Topiramate in Adolescents with Juvenile Bipolar Disorder Presenting Weight Gain Due to Atypical Antipsychotics or Mood Stabilizers: An Open Clinical Trial

2007 ◽  
Vol 17 (1) ◽  
pp. 129-134 ◽  
Author(s):  
Silzá Tramontina ◽  
Cristian Patrick Zeni ◽  
Gabriel Pheula ◽  
Luis Augusto Rohde
Keyword(s):  
Clinical Trial ◽  
Bipolar Disorder ◽  
Weight Gain ◽  
Atypical Antipsychotics ◽  
Mood Stabilizers

Differential Diagnosis of Borderline Personality Disorder from Bipolar Disorder

2010 ◽  
Vol 32 (3) ◽  
pp. 189-205 ◽  
Author(s):  
Gregory Hatchett
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Atypical Antipsychotics ◽  
Treatment Approach ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Health Counseling ◽  
Dsm V

Many psychiatrists have reconceptualized borderline personality disorder (BPD) as a variant of bipolar disorder and, consistent with the treatment of bipolar disorder, emphasize the use of mood stabilizers and atypical antipsychotics in treatment. This change in diagnostic practice is unfortunate. BPD is a distinct diagnostic construct, and clients who fit this pattern require a fundamentally different treatment approach than what is typically recommended for bipolar disorder. The purpose of this article is to update counselors on the expansion of bipolar disorder in the psychiatric literature, present evidence for the validity of BPD, discuss strategies for the differential diagnosis of it from bipolar disorder, review proposed changes in DSM-V, and integrate the literature into a mental health counseling framework.

Maintenance Therapies in Bipolar Disorder: Focus on Randomized Controlled Trials

2005 ◽  
Vol 39 (8) ◽  
pp. 652-661 ◽  
Author(s):  
David J. Muzina ◽  
Joseph R. Calabrese
Keyword(s):  
Bipolar Disorder ◽  
Combination Therapy ◽  
Maintenance Therapy ◽  
Atypical Antipsychotics ◽  
Mood Stabilizers ◽  
Antidepressant Effect ◽  
Controlled Trials ◽  
Research Database ◽  
Concomitant Treatment ◽  
Rapid Cycling

Objective: Lithium remains the cornerstone of maintenance therapy for bipolar disorder despite growing use of other agents, including divalproex, lamotrigine, carbamazepine and the atypical antipsychotics. Lithium has the largest body of data to support its continued use as a prophylactic agent; however, most of this data comes from early studies that did not use contemporary analytic methods. Alternatives to lithium are needed because of the relatively high rate of non-response to lithium monotherapy and the drug's frequent side-effects. This article reviews available data with an emphasis on double-blind, placebo controlled studies that examine the efficacy of lithium and other putative mood stabilizers: carbamazepine, divalproex, lamotrigine and olanzapine. Method: The authors reviewed key literature using Medline searches using key words: bipolar disorder, controlled trials, mood stabilizer, lithium, lomotrigine, divalproex, olanzapine, carbamazepine. Results: Lithium remains the gold standard for overall preventative efficacy in bipolar disorder, especially to decrease manic or hypomanic relapse. Of the mood stabilizers that have marked prophylactic antimanic properties, lithium appears to possess the greatest antidepressant effect. Divalproexmay also prevent recurrent bipolar mood episodes but the relative lack of controlled maintenance studies makes this less certain. There now exists an extensive and well-designed research database supporting the use of lamotrigine in the acute and prophylactic management of bipolar I disorder. Lamotrigine offers a spectrum of clinical effectiveness that complements lithium, in that it appears to stabilize mood ‘from below baseline’ by preventing episodes of depression and has been shown to be effective in rapid-cycling bipolar II disorder. Carbamazepine may be a useful alternative to lithium, divalproex and lamotrigine, particularly for patients with a history of mood-incongruent delusions and other comorbidities, but controlled data is more equivocal and it may lose some of its prophylactic effect over time. Emerging data continue to support the growing use of atypical antipsychotics, particularly olanzapine. Conclusions: Any monotherapy for use as a maintenance therapy of bipolar disorder appears to be inadequate for long-term use in the management of the majority of patients with bipolar disorder. Combination therapy has become the standard of care in the treatment of bipolar disorder and particularly in patients with treatment-refractory variants such as those with rapid-cycling. The emerging consensus is that patients on monotherapy, if followed for sufficiently long periods, will eventually require concomitant treatment to maintain a full remission. There exists a need for controlled trials that use random assignment to parallel arms including combination therapy followed by data analyses that include both relapse rate and survival techniques.

Antipsychotic in children and adolescents: Metabolic effects

2016 ◽  
Vol 33 (S1) ◽  
pp. S358-S358
Author(s):  
M.D.L.C. Ramirez Dominguez ◽  
I. Prieto Sánchez ◽  
L. Hernandez Gonzalez ◽  
S. Fernandez Leon ◽  
M. Reina Dominguez
Keyword(s):  
Bipolar Disorder ◽  
Weight Gain ◽  
Waist Circumference ◽  
Metabolic Rate ◽  
Atypical Antipsychotics ◽  
Fasting Glucose ◽  
Metabolic Effects ◽  
Tight Control ◽  
Competing Interest ◽  
Early Schizophrenia

IntroductionThe use of antipsychotics in children is controversial, one of the considerations to take into account is the possible effect on the values of fasting glucose, prolactin or weight gain are very important.ObjectivesTo study the effect of these drugs on metabolic rate in children.MethodsWe measured the weight, waist circumference, fasting glucose and basal prolactin in 6 children at Children's Hospital in the province of Huelva, diagnosed with bipolar disorder and early schizophrenia, atypical antipsychotics before starting treatment and 6 months later.ResultsIn the provisional results it is found that a there is not a significant weight gain (less than 3%), no impairment of glucose and only in one case basal prolactin was elevated.ConclusionsThe use of atypical antipsychotics in children should be reserved when strictly necessary. Once established, keep tight control of metabolic parameters, although the data of our study coincide with the literature, do not produce significant alterations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Epidemiological and Clinical Variables Related with the Predominant Polarity on Bipolar Disorder: A Systematic Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S115-S116
Author(s):  
J. García-Jiménez ◽  
A. Porras-Segovia ◽  
J.M. Gota-Garcés ◽  
J.E. Muñoz-Negro ◽  
L. Gutiérrez-Rojas
Keyword(s):  
Bipolar Disorder ◽  
Atypical Antipsychotics ◽  
Mood Stabilizers ◽  
Future Research ◽  
Type I ◽  
Inclusion Criteria ◽  
Clinical Correlates ◽  
History Of ◽  
Competing Interest

IntroductionType I and type II classification of bipolar disorder (BD) may not provide useful information to the clinician regarding epidemiological and clinical correlates.New classifications have recently been proposed, such as the Predominant Polarity (PP) classification, which is based on the tendency of the patient to relapse in the manic (Manic Predominant Polarity [MPP]) or the depressive (Depressive Predominant Polarity [DPP]) poles along the course of the disease.ObjectivesTo explore the epidemiological and clinical correlates of PP.MethodsWe performed a search of the PubMed and Web of Science databases up to June 1st 2016, using the keywords “bipolar disorder”, “polarity” and “predominant polarity”.ResultsThe initial search identified 1598 articles. Only 17 articles met inclusion criteria. Factors associated with MPP are manic onset, history of drug abuse and a better response to atypical antipsychotics and mood stabilizers. Meanwhile DPP is associated with depressive onset, more relapses, longer acute episodes, and a higher risk of suicide. Moreover, delay until diagnosis, mixed episodes and comorbid anxiety disorders are more prevalent in DPP patients, whose treatment often involves quetiapine and lamotrigine.LimitationsFew prospective studies. Variability of results.ConclusionsPP classification may be useful for the clinical management of BD. Further research in this field is needed. Future research should use standardized definitions and more comparable methods.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Pola Penggunaan Obat Mood Stabilizer Pada Pasien Bipolar di Rumah Sakit Jiwa Daerah Atma Husada Mahakam

2019 ◽  
Vol 10 ◽  
pp. 86-93
Author(s):  
Annida Rifaya ◽  
Risna Agustina ◽  
Rolan Rusli
Keyword(s):  
Bipolar Disorder ◽  
Atypical Antipsychotics ◽  
Early Adulthood ◽  
Mood Stabilizer ◽  
Mood Stabilizers ◽  
School Level ◽  
Research Subjects ◽  
High School Level ◽  
Bipolar Patients ◽  
Depressive Episodes

Bipolar disorder is a chronic mood disorder characterized by episodes of mania or hypomania that occur alternately or mixed with depressive episodes. This study aims to determine the characteristics of bipolar patients and patterns of drug use inpatient and outpatient bipolar patients at Atma Husada Mahakam Hospital. The type of this research is non experimental (descriptive) and done retrospectively. Data are collected from medical record. Research subjects were 84 inpatients and 137 outpatients with bipolar disorder diagnosis. Data are analyzed by describing research's objects. The results were obtained from inpatient and outpatient data showing 63% and 60% female sex, showing 26-35 years (early adulthood), not working, not married, and high school level education. The most usage pattern of drugs is a combination of 2 and 3 drugs, namely 74.99% for inpatient care and 73.71% for outpatient treatment. The drugs most commonly used are mood stabilizers (valproate acid) and atypical antipsychotics (risperidone).

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