scholarly journals The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm

2016 ◽  
pp. pyw100 ◽  
Author(s):  
Konstantinos N. Fountoulakis ◽  
Lakshmi Yatham ◽  
Heinz Grunze ◽  
Eduard Vieta ◽  
Allan Young ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Treatment Guidelines ◽  
International College

Methodological differences between pharmacological treatment guidelines for bipolar disorder: what to do for the clinicians?

2013 ◽  
Vol 54 (4) ◽  
pp. 309-320 ◽  
Author(s):  
Ludovic Samalin ◽  
Sebastien Guillaume ◽  
Philippe Courtet ◽  
Mocrane Abbar ◽  
Sylvie Lancrenon ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Pharmacological Treatment ◽  
Treatment Guidelines

Treatment of Rapid-Cycling Bipolar Disorder

CNS Spectrums ◽  
2004 ◽  
Vol 9 (S2) ◽  
pp. 1-4
Author(s):  
Robert M. Post ◽  
Kiki D. Chang ◽  
Trisha Suppes ◽  
David L. Ginsberg
Keyword(s):  
Bipolar Disorder ◽  
Treatment Guidelines ◽  
Antidepressant Treatment ◽  
Rapid Cycling ◽  
Controlled Clinical Trials ◽  
Safety Considerations ◽  
Bipolar Patients ◽  
Patients Experience ◽  
Patient Use

AbstractApproximately 40% of bipolar patients experience rapid cycling, and half of these suffer from ultra-rapid or ultradian cycling. These patterns are also common in children. Rapid-cycling bipolar disorder is difficult to bring to remission and often requires treatment with four or more classes of psychotropic medications. Lithium, even in combination with anticonvulsants or antidepressants, is often associated with residual episodic depressions. Concerns with adjunctive antidepressant treatment include their low response and remission rates and their tendency to cause switch into mania. Atypical antipsychotics and selected agents within the anticonvulsant class are becoming increasingly important in the treatment of rapid cycling. In the absence of clear treatment guidelines, the use and sequencing of drugs in complex combination treatment remains exploratory, but should be individualized based on careful prospective mood charting by the patient. Use of several drugs below their side-effect thresholds may prevent certain side effects. In children, long-term safety considerations are particularly important in the absence of a strong controlled clinical trials database.

Treatment guidelines for bipolar disorder: A critical review

2005 ◽  
Vol 86 (1) ◽  
pp. 1-10 ◽  
Author(s):  
K.N. Fountoulakis ◽  
E. Vieta ◽  
J. Sanchez-Moreno ◽  
S.G. Kaprinis ◽  
J.M. Goikolea ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Critical Review ◽  
Treatment Guidelines

scholarly journals Pharmacological treatment of depression and bipolar disorder in children and adolescents

2010 ◽  
Vol 16 (6) ◽  
pp. 402-412 ◽  
Author(s):  
Bernadka Dubicka ◽  
Paul Wilkinson ◽  
Raphael G. Kelvin ◽  
Ian M. Goodyer
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Treatment Guidelines ◽  
Evidence Base ◽  
Current Treatment ◽  
Risks And Benefits ◽  
Treatment Of Depression ◽  
Increased Risk ◽  
Potential Risks ◽  
Considerable Morbidity

SummaryMajor depression and bipolar disorder in children and adolescents are serious conditions associated with considerable morbidity as well as increased risk of suicide. The treatment of depression in young people is currently controversial and this article reviews the evidence base and potential risks and benefits of antidepressants. Although the diagnosis of bipolar disorder is also controversial, medication is the first-line treatment of choice in cases that meet diagnostic criteria. The limited evidence base in children and adolescents is presented, along with current treatment guidelines. Despite the controversies in this field, this article concludes that medication remains an important part of the treatment approach for both disorders, although the risks and benefits of pharmacotherapy need to be carefully assessed in each patient.

Late-onset bipolar disorder: What else?

2016 ◽  
Vol 33 (S1) ◽  
pp. S121-S121
Author(s):  
C.P. Ferreira ◽  
S. Alves ◽  
C. Oliveira ◽  
M.J. Avelino
Keyword(s):  
Elderly Patient ◽  
Bipolar Disorder ◽  
Treatment Guidelines ◽  
Late Onset ◽  
Mood Stabilizer ◽  
The Elderly ◽  
First Episode ◽  
Therapeutic Implications ◽  
Psychiatric Conditions ◽  
New Onset

IntroductionGeriatric-onset of a first-episode mania is a rare psychiatric condition, which may be caused by a heterogeneous group of non-psychiatric conditions. To confirm late-onset bipolar disorder (LOBD) diagnosis, secondary-mania causes should be ruled out.ObjectivesTo provide a comprehensive review reporting prevalence, features, differential diagnosis, comorbidity and treatment of LOBD.MethodsThe literature was systematically reviewed by online searching using PubMed®. The authors selected review papers with the words “Late-onset mania” and/or “Late-onset bipolar” in the title and/or abstract published in the last 10 years.Results and discussionWith population ageing, LOBD is becoming a more prevalent disorder. Clinical presentation may be atypical and confounding, making the diagnosis not always obvious. Several non-psychiatric conditions must be considered in an elderly patient presenting with new-onset mania, namely stroke, dementia, hyperthyroidism or infection causing delirium. Only then LOBD diagnosis may be done, making that an exclusion diagnosis. Comorbidities, such as hypertension or renal insufficiency are often present in the elderly and must be taken into account when choosing a mood stabilizer.ConclusionsLOBD remains a complex and relatively understudied disorder with important diagnostic and therapeutic implications. This diagnosis must be kept in mind for every elderly patient presenting with new-onset mania. Further investigations could contribute to a better understanding of LOBD etiopathogenesis and to set out better treatment guidelines.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychoeducation: improving outcomes in bipolar disorder

2005 ◽  
Vol 20 (5-6) ◽  
pp. 359-364 ◽  
Author(s):  
Francesc Colom ◽  
Dominic Lam
Keyword(s):  
Bipolar Disorder ◽  
Health Beliefs ◽  
Relapse Prevention ◽  
Treatment Guidelines ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizers ◽  
Psychological Interventions ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Positive Results

AbstractBackgroundA relevant paradigm shift in the treatment of bipolar disorder started a few years ago; crucial findings on the usefulness of psychological interventions clearly support switching from an exclusively pharmacological therapeutic approach to a combined yet hierarchical model in which pharmacotherapy plays a central role, but psychological interventions may help cover the gap that exists between theoretical efficacy and “real world” effectiveness. Hereby we review the efficacy of several adjunctive psychotherapies in the maintenance treatment of bipolar patients.MethodsA systematic review of the literature on the issue was performed, using MEDLINE and CURRENT CONTENTS databases. “Bipolar”, “Psychotherapy”, “Psychoeducation”, “Cognitive-behavioral” and “Relapse prevention” were entered as keywords.ResultsPsychological treatments specifically designed for relapse prevention in bipolar affective disorder are useful tools in conjunction with mood stabilizers. Most of the psychotherapy studies recently published report positive results on maintenance as an add-on treatment, and efficacy on the treatment of depressive episodes. Interestingly, several groups from all over the world reported similar positive results and reached very similar conclusions; almost every intervention tested contains important psychoeducative elements including both compliance enhancement and early identification of prodromal signs — stressing the importance of life-style regularity — and exploring patients' health beliefs and illness-awareness.ConclusionsThe usefulness of psychotherapy for improving treatment adherence and clinical outcome of bipolar patients is nowadays unquestionable, and future treatment guidelines should promote its regular use amongst clinicians. As clinicians, it is our major duty, to offer the best treatment available to our patients and this includes both evidence-based psychoeducation programs and newer pharmacological agents.

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