scholarly journals Ziprasidone as Adjunctive Therapy in Severe Bipolar Patients Treated with Clozapine

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Natalia Bartolommei ◽  
Francesco Casamassima ◽  
Laura Pensabene ◽  
Federica Luchini ◽  
Antonella Benvenuti ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Bipolar Disorder ◽  
Plasma Levels ◽  
Adjunctive Therapy ◽  
Negative Symptoms ◽  
Bipolar Patients ◽  
Psychotic Bipolar Disorder

Aim. To confirm the efficacy and tolerability of ziprasidone as adjunctive therapy in bipolar patients partially responding to clozapine or with persisting negative symptoms, overweight, or with metabolic syndrome. Methods. Eight patients with psychotic bipolar disorder were tested with the BPRS, the HAM-D, and the CGI at T0 and retested after 2 weeks (T1). Plasma clozapine and norclozapine levels and BMI were tested at T0 and T1. Results. Ziprasidone was well tolerated by all the patients. BPRS and HAM-D scores were reduced in all patients. BMI was reduced in patients with a BMI at T0 higher than 25. Plasma levels of clozapine and norclozapine showed an irregular course.

Awareness of Metabolic Concerns in Patients With Bipolar Disorder: A Survey of European Psychiatrists

2007 ◽  
Vol 23 (3) ◽  
pp. 169-177 ◽  
Author(s):  
Michael Bauer ◽  
Yves Lecrubier ◽  
Trisha Suppes
Keyword(s):  
Metabolic Syndrome ◽  
Bipolar Disorder ◽  
General Population ◽  
Adverse Effects ◽  
Online Survey ◽  
Direct Patient Care ◽  
Eligibility Criteria ◽  
The Metabolic Syndrome ◽  
Bipolar Patients ◽  
Monitoring Treatment

AbstractPurpose.An online survey of European psychiatrists assessed awareness of the metabolic syndrome and its influence on the management of bipolar disorder.Materials and methods.Psychiatrists in the United Kingdom, France, Germany, Spain, and Italy were surveyed from April to June 2006. Eligibility criteria w ere 4–30 years in practice, ≥50% of time in direct patient care, had seen ≥10 bipolar patients in the preceding month. Aggregate data were weighted to represent the practicing physician population per country.Results.of 718 respondents, 56% had diagnosed metabolic syndrome. Respondents reported that metabolic syndrome prevalence was higher in bipolar patients (25%) than in the general population (20%). Seventy-two percent felt that metabolic syndrome poses significant health risks, warranting monitoring/treatment, and were most concerned with the bipolar medication adverse effects of weight gain, cognitive impairment, and glucose intolerance. Survey respondents recognized clear differences among psychotropic agents in the propensity to induce metabolic adverse effects. Sixty-five percent of respondents indicated that they had made interviewing and monitoring changes in the past three years as a result of metabolic concerns.Conclusions.European psychiatrists view metabolic syndrome as highly prevalent in the general population and in bipolar patients; twothirds have changed their management of bipolar patients because of metabolic health concerns.

Are auditory P300 and duration MMN heritable and putative endophenotypes of psychotic bipolar disorder? A Maudsley Bipolar Twin and Family Study

2009 ◽  
Vol 39 (8) ◽  
pp. 1277-1287 ◽  
Author(s):  
M.-H. Hall ◽  
K. Schulze ◽  
F. Rijsdijk ◽  
S. Kalidindi ◽  
C. McDonald ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Structural Equation ◽  
Family Study ◽  
Genetic Model ◽  
Model Fitting ◽  
P300 Amplitude ◽  
P300 Latency ◽  
Bipolar Patients ◽  
Psychotic Bipolar Disorder ◽  
Shared Genetic

BackgroundImpaired P300 auditory response has been reported in patients with psychotic bipolar disorder (BPD) and unaffected relatives of psychotic bipolar patients. Deficits in mismatch negativity (MMN), however, have not been observed in bipolar patients. To our knowledge, no family study of MMN in BPD has been reported. The current study combined the Maudsley twin and bipolar family samples using genetic model fitting analyses to: (1) assess the relationship between BPD and MMN, (2) substantiate the association between psychotic BPD and P300 variables, (3) verify the genetic overlap of BPD with P300 amplitude previously reported in the twin sample, and (4) examine the shared genetic influences between BPD and bilateral temporal scalp locations of P300 components.MethodA total of 301 subjects were included in this study, including 94 twin pairs, 31 bipolar families, and 39 unrelated healthy controls. Statistical analyses were based on structural equation modelling.ResultsBoth P300 and MMN are heritable, with heritability estimates of 0.58 for MMN, 0.68–0.80 for P300 amplitude, and 0.21–0.56 for P300 latency. The bipolar patients and their relatives showed normal MMN. No significant association, either genetic or environmental, was found with BPD. BPD was significantly associated with reduced P300 amplitude and prolonged latency on midline and bilateral temporal-posterior scalp areas. Shared genetic factors were the main source of these associations.ConclusionsThe results confirm that MMN is not an endophenotype for psychotic BPD whereas P300 amplitude and latency components are valid endophenotypes for psychotic BPD.

scholarly journals S169. THE IMPACT OF PSYCHOSIS IN ADOLESCENT-ONSET BIPOLAR DISORDER: A STRUCTURAL MRI STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
Cristian Llach ◽  
Adriana Fortea ◽  
Isabel Valli ◽  
Iria Mendez ◽  
Sara Lera ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Cortical Thickness ◽  
Orbitofrontal Cortex ◽  
Child And Adolescent ◽  
Psychotic Symptoms ◽  
Adolescent Patients ◽  
Bipolar Patients ◽  
Psychotic Features ◽  
The Impact ◽  
Psychotic Bipolar Disorder

Abstract Background Bipolar Disorder (BD) is a major psychiatric illness defined by episodic mood changes, which in approximately 50% of cases is associated with psychotic features. Over the past decades, a large amount of research has identified brain structural and functional alterations in patients with this mental disorder. Some findings have been found to be specific to patients with psychotic symptoms, raising suggestions that this could represent a biological subtype of the disorder. Recent interest has been addressed to Early-Onset Bipolar Disorder (EOBD, onset prior to age 18). Latest reviews in EOBD samples have pointed to abnormalities in the frontal lobe and limbic structures, with some inconsistencies in the reported results possibly caused by differences in the methodology. In addition, no study so far has examined the neural structural correlates of psychotic symptoms in adolescent-onset bipolar disorder (AOBD). The aim of the present study is to examine the impact of psychosis on the neurobiological architecture in a sample of patients with AOBD. To our knowledge, this is the first study comparing gray matter structure between AOBD patients with or without psychotic features. Methods We conducted a cross-sectional study collecting T1-weighted structural magnetic resonance neuroimaging (3T-MRI) data in patients diagnosed with Bipolar Disorder type I or II between 12 and 19 years old (N=46, mean age (SD)=15.89 (1.94), gender=52.2% females). All patients were recruited from child and adolescent mental health services of the Hospital Clinic of Barcelona, Spain. Diagnoses were confirmed with a semi-structured clinical interview (Kiddie-Sads present and lifetime version) by child and adolescent psychiatrists. Images were pre-processed employing FreeSurfer 5.3.0, and data corresponding to Cortical Thickness (CTH) and Subcortical Volumes (SCV) was obtained. Groups were compared according to whether patients had experienced psychotic symptoms at any point during their illness: Non-Psychotic Bipolar Disorder (NPSBD, N=25) and Psychotic Bipolar Disorder (PSBD, N=21). No differences in age (t=0.498, p=0.621) or sex (χ2=0.001, p=0.979). Group effects in relation to both CT and SCV were examined with a general linear model. The main effect of group on CTH and SCV, was performed for the whole brain, performing a correction for multiple comparisons (Montecarlo correction, threshold = 0.05). Results Between-group analyses showed smaller CTH in a cluster in the left medial orbitofrontal cortex (cluster size= 1142.58 mm2) in PSBD relative to NPSBD (x, y, z: 25.63, 89.61, -42.74; p=0.002). In addition, we observed a smaller right hippocampus volume (p=0.025) in PSBD relative to NPSBD. No other statistically significant differences were obtained. Discussion PSBD showed smaller cortical thickness in the left medial orbitofrontal cortex, as well as a volumetric reduction in the right hippocampal volume. Similar results have been reported in a study comparing adolescent patients with psychotic BD and healthy controls. These results add evidence about the role of these two structures in the genesis of psychotic symptoms in a population diagnosed with AOBD. Interestingly, one study has reported a surface area decreased of the orbitofrontal cortex in adolescent patients with a non-bipolar psychotic disorder, which suggests that they may be a common substrate to psychotic symptoms during adolescence regardless of co-occurring affective symptoms. In summary, this study points to the existence of a distinct biological nature between bipolar patients according to psychotic symptoms, underpinned by a different neurobiological architecture. Future research should focus on replication and on examining the clinical value of this finding.

scholarly journals Obesity and Metabolic Comorbidity in Bipolar Disorder: Do Patients on Lithium Comprise A Subgroup? A Naturalistic Study.

2020 ◽  
Author(s):  
Jake Prillo ◽  
Jocelyn Fotso Soh ◽  
Annemick Dols ◽  
Haley Park ◽  
Serge Beaulieu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Bipolar Disorder ◽  
Body Mass ◽  
Type Ii Diabetes ◽  
Tertiary Care ◽  
Type Ii ◽  
Wide Range ◽  
Prevalence Of Obesity ◽  
Bipolar Patients

Abstract Background: Bipolar disorders (BD) are associated with increased prevalence of obesity and metabolic syndrome (MetS). Nevertheless, there is a wide range in prevalence estimates, and little is known about the relative contributions of medications, especially lithium. We hypothesized that lithium use is not associated with increased body mass index (BMI), metabolic syndrome, and type II diabetes (DM II), when compared to non-lithium users (those on anticonvulsants (ACs) or second-generation antipsychotics (APs)). Methods: Cross-sectional study of 129 patients aged 18-85 with bipolar disorder, followed at tertiary care clinics in Montreal. Patients using lithium were compared with those not on lithium, for body mass index and metabolic syndrome. Results: The prevalence of obesity and MetS in the sample of lithium-using bipolar patients was 42.4% and 34.9%, respectively, with an average BMI of 29.10 (+/-6.70). Lithium and non-lithium groups did not differ in BMI or prevalence of MetS. However, compared to the non-lithium group, lithium users had lower hemoglobin A1C (5.24 +/- 0.53 versus 6.01 +/- 1.83, U=753.5, p=0.006) and lower triglycerides (1.46 +/- 0.88 versus 2.01 +/-1.25, U=947, p=0.020). Conclusions: There is a high prevalence of obesity and metabolic syndrome among bipolar disorder patients. However, this did not appear to be associated with lithium use, when compared to those not on lithium. The lithium subgroup was also associated with lower prevalence of type II diabetes. Future prospective and intervention studies with larger sample sizes are necessary to further explore the association between lithium and insulin resistance, as well as its underlying mechanisms.

Prevalence of metabolic syndrome in never treated mood disordered patientss

2007 ◽  
Vol 30 (4) ◽  
pp. 95
Author(s):  
Valerie Taylor ◽  
Glenda M. MacQueen
Keyword(s):  
Metabolic Syndrome ◽  
Mood Disorders ◽  
Population Attributable Risk ◽  
Disease Process ◽  
Visceral Obesity ◽  
Premature Mortality ◽  
Overweight And Obesity ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Bipolar Patients

Bipolar disorder and major depression are life-shortening illnesses. Unnatural causes such as suicide and accidents account for only a portion of this premature mortality1 Research is beginning to identify that mood disordered patients have a higher incidence of metabolic syndrome, an illness characterized by dyslipidemia, impaired glucose tolerance, hypertension and obesity.2 Metabolic syndrome is associated with an increased risk for a variety of physical illnesses. Hypothesis: Never treated patients with mood disorders have preexisting elevations in the prevalence of the component variables of metabolic syndrome. Central obesity will be especially elevated, predicting increased premature mortality. Methods: We assessed never treated patients with mood disorders for metabolic syndrome and its component variables. Patients were assessed at baseline and followed up at 6-month intervals. All psychiatric pharmacotherapy was documented. Body mass index (BMI) was also obtained and the percentage of deaths attributable to overweight and obesity was calculated using the population attributable risk (PAR). [PAR= ∑[P (RR-1)/RR] Results: Prior to the initiation of treatment, patients did not differ from population norms with respect to metabolic syndrome or BMI. At 2-year follow-up, BMI had increased for unipolar patients 2.02 points and 1.92 points for bipolar patients. (p < .001) This increase in BMI predicted an increase in mortality of 19.4%. Conclusion: An increase in visceral obesity is often the first component of metabolic syndrome to appear and may indicate the initiation of this disease process prematurely in this group. The increase in BMI places patients with mood disorders at risk for premature mortality and indicates a need for early intervention. References 1.Osby U, Brandt L, Correia N, Ekbom A & Sparen P. Excess mortability in bipolar and Unipolar disorder rin Sweden. Archives of General Psychiatry, 2001;58: 844-850 2.Toalson P, Saeeduddin A, Hardy T & Kabinoff G. The metabolic syndrome in patients with severe mental illness. Journal of Clinical Psychiatry, 2004; 6(4): 152-158

scholarly journals Patients’ adherence to smartphone apps in the management of bipolar disorder: a systematic review

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Marie-Camille Patoz ◽  
Diego Hidalgo-Mazzei ◽  
Bruno Pereira ◽  
Olivier Blanc ◽  
Ingrid de Chazeron ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bipolar Disorder ◽  
Mobile Health ◽  
Smartphone Apps ◽  
Exclusion Criteria ◽  
Future Studies ◽  
Health Apps ◽  
Definition Of ◽  
Bipolar Patients ◽  
Digital Or

Abstract Background Despite an increasing number of available mental health apps in the bipolar disorder field, these tools remain scarcely implemented in everyday practice and are quickly discontinued by patients after downloading. The aim of this study is to explore adherence characteristics of bipolar disorder patients to dedicated smartphone interventions in research studies. Methods A systematic review following PRISMA guidelines was conducted. Three databases (EMBASE, PsychInfo and MEDLINE) were searched using the following keywords: "bipolar disorder" or "mood disorder" or “bipolar” combined with “digital” or “mobile” or “phone” or “smartphone” or “mHealth” or “ehealth” or "mobile health" or “app” or “mobile-health”. Results Thirteen articles remained in the review after exclusion criteria were applied. Of the 118 eligible studies, 39 did not provide adherence characteristics. Among the selected papers, study length, sample size and definition of measures of adherence were strongly heterogeneous. Activity rates ranged from 58 to 91.6%. Conclusion The adherence of bipolar patients to apps is understudied. Standardised measures of adherence should be defined and systematically evaluated in future studies dedicated to these tools.

scholarly journals Higher Lipopolysaccharide Binding Protein and Chemerin Concentrations Were Associated with Metabolic Syndrome Features in Pediatric Subjects with Abdominal Obesity during a Lifestyle Intervention

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 289
Author(s):  
Amelia Marti ◽  
Isabel Martínez ◽  
Ana Ojeda-Rodríguez ◽  
María Cristina Azcona-Sanjulian
Keyword(s):  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Lifestyle Intervention ◽  
Abdominal Obesity ◽  
Plasma Levels ◽  
Intervention Program ◽  
Binding Protein ◽  
Controlled Trial ◽  
Lipopolysaccharide Binding Protein ◽  
Lipopolysaccharide Binding

Background: Elevated circulating plasma levels of both lipopolysaccharide-binding protein (LBP) and chemerin are reported in patients with obesity, but few studies are available on lifestyle intervention programs. We investigated the association of both LBP and chemerin plasma levels with metabolic syndrome (MetS) outcomes in a lifestyle intervention in children and adolescents with abdominal obesity Methods: Twenty-nine patients enrolled in a randomized controlled trial were selected. The lifestyle intervention with a 2-month intensive phase and a subsequent 10-month follow-up consisted of a moderate calorie-restricted diet, recommendations to increase physical activity levels, and nutritional education. Results: Weight loss was accompanied by a significant reduction in MetS prevalence (−43%; p = 0.009). Chemerin (p = 0.029) and LBP (p = 0.033) plasma levels were significantly reduced at 2 months and 12 months, respectively. At the end of intervention, MetS components were associated with both LBP (p = 0.017) and chemerin (p < 0.001) plasma levels. Conclusions: We describe for the first time a reduction in both LBP and chemerin plasma levels and its association with MetS risk factors after a lifestyle intervention program in children and adolescents with abdominal obesity. Therefore, LBP and chemerin plasma levels could be used as biomarkers for the progression of cardiovascular risk in pediatric populations.

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