant effects while minimizing extrapyramidal side effects via selective D2 receptor binding. Recent phase 2 trials have demonstrated SEP-4199's efficacy in treating depressive symptoms in bipolar disorder I, capitalizing on D2-mediated anti-anhedonic and D3-mediated reward effects. EXPERT OPINION The development of SEP-4199 presents a potential breakthrough for managing depressive symptoms in bipolar disorder I. Further exploration of D2 and D3 receptor-mediated effects could lead to improved treatment strategies.
Collapse
Affiliation(s)
- Jie Wu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Angela Th Kwan
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Taeho Greg Rhee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Giacomo d'Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Kayla M Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Felicia Ceban
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Roger S McIntyre
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
23
|
Chan YC. Metronidazole-Induced Mania. Prim Care Companion CNS Disord 2023; 25:22cr03408. [PMID: 37347677 DOI: 10.4088/pcc.22cr03408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Affiliation(s)
- Yiu-Chung Chan
- Department of Psychiatry, The Ohio State University Medical Center, Columbus, Ohio
- Corresponding Author: Yiu-Chung Chan, MD, Department of Psychiatry, The Ohio State University Medical Center, 1670 Upham Dr, Columbus, OH 43210
| |
Collapse
|
24
|
Abstract
Objective: The authors investigated transitions to schizophrenia spectrum or bipolar disorder following different types of substance-induced psychosis and the impact of gender, age, number of emergency admissions related to substance-induced psychosis, and type of substance-induced psychosis on such transitions. Methods: All patients in the Norwegian Patient Registry with a diagnosis of substance-induced psychosis from 2010 to 2015 were included (N=3,187). The Kaplan-Meier method was used to estimate cumulative transition rates from substance-induced psychosis to either schizophrenia spectrum disorder or bipolar disorder. Cox proportional hazard regression was used to estimate hazard ratios for transitions to schizophrenia spectrum or bipolar disorders associated with gender, age, number of emergency admissions, and type of substance-induced psychosis. Results: The 6-year cumulative transition rate from substance-induced psychosis to schizophrenia spectrum disorder was 27.6% (95% CI=25.6–29.7). For men, the risk of transition was higher among younger individuals and those with either cannabis-induced psychosis or psychosis induced by multiple substances; for both genders, the risk of transition was higher among those with repeated emergency admissions related to substance-induced psychosis. The cumulative transition rate from substance-induced psychosis to bipolar disorder was 4.5% (95% CI=3.6–5.5), and the risk of this transition was higher for women than for men. Conclusions: Transition rates from substance-induced psychosis to schizophrenia spectrum disorder were six times higher than transition rates to bipolar disorder. Gender, age, number of emergency admissions, and type of substance-induced psychosis affected the risk of transition.
Collapse
Affiliation(s)
- Eline B Rognli
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo (Rognli); Center for Clinical Documentation and Evaluation, Tromsø, Norway (Heiberg, Jacobsen, Høye); Center for Sami Health Research and Epidemiology of Chronic Diseases Research Group, Department of Community Medicine (Jacobsen), and Department of Clinical Medicine (Høye, Bramness), UiT-Arctic University of Norway, Tromsø; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø (Heiberg, Høye); Norwegian Institute of Public Health, Oslo, and Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Ina H Heiberg
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo (Rognli); Center for Clinical Documentation and Evaluation, Tromsø, Norway (Heiberg, Jacobsen, Høye); Center for Sami Health Research and Epidemiology of Chronic Diseases Research Group, Department of Community Medicine (Jacobsen), and Department of Clinical Medicine (Høye, Bramness), UiT-Arctic University of Norway, Tromsø; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø (Heiberg, Høye); Norwegian Institute of Public Health, Oslo, and Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Bjarne K Jacobsen
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo (Rognli); Center for Clinical Documentation and Evaluation, Tromsø, Norway (Heiberg, Jacobsen, Høye); Center for Sami Health Research and Epidemiology of Chronic Diseases Research Group, Department of Community Medicine (Jacobsen), and Department of Clinical Medicine (Høye, Bramness), UiT-Arctic University of Norway, Tromsø; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø (Heiberg, Høye); Norwegian Institute of Public Health, Oslo, and Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Anne Høye
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo (Rognli); Center for Clinical Documentation and Evaluation, Tromsø, Norway (Heiberg, Jacobsen, Høye); Center for Sami Health Research and Epidemiology of Chronic Diseases Research Group, Department of Community Medicine (Jacobsen), and Department of Clinical Medicine (Høye, Bramness), UiT-Arctic University of Norway, Tromsø; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø (Heiberg, Høye); Norwegian Institute of Public Health, Oslo, and Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Jørgen G Bramness
- Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo (Rognli); Center for Clinical Documentation and Evaluation, Tromsø, Norway (Heiberg, Jacobsen, Høye); Center for Sami Health Research and Epidemiology of Chronic Diseases Research Group, Department of Community Medicine (Jacobsen), and Department of Clinical Medicine (Høye, Bramness), UiT-Arctic University of Norway, Tromsø; Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø (Heiberg, Høye); Norwegian Institute of Public Health, Oslo, and Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| |
Collapse
|
25
|
Martinotti G, Dell'Osso B, Di Lorenzo G, Maina G, Bertolino A, Clerici M, Barlati S, Rosso G, Di Nicola M, Marcatili M, d'Andrea G, Cavallotto C, Chiappini S, De Filippis S, Nicolò G, De Fazio P, Andriola I, Zanardi R, Nucifora D, Di Mauro S, Bassetti R, Pettorruso M, McIntyre RS, Sensi SL, di Giannantonio M, Vita A. Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment-resistant depression. Bipolar Disord 2023; 25:233-244. [PMID: 36636839 DOI: 10.1111/bdi.13296] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Bipolar depression accounts for most of the disease duration in type I and type II bipolar disorder (BD), with few treatment options, often poorly tolerated. Many individuals do not respond to first-line therapeutic options, resulting in treatment-resistant bipolar depression (B-TRD). Esketamine, the S-enantiomer of ketamine, has recently been approved for treatment-resistant depression (TRD), but no data are available on its use in B-TRD. OBJECTIVES To compare the efficacy of esketamine in two samples of unipolar and bipolar TRD, providing preliminary indications of its effectiveness in B-TRD. Secondary outcomes included the evaluation of the safety and tolerability of esketamine in B-TRD, focusing on the average risk of an affective switch. METHODS Thirty-five B-TRD subjects treated with esketamine nasal spray were enrolled and compared with 35 TRD patients. Anamnestic data and psychometric assessments (Montgomery-Asberg Depression Rating Scale/MADRS, Hamilton-depression scale/HAM-D, Hamilton-anxiety scale/HAM-A) were collected at baseline (T0), at one month (T1), and three months (T2) follow up. RESULTS A significant reduction in depressive symptoms was found at T1 and T2 compared to T0, with no significant differences in response or remission rates between subjects with B-TRD and TRD. Esketamine showed a greater anxiolytic action in subjects with B-TRD than in those with TRD. Improvement in depressive symptoms was not associated with treatment-emergent affective switch. CONCLUSIONS Our results supported the effectiveness and tolerability of esketamine in a real-world population of subjects with B-TRD. The low risk of manic switch in B-TRD patients confirmed the safety of this treatment.
Collapse
Affiliation(s)
- Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giuseppe Maina
- Department of Neurosciences Rita Levi Montalcini, University of Torino, Turin, Italy
| | | | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Italy
| | - Gianluca Rosso
- Department of Neurosciences Rita Levi Montalcini, University of Torino, Turin, Italy
| | - Marco Di Nicola
- Section of Psychiatry, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Matteo Marcatili
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Giacomo d'Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Clara Cavallotto
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Stefania Chiappini
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - Giuseppe Nicolò
- Department of Mental Health and Addiction, ASL Roma 5, Rome, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Raffaella Zanardi
- Mood Disorder Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy
| | | | | | - Roberta Bassetti
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network, ON, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, ON, Toronto, Canada
- Canadian Rapid Treatment Center of Excellence, ON, Mississauga, Canada
- Brain and Cognition Discovery Foundation, ON, Toronto, Canada
- Department of Psychiatry, University of Toronto, ON, Toronto, Canada
| | - Stefano L Sensi
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Massimo di Giannantonio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Italy
| |
Collapse
|
26
|
Köhler-Forsberg O, Sylvia LG, Thase M, Calabrese JR, Tohen M, Bowden CL, McInnis M, Iosifescu DV, Kocsis JH, Friedman ES, Ketter TA, McElroy SL, Shelton RC, Fung V, Ostacher MJ, Nierenberg AA. Lithium plus antipsychotics or anticonvulsants for bipolar disorder: Comparing clinical response and metabolic changes. Aust N Z J Psychiatry 2023; 57:93-103. [PMID: 35164524 DOI: 10.1177/00048674221077619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Patients with bipolar disorder treated with lithium often require additional antipsychotics or anticonvulsants. However, the comparative effectiveness and safety of these agents as add-on to lithium has not been studied. METHODS This secondary analysis combined two similar 24-week trials on outpatients with bipolar disorder randomized to lithium (target serum level 0.4-0.6 mEq/L). Guideline-based adjunctive antipsychotics (Li+AP) and anticonvulsants (Li+AC) could be used if clinically indicated and was assessed at every study visit. Response was measured on the Clinical Global Impression scale and we performed adjusted mixed effects linear regression analyses. Analysis of variance tests compared metabolic measures including a binary diagnosis of metabolic syndrome before and after 24 weeks of treatment. RESULTS Among 379 outpatients (57% female, mean age 38 years, mean Clinical Global Impression 4.4), users of Li+AP (N = 50, primarily quetiapine and aripiprazole) improved to a similar degree (mean Clinical Global Impression improvement = 1.6, standard deviation = 1.5) as those using lithium-only (i.e. without adjunctive antipsychotics or anticonvulsants, N = 149, mean Clinical Global Impression improvement = 1.7, standard deviation = 1.4) (p = 0.59). Users of Li+AC (N = 107, primarily lamotrigine and valproate, mean Clinical Global Impression improvement = 1.2, standard deviation = 1.3) and users of Li+AP+AC (N = 73, mean Clinical Global Impression improvement = 1.1, standard deviation = 1.3) showed worse response compared to lithium-only users (all p < 0.01). When comparing Li+AP to Li+AC, users of Li+AP improved slightly better on general (p = 0.05) and manic symptoms (p = 0.01), but showed a worse development of glucose, triglycerides, and metabolic syndrome. CONCLUSION Despite treatment-by-indication confounding, these findings are relevant for real-world treatment settings and emphasize the need for randomized trials on this clinically important topic.
Collapse
Affiliation(s)
- Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Denmark
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Michael Thase
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Mauricio Tohen
- Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Charles L Bowden
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Dan V Iosifescu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - James H Kocsis
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - Edward S Friedman
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
| | - Susan L McElroy
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Psychiatry, Lindner Center of HOPE, Mason, OH, USA
| | - Richard C Shelton
- Department of Psychiatry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vicki Fung
- Department of Psychiatry, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Michael J Ostacher
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
27
|
Gardea-Resendez M, Taylor-Desir MJ, Romo-Nava F, Bond D, Vallender EJ, Cuellar-Barboza AB, Prieto ML, Nunez N, Veldic M, Ozerdem A, Singh B, Markota M, Colby CL, Coombes BJ, Biernacka JM, McElroy SL, Frye MA. Clinical Phenotype of Tardive Dyskinesia in Bipolar Disorder. J Clin Psychopharmacol 2022; 42:159-162. [PMID: 35230047 DOI: 10.1097/jcp.0000000000001532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Recognizing the negative impact that antipsychotic-induced movement disorders have on the quality of life and treatment outcomes in bipolar disorder (BD), this study aimed to assess clinical correlates and antipsychotic use patterns of tardive dyskinesia (TD+) in BD. MATERIALS AND METHODS Participants with and without TD were included. Clinical variables were compared using t-test and χ2 test. Antipsychotic use patterns in TD+, including number of trials, mean doses, and estimated cumulative exposure, were assessed in a case-only analysis. RESULTS The prevalence rate of TD was 5.1%. In comparison to the TD- group (n = 1074), TD+ participants (n = 58) were older, more likely to be female and have type I bipolar illness. There were 60.3% of the TD+ group that continued using antipsychotics at study entry and had a mean cumulative exposure to antipsychotics of 18.2 ± 15.6 years. Average dose, in haloperidol equivalents, was 5.9 ± 3.5 mg and 77.7% of the trials were second-generation antipsychotics. CONCLUSIONS This study confirms previously identified TD risk factors, such as age, sex, and bipolar subtype in a large BD cohort. Limitations included a cross-sectional design and the lack of tardive illness severity assessment. As atypical antipsychotics continue to be primary mood stabilization treatment, attempting to harmonize large data sets to identify additional biomarkers of tardive risk will optimize individualized care for patients with BD.
Collapse
Affiliation(s)
| | | | | | - David Bond
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Eric J Vallender
- Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, Jackson, MS
| | | | | | - Nicolas Nunez
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - Marin Veldic
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - Aysegul Ozerdem
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - Balwinder Singh
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - Matej Markota
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| | - Colin L Colby
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Susan L McElroy
- Lindner Center of HOPE/University of Cincinnati, Cincinnati, OH
| | - Mark A Frye
- From the Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN
| |
Collapse
|
28
|
Gutiérrez-Arango F, Anmella G, Hidalgo-Mazzei D, Gomes-da-Costa S, Gil-Badenes J, Marco-Hernández J, Espinosa G, Colomer L, Baldaquí N, Pujal E, Fico G, Giménez A, Verdolini N, Murru A, Vieta E, Pacchiarotti I. Bipolar disorder and Susac syndrome: a case report. Int Clin Psychopharmacol 2021; 36:305-309. [PMID: 34270507 DOI: 10.1097/yic.0000000000000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Susac-syndrome is a rare autoimmune disease that manifests with mood alterations in up to 15% of cases and is usually treated with corticosteroids. We present the case of a 41-year-old woman with a first manic episode and history of Susac-syndrome, secondary Cushing's syndrome after receiving high doses of corticosteroids and a previous depressive episode. Differentiating between primary and secondary mania is difficult, as people with bipolar disorder are prone to multiple psychiatric and nonpsychiatric comorbidities, in this case, the differential diagnosis included secondary mania, corticoid-induced manic episode and primary bipolar disorder. Upon admission, corticosteroid treatment was suspended, and the patient was started on lithium and risperidone. Secondary causes of mania were discarded and, assessing temporal and dosage criteria, it was deemed unlikely that the present episode was corticosteroid-induced. One-year outpatient follow-up pointed towards a primary bipolar type I disorder, as a separate entity from her Susac-syndrome. Corticosteroid use or abrupt withdrawal pose an underestimated risk of inducing depressive or manic symptoms, which may unmask affective disorders in susceptible individuals. Many medical conditions share CNS involvement and/or high-dose/prolonged corticosteroid treatment. In such cases, psychiatric manifestations such as mania or depression should be regarded as secondary and studied to determine the existence of medical complications before considering primary psychiatric conditions.
Collapse
Affiliation(s)
- Felipe Gutiérrez-Arango
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Susana Gomes-da-Costa
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Joaquín Gil-Badenes
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Javier Marco-Hernández
- Autoimmune Diseases Department, Institut d'Investigacions August Pi i Sunyer, Universitat de Barcelona, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Gerard Espinosa
- Autoimmune Diseases Department, Institut d'Investigacions August Pi i Sunyer, Universitat de Barcelona, Hospital Clinic, Barcelona, Catalonia, Spain
| | - Lluc Colomer
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Nuria Baldaquí
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Ester Pujal
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Anna Giménez
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| | - Isabella Pacchiarotti
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM
| |
Collapse
|
29
|
León EA. [Mania and hypomania induced by antidepressants in children and adolescents. Bibliographic review]. Vertex 2021; XXXII:24-28. [PMID: 34783792 DOI: 10.53680/vertex.v32i152.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Children are more prone to adverse effects of selective serotonin reuptake inhibitors than adults. The aim of this study is to review the bibliography on mania and hypomania induced by these antidepressants. Most of the young people diagnosed with bipolar disorder had been exposed to this type of drug. The hypomania associated with these antidepressants in children with anxiety disorders is as relevant as that of those who had previously received a diagnosis of depression. As a limitation, in the selected papers, the activation syndrome could or could not include (hypo) mania. When indicating an antidepressant, we must be extremely prudent and place special emphasis on the risk-benefit analysis. It is essential to conduct a thorough search of family history of bipolar disorder together with a personal history investigation and a meticulous analysis of the semiology of our patients due to the risks of (hypo) mania.
Collapse
Affiliation(s)
- Estefanía Adela León
- Médica especialista en psiquiatría infanto-juvenil. Magister en ciencias, tecnologías y salud, mención biología integrativa especializada en neurociencias (M2). Sorbonne Université, París, Francia. Psiquiatra infanto juvenil del Hospital Interzonal de Agudos Especializado en Pediatría "Sor María Ludovica". La Plata, Prov. de Buenos Aires, Argentina. E-mail:
| |
Collapse
|
30
|
Fenger-Grøn M, Vestergaard CH, Ribe AR, Johnsen SP, Frost L, Sandbæk A, Davydow DS. Association Between Bipolar Disorder or Schizophrenia and Oral Anticoagulation Use in Danish Adults With Incident or Prevalent Atrial Fibrillation. JAMA Netw Open 2021; 4:e2110096. [PMID: 33999163 PMCID: PMC8129823 DOI: 10.1001/jamanetworkopen.2021.10096] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Individuals with bipolar disorder or schizophrenia have a higher risk of adverse outcomes from cardiovascular diseases. Oral anticoagulation therapy (OAT) for patients with atrial fibrillation (AF) is needed for stroke prevention, but whether patients with bipolar disorder or schizophrenia face disparities in receiving this therapy is unknown. OBJECTIVE To assess whether bipolar disorder or schizophrenia is associated with a lower rate of OAT initiation in patients with incident AF and lower prevalence of OAT in those with prevalent AF. DESIGN, SETTING, AND PARTICIPANTS A nationwide cohort study of Danish patients with AF was conducted from January 1, 2005, to December 31, 2016, and data were analyzed from January 1 to June 15, 2020. Data from national registries included information on all redeemed prescriptions and all hospital contacts of all patients with incident or prevalent AF (age, 18-100 years) and increased risk status, defined by a CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) risk score greater than or equal to 2. EXPOSURES Hospital diagnosis of bipolar disorder or schizophrenia. MAIN OUTCOMES AND MEASURES Adjusted proportion differences for OAT initiation and OAT prevalence, comparing individuals with and without bipolar disorder or schizophrenia. RESULTS Patients included with incident AF (n = 147 810) had a mean (SD) age of 76.9 (10.1) years, 78 577 (53.2%) were women, 1208 (0.8%) had bipolar disorder, and 572 (0.4%) had schizophrenia. Accounting for age, sex, and calendar time, bipolar disorder and schizophrenia were associated with significantly lower frequency of OAT initiation within 90 days after incident AF (bipolar disorder: -12.7%; 95% CI, -15.3% to -10.0%; schizophrenia: -24.5%; 95% CI, -28.3% to -20.7%) and lower OAT prevalence in patients with prevalent AF (bipolar disorder: -11.6%; 95% CI, -13.9% to -9.3% schizophrenia: -21.6%; 95% CI, -24.8% to -18.4%). Adjusting for socioeconomic factors and other comorbid conditions attenuated these associations, particularly for patients with bipolar disorder. However, schizophrenia continued to be associated with a with a lower rate of OAT initiation (-15.5%, 95% CI, -19.3% to -11.7%) and a -12.8% (95% CI, -15.9% to -9.7%) lower OAT prevalence. These associations were also present after the introduction of non-vitamin K antagonists (adjusted proportion difference in 2013-2016: -12.4%; 95% CI, -18.7% to -6.1% for initiation and -10.1%; 95% CI, -13.8% to -6.4% for prevalence). CONCLUSIONS AND RELEVANCE In this study, patients with bipolar disorder or schizophrenia were less likely to receive OAT in the setting of AF. For patients with bipolar disorder, this deficit was largely associated with socioeconomic factors and comorbidities, especially toward the end of the study period. For patients with schizophrenia, disparities in this stroke prevention therapy persistently exceeded what could be explained by other patient characteristics.
Collapse
Affiliation(s)
- Morten Fenger-Grøn
- Research Unit for General Practice, Aarhus Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | | | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lars Frost
- Department of Clinical Medicine, Aarhus University, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Annelli Sandbæk
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center, Aarhus University Hospital, Aarhus, Denmark
| | | |
Collapse
|
31
|
Damri O, Asslih S, Shemesh N, Natour S, Noori O, Daraushe A, Einat H, Kara N, Las G, Agam G. Using mitochondrial respiration inhibitors to design a novel model of bipolar disorder-like phenotype with construct, face and predictive validity. Transl Psychiatry 2021; 11:123. [PMID: 33579900 PMCID: PMC7881114 DOI: 10.1038/s41398-021-01215-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
We mimicked mild mitochondrial-distress robustly reported in bipolar-disorder (BD) by chronic exposure to uniquely low doses of inhibitors of mitochondrial-respiration complexes in vitro and in vivo. Exposure of the neuronal-originating SH-SY5Y cells to very low dose (10 pM) rotenone, a mitochondrial-respiration complex (Co)I inhibitor, for 72 or 96 h did not affect cell viability and reactive oxygen species (ROS) levels. Yet, it induced a dual effect on mitochondrial-respiration: overshooting statistically significant several-fold increase of most oxygen-consumption-rate (OCR) parameters vs. significantly decreased all OCR parameters, respectively. Chronic low doses of 3-nitropropionic acid (3-NP) (CoII inhibitor) did not induce long-lasting changes in the cells' mitochondria-related parameters. Intraperitoneal administration of 0.75 mg/kg/day rotenone to male mice for 4 or 8 weeks did not affect spontaneous and motor activity, caused behaviors associated with mania and depression following 4 and 8 weeks, respectively, accompanied by relevant changes in mitochondrial basal OCR and in levels of mitochondrial-respiration proteins. Our model is among the very few BD-like animal models exhibiting construct (mild mitochondrial dysfunction), face (decreased/increased immobility time in the forced-swim test, increased/decreased consumption of sweet solution, increased/decreased time spent in the open arms of the elevated plus maze) and predictive (reversal of rotenone-induced behavioral changes by lithium treatment) validity. Our rotenone regime, employing doses that, to the best of our knowledge, have never been used before, differs from those inducing Parkinson's-like models by not affecting ROS-levels and cell-viability in vitro nor motor activity in vivo.
Collapse
Affiliation(s)
- O Damri
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - S Asslih
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - N Shemesh
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - S Natour
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - O Noori
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - A Daraushe
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - H Einat
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv-Yafo, Israel
| | - N Kara
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv-Yafo, Israel
| | - G Las
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel
| | - G Agam
- Department of Clinical Biochemistry and Pharmacology and Psychiatry Research Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev and Mental Health Center, Beer-Sheva, Israel.
| |
Collapse
|
32
|
Kurhan F, Kamiş GZ. Isotretinoin Induced Psychotic Mania: A Case Report. Turk Psikiyatri Derg 2021; 32:214-218. [PMID: 34750797 DOI: 10.5080/u25066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Biological, genetic and psychosocial factors may play a role in the aetiology of bipolar mood disorder (BPD). BPD episodes might be triggered by isotretinoin, a retinoid derivative of vitamin A with a role in cellular proliferation and differentiation. Due to its association with depression, suicidal ideation and suicide attempts, American Food and Drug Administration (FDA) issued a placement of a label warning for isotretionin. Personal or family history of psychiatric disorders was emphasized in the literature for the risk of mood episodes following isotretionin treatment. Here we aim to present the case of an 18- year old young male adult, without personal or family history of a psychiatric disorder, who developed psychotic mania within the first week of isoretinoin which was prescribed for acne vulgaris. Psychotic mania symptoms receded within one week after starting olanzapine (10 mg/day). We believe this case is significant in demonstrating the occurence of a manic episode after isoretinoin in individuals lacking a personal or family history of psychiatric diagnoses.
Collapse
|
33
|
Kurhan F, Kamiş GZ. Isotretinoin Induced Psychotic Mania: A Case Report. Turk Psikiyatri Derg 2021; 32:214-218. [PMID: 34647293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Biological, genetic and psychosocial factors may play a role in the aetiology of bipolar mood disorder (BPD). BPD episodes might be triggered by isotretinoin, a retinoid derivative of vitamin A with a role in cellular proliferation and differentiation. Due to its association with depression, suicidal ideation and suicide attempts, American Food and Drug Administration (FDA) issued a placement of a label warning for isotretionin. Personal or family history of psychiatric disorders was emphasized in the literature for the risk of mood episodes following isotretionin treatment. Here we aim to present the case of an 18- year old young male adult, without personal or family history of a psychiatric disorder, who developed psychotic mania within the first week of isoretinoin which was prescribed for acne vulgaris. Psychotic mania symptoms receded within one week after starting olanzapine (10 mg/day). We believe this case is significant in demonstrating the occurence of a manic episode after isoretinoin in individuals lacking a personal or family history of psychiatric diagnoses.
Collapse
|
34
|
Abstract
Manic and hypomanic states associated with antidepressant treatments are relatively common; however, when specifically considering mirtazapine, those side effects are infrequent. The authors report a clinical case regarding a manic episode with dysphoric features in a patient with no personal or family previous psychiatric history. It began two weeks after starting treatment with mirtazapine up to 30 mg/day. This episode was treated discontinuing mirtazapine and initiating olanzapine (10 mg), with symptomatic remission. Mirtazapine has a specific pharmacodynamics, blocking not only post-synaptic serotonergic receptors but also α2-presynaptic adrenergic receptors. Taking this into consideration, it was hypothesized that this case could be attributed to a noradrenergic syndrome, characterized by dysphoria, irritability, insomnia and psychomotor agitation.
Collapse
Affiliation(s)
- Catarina Freitas
- Departamento de Psiquiatria e Saúde Mental. Centro Hospitalar de Trás-os-Montes e Alto Douro. Vila Real. Portugal
| | - Rui Barranha
- Departamento de Psiquiatria e Saúde Mental. Centro Hospitalar do Tâmega e Sousa. Penafiel. Portugal
| | - Tânia Abreu
- Departamento de Psiquiatria e Saúde Mental. Centro Hospitalar do Tâmega e Sousa. Penafiel. Portugal
| | - Orlando Von Doellinger
- Departamento de Psiquiatria e Saúde Mental. Centro Hospitalar do Tâmega e Sousa. Penafiel. Portugal
| |
Collapse
|
35
|
Ioachimescu AG, Fleseriu M, Hoffman AR, Vaughan Iii TB, Katznelson L. Psychological effects of dopamine agonist treatment in patients with hyperprolactinemia and prolactin-secreting adenomas. Eur J Endocrinol 2019; 180:31-40. [PMID: 30400048 DOI: 10.1530/eje-18-0682] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/25/2018] [Indexed: 11/08/2022]
Abstract
Background Dopamine agonists (DAs) are the main treatment for patients with hyperprolactinemia and prolactinomas. Recently, an increasing number of reports emphasized DAs' psychological side effects, either de novo or as exacerbations of prior psychiatric disease. Methods Review of prospective and retrospective studies (PubMed 1976, September 2018) evaluating the psychological profile of DA-treated patients with hyperprolactinemia and prolactinomas. Case series and case reports of psychiatric complications were also reviewed. Results Most studies were cross-sectional and had a control group of healthy volunteers or patients with nonfunctioning pituitary adenomas. There were few prospective studies, with/without control group, that included small numbers of patients. Compared with controls, patients with hyperprolactinemia generally had worse quality of life, anxiety, depression and certain personality traits. Patients receiving DAs had higher impulsivity scores than normoprolactinemic controls. Impulse control disorders (ICDs) were reported in both genders, with hypersexuality mostly in men. Multiple ICDs were sometimes reported in the same patient, usually reversible after DA discontinuation. In case reports, DA therapy was temporally associated with severe depression, manic episodes or psychosis, which improved after discontinuation and administration of psychiatric medications. Gender type of DA, dose and duration of therapy did not correlate with occurrence of psychiatric pathology. Conclusion Patients with hyperprolactinemia receiving DAs may develop changes in mood and behavior regardless of prior psychiatric history. Increased awareness for ICDs, depression, mania and other types of psychosis is needed by all physicians who prescribe DAs. Larger prospective controlled clinical studies are needed to delineate prevalence, risk stratification and management.
Collapse
Affiliation(s)
- Adriana G Ioachimescu
- Division of Endocrinology, Diabetes and Metabolism, Departments of Medicine, Neurosurgery and Emory Pituitary Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Maria Fleseriu
- Division of Endocrinology, Diabetes and Clinical Nutrition, Departments of Medicine, Neurosurgery and Northwest Pituitary Center, Oregon Health and Science University, Portland, Oregon, USA
| | - Andrew R Hoffman
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - T Brooks Vaughan Iii
- Division of Diabetes, Endocrinology and Metabolism and Veteran Affairs Hospital, Department of Medicine and Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Laurence Katznelson
- Division of Endocrinology, Gerontology and Metabolism, Department of Medicine and Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
36
|
Abstract
A 49-year-old male with major depressive disorder well-managed with venlafaxine [serotonin and norepinephrine reuptake inhibitor (SNRI)] and no history of manic episodes developed his first manic episode following use of tramadol. Tramadol-induced mania has been described with selective serotonin reuptake inhibitors but not SNRIs. In addition, mania is not listed as a potential clinical side effect-further illustrating this relative rarity. Due to tramadol's SNRI activity, there is definitive risk for mood lability in individuals managed with tramadol and other serotonergic medications as seen in this patient. The authors findings suggest the need for greater risk consideration when prescribing tramadol with other related agents such as venlafaxine.
Collapse
Affiliation(s)
- Nousha Hefzi
- Wayne State University School of Medicine, Detroit, Michigan
| | - Jeremy Grekin
- Wayne State University School of Medicine, Detroit, Michigan
| | | |
Collapse
|
37
|
Wang YC, Yu YH, Tsai ML, Huang ACW. Motor function in an animal model with ouabain-induced bipolar disorder and comorbid anxiety behavior. Psychiatry Res 2018; 268:508-513. [PMID: 30165326 DOI: 10.1016/j.psychres.2018.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 04/10/2018] [Accepted: 07/18/2018] [Indexed: 12/26/2022]
Abstract
In a clinical setting, anxiety disorder is highly correlated with bipolar I disorder in humans. However, the comorbidity of anxiety behavior and bipolar disorder still remains unclear in an animal model. This study utilized an ouabain-induced animal mode to examine anxiety and mania in an open field test. In the present study, 5 µl of artificial cerebrospinal fluid (aCSF) or ouabain (10-5, 10-4, and 10-3 M) were administered into the left ventricle. The animals' motor functions and anxiety behaviors were measured for 15 min. The results showed that 10-3 M ouabain significantly increased the animal's total distance traveled, average speed, and maximum speed compared to the control group. The time spent inside (i.e., how much time rats spent in the center of the square) and the inside-outside times of the central square (i.e., how many times rats ran across the center square) of the higher-concentration groups (10-4 M and 10-3 M) were significantly decreased. Therefore, a high concentration of ouabain may induce hyperactivity. The 10-4 M and 10-3 M ouabain groups exhibited more anxiety behaviors. The study is the first model to examine comorbid anxiety behaviors and bipolar disorder in an animal model. The study provides some insights for comorbid anxiety and bipolar disorder in clinics.
Collapse
Affiliation(s)
- Ying-Chou Wang
- Department of Clinical Psychology, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Ying Hao Yu
- Department of Psychology, Fo Guang University, Yilan County 26247, Taiwan
| | - Meng-Li Tsai
- Department of Biomechatronic Engineering, National Ilan University, Ilan, Taiwan
| | | |
Collapse
|
38
|
Affiliation(s)
- Jawahar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
| | - Rishab Gupta
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, United States.
| | | | - Ravindra Rao
- Department of Psychiatry & National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
39
|
Affiliation(s)
- John B Taylor
- From the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Massachusetts General Hospital, and the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Harvard Medical School - both in Boston
| | - Laura M Prager
- From the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Massachusetts General Hospital, and the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Harvard Medical School - both in Boston
| | - Nadia V Quijije
- From the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Massachusetts General Hospital, and the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Harvard Medical School - both in Boston
| | - Pamela W Schaefer
- From the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Massachusetts General Hospital, and the Departments of Psychiatry (J.B.T., L.M.P., N.V.Q.) and Radiology (P.W.S.), Harvard Medical School - both in Boston
| |
Collapse
|
40
|
Casas-Gómez C, Muñoz-Molero MJ, Guerrero-Sánchez R, Martínez-León F. Mania and energy drinks. Actas Esp Psiquiatr 2018; 46:156-158. [PMID: 30079930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
|
41
|
Ithman M, Malhotra K, Bordoloi M, Singh G. Treatment-Refractory Mania with Psychosis in a Post-Transplant Patient on Tacrolimus: A Case Report. Clin Med Res 2018; 16:47-49. [PMID: 29776917 PMCID: PMC6108512 DOI: 10.3121/cmr.2018.1409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/13/2018] [Accepted: 05/01/2018] [Indexed: 11/18/2022]
Abstract
Bipolar affective disorder type I imparts significant morbidity and disease burden in the population. It is characterized by occurrence of one or more manic episodes which may be preceded or followed by a depressive or hypomanic phase. About half of these manic episodes are characterized by the presence of psychotic features. The condition is further complicated when the patient has multiple comorbid conditions. We report here the case of a Caucasian woman, aged 66 years, previously diagnosed with Bipolar disorder who developed treatment refractory mania with psychotic feature after being on the immunosuppressive agent, tacrolimus, after kidney transplantation.
Collapse
Affiliation(s)
- Muaid Ithman
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Kunal Malhotra
- Department of Nephrology, University of Missouri-Columbia, Columbia, Missouri
| | - Meelie Bordoloi
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| | - Garima Singh
- Department of Psychiatry, University of Missouri-Columbia, Columbia, Missouri
| |
Collapse
|
42
|
Ismail Z. Dispensary cannabidiol marijuana and first-episode mania. J Psychiatry Neurosci 2018; 43:215-216. [PMID: 29688878 PMCID: PMC5915243 DOI: 10.1503/jpn.180034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Zahinoor Ismail
- From the Mathison Centre for Mental Health Research & Education; Hotchkiss Brain Institute, University of Calgary, Calgary, Alta., Canada
| |
Collapse
|
43
|
Geniş B, Coşar B. [Mania Associated with the Use of Bortezomib and Dexamethasone]. Turk Psikiyatri Derg 2018; 29:209-215. [PMID: 30260467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Bortezomib, an antineoplastic agent used in Multiple Myeloma, is a modified dipeptidyl boronic acid that is selectively and reversibly attached to the 26S proteasome. Bortezomib may be combined with corticosteroids in treatment-resistant multiple myeloma patients. Corticosteroids can cause many psychiatric disorders ncluding mania, depression, psychosis, delirium, suicide and aggression. To date only one case of mania associated with the use of bortezomib was reported in which the patient responded to the treatment with olanzapine and valproic acid. In this article, we present a 57-year-old female with multiple myeloma in whom mania developed after the use of bortezomib combined with dexamethasone.Psychiatric symptoms such as sleep deprivation, increased self-esteem and excessive speech appeared within the first week of bortezomib and dexamethasone treatment. Quetiapine was administered for the treatment of psychiatric symptoms. A gradual improvement was noted in manic symptoms after treatment. Bortezomib is a relatively new drug and there are only a few reports with respect to its psychiatric side effects. While using antineoplastic drugs such as bortezomib, caution should be exercised with regards to the psychiatric symptoms.
Collapse
|
44
|
Cappai MN, Jacobs BAW, Tulner L, Holwerda TJ. [Hypomania induced by intranasal corticosteroid fluticasone spray]. Tijdschr Psychiatr 2018; 60:419. [PMID: 29943800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A 79-year old man was diagnosed with an episode of hypomania during the use of fluticasone intranasal spray. After discontinuation the patient recovered completely. Patients with oral corticosteroid treatment have an increased risk of developing severe neuropsychiatric symptoms. This case-report shows that adverse systemic effects can also occur when using local corticosteroids. While the incidence of systemic side effects after using local treatment is not well known, there are various case reports. It is advised to be cautious when using multiple corticosteroids simultaneously due to the additive effect, when treating risk groups and when treating patients with a history of psychiatric disease.
Collapse
|
45
|
Aas M, Melle I, Bettella F, Djurovic S, Le Hellard S, Bjella T, Ringen PA, Lagerberg TV, Smeland OB, Agartz I, Andreassen OA, Tesli M. Psychotic patients who used cannabis frequently before illness onset have higher genetic predisposition to schizophrenia than those who did not. Psychol Med 2018; 48:43-49. [PMID: 28967348 DOI: 10.1017/s0033291717001209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Schizophrenia (SZ) and bipolar disorder (BD) are heritable, polygenic disorders with shared clinical and genetic components, suggesting a psychosis continuum. Cannabis use is a well-documented environmental risk factor in psychotic disorders. In the current study, we investigated the relationship between SZ genetic load and cannabis use before illness onset in SZ and BD spectrums. Since frequent early cannabis use (age <18 years) is believed to increase the risk of developing psychosis more than later use, follow-up analyses were conducted comparing early use to later use and no use. METHODS We assigned a SZ-polygenic risk score (PGRS) to each individual in our independent sample (N = 381 SZ spectrum cases, 220 BD spectrum cases and 415 healthy controls), calculated from the results of the Psychiatric Genomics Consortium (PGC) SZ case-control study (N = 81 535). SZ-PGRS in patients who used cannabis weekly to daily in the period before first illness episode was compared with that of those who never or infrequently used cannabis. RESULTS Patients with weekly to daily cannabis use before illness onset had the highest SZ-PGRS (p = 0.02, Cohen's d = 0.33). The largest difference was found between patients with daily or weekly cannabis use before illness onset <18 years of age and patients with no or infrequent use of cannabis (p = 0.003, Cohen's d = 0.42). CONCLUSIONS Our study supports an association between high SZ-PGRS and frequent cannabis use before illness onset in psychosis continuum disorders.
Collapse
Affiliation(s)
- M Aas
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - I Melle
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - F Bettella
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - S Djurovic
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - S Le Hellard
- NORMENT,KG Jebsen Centre for Psychosis Research,Department of Clinical Science,University of Bergen,Bergen,Norway
| | - T Bjella
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - P A Ringen
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - T V Lagerberg
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - O B Smeland
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - I Agartz
- NORMENT,KG Jebsen Centre for Psychosis Research,Division of Mental Health and Addiction,University of Oslo,Oslo,Norway
| | - O A Andreassen
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - M Tesli
- NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| |
Collapse
|
46
|
Viktorin A, Rydén E, Thase ME, Chang Z, Lundholm C, D’Onofrio BM, Almqvist C, Magnusson PKE, Lichtenstein P, Larsson H, Landén M. The Risk of Treatment-Emergent Mania With Methylphenidate in Bipolar Disorder. Am J Psychiatry 2017; 174:341-348. [PMID: 27690517 PMCID: PMC6641557 DOI: 10.1176/appi.ajp.2016.16040467] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to determine the risk of treatment-emergent mania associated with methylphenidate, used in monotherapy or with a concomitant mood-stabilizing medication, in patients with bipolar disorder. METHOD Using linked Swedish national registries, the authors identified 2,307 adults with bipolar disorder who initiated therapy with methylphenidate between 2006 and 2014. The cohort was divided into two groups: those with and those without concomitant mood-stabilizing treatment. To adjust for individual-specific confounders, including disorder severity, genetic makeup, and early environmental factors, Cox regression analyses were used, conditioning on individual to compare the rate of mania (defined as hospitalization for mania or a new dispensation of stabilizing medication) 0-3 months and 3-6 months after medication start following nontreated periods. RESULTS Patients on methylphenidate monotherapy displayed an increased rate of manic episodes within 3 months of medication initiation (hazard ratio=6.7, 95% CI=2.0-22.4), with similar results for the subsequent 3 months. By contrast, for patients taking mood stabilizers, the risk of mania was lower after starting methylphenidate (hazard ratio=0.6, 95% CI=0.4-0.9). Comparable results were observed when only hospitalizations for mania were counted. CONCLUSIONS No evidence was found for a positive association between methylphenidate and treatment-emergent mania among patients with bipolar disorder who were concomitantly receiving a mood-stabilizing medication. This is clinically important given that up to 20% of people with bipolar disorder suffer from comorbid ADHD. Given the markedly increased hazard ratio of mania following methylphenidate initiation in bipolar patients not taking mood stabilizers, careful assessment to rule out bipolar disorder is indicated before initiating monotherapy with psychostimulants.
Collapse
Affiliation(s)
- Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eleonore Rydén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michael E. Thase
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA,
USA
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Lundholm
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M. D’Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Patrik KE Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of medical sciences, Örebro University, Örebro, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
47
|
Arslan FC, Tiryaki A, Yıldırım M, Özkorumak E, Alver A, Altun İK, İnce İ, Gedikli Ö. The effects of edaravone in ketamine-induced model of mania in rats. Acta Neurobiol Exp (Wars) 2017; 76:192-8. [PMID: 27685772 DOI: 10.21307/ane-2017-019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Bipolar disorder is a chronic disease characterized by recurring episodes of mania and depression that can lead to disability. This study investigates the protective effects of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one), a drug with well-known antioxidant properties, in a model of mania induced by ketamine in rats. Locomotor activity was assessed in the open-field test. Superoxide dismutase (SOD), catalase (CAT) and thiobarbituric acid reactive substances (TBARS) levels were measured in order to evaluate oxidative damage in the rat hippocampus and prefrontal cortex. Increased locomotor activity (hyperlocomotion) was observed at the open-field test with ketamine treatment (25 mg/kg, i.p., 8 days). Edaravone (18 mg/kg) treatment did not prevent hyperlocomotion in the mania model induced with ketamine in rats, but lithium chloride (47.5 mg/kg, i.p., positive control) did prevent hyperlocomotion. Edaravone and lithium chloride treatments were found to reduce the increase in SOD and CAT activity following ketamine administration in a non-significant manner but caused no change in TBARS levels.
Collapse
Affiliation(s)
- Filiz Civil Arslan
- Department of Psychiatry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
| | - Ahmet Tiryaki
- Department of Psychiatry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Yıldırım
- Department of Medical Physiology, Faculty of Medicine, Health Sciences University, Istanbul, Turkey
| | - Evrim Özkorumak
- Department of Psychiatry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Alver
- Department of Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - İlkay Keleş Altun
- Department of Psychiatry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - İmran İnce
- Department of Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Öznur Gedikli
- Department of Physiology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| |
Collapse
|
48
|
Di Tommaso Morrison MC, Carinci F, Lessiani G, Spinas E, Kritas SK, Ronconi G, Caraffa A, Conti P. Fibromyalgia and bipolar disorder: extent of comorbidity and therapeutic implications. J BIOL REG HOMEOS AG 2017; 31:17-20. [PMID: 28337866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Fibromyalgia (FM) is a syndrome that affects muscles and soft tissues. Presenting symptoms include chronic muscle pain, fatigue, sleep problems and psychological symptoms, including depression and anxiety. There exists strong evidence of a comorbidity between FM and Bipolar Disorder (BD). In this study, papers from 2006 to February 2016 that examined the comorbidity and etiological similarities of FM and BD were reviewed, as well as the therapeutic implications of these findings. The reviewed articles showed that an adequate psychiatric screening for BD is recommended in FM patients with depressive symptoms, in order to decrease administration of antidepressants for BD, due to the lack of proven efficacy, and to limit antidepressant-induced mania. Alternative therapies, such as agomelatine, memantine and psychotherapic treatment should be considered.
Collapse
Affiliation(s)
| | - F Carinci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - G Lessiani
- Angiology Unit, Medicine and Geriatric Department, Villa Serena Hospital, Italy
| | - E Spinas
- Department of Surgery and Odontostomatological Sciences, University of Cagliari, Italy
| | - S K Kritas
- Department of Microbiology and Infectious Diseases, School of Veterinary Medicine, Aristotle University of Thessaloniki, Macedonia, Greece
| | - G Ronconi
- UOS Clinica dei Pazienti del Territorio, Policlinico Gemelli, Roma, Italy
| | - Al Caraffa
- Department of Pharmacology, University of Perugia, Perugia, Italy
| | - P Conti
- Immunology Division, Postgraduate Medical School, University of Chieti-Pescara, Chieti, Italy
| |
Collapse
|
49
|
Abstract
A variety of medications, most notably tricyclic antidepressants, and other antidepressants including venlafaxine have been reported to have triggered manic episodes in patients with bipolar disorder. The synthetic opioid tramadol has also been associated with mania activation. This report describes an unusual case of tramadol-associated mania in a patient without a charted diagnosis of bipolar disorder. However, she had a history of two prior episodes of mania following administration of tramadol that were also believed to be related to medication-induced mood disorder rather than underlying bipolar disorder. We hypothesize that tramadol-associated mania may have an underlying mechanism involving monoamine neurotransmission and increased oxidative stress.
Collapse
Affiliation(s)
- Jamaluddin Nimah
- Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Alexander Chen
- Department of Psychiatry, School of Medicine, Saint Louis University, St. Louis, Missouri
| | - Kelly N Gable
- BCPP, School of Pharmacy, Southern Illinois University at Edwardsville, Edwardsville, Illinois
| | - Alan R Felthous
- Forensic Psychiatry Division, Department of Psychiatry, School of Medicine, Saint Louis University, St. Louis, Missouri
| |
Collapse
|
50
|
|