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Do we really know how to treat a child with bipolar disorder or one with severe mood dysregulation? Is there a magic bullet?
Conclusions. Valproate, lithium, risperidone, olanzapine, aripiprazole and quetiapine remain first line treatments for acute episodes in the under 18s with BD. Their efficacy in maintenance treatment remains unclear. There is no validated treatment for SMD. It is likely that some children who are currently diagnosed with BD and DBD and possibly most children currently diagnosed with SMD will be subsumed under the proposed category in the DSM V of disruptive mood dysregulation disorder with dysphoria.
PMID: 22203894 [PubMed]
Source: Depression Research and Treatment - March 9, 2013 Category: Psychiatry Tags: Depress Res Treat Source Type: research
Methodological differences between pharmacological treatment guidelines for bipolar disorder: what to do for the clinicians?
Conclusions: The choice of policy, whatever the methodology used, is up to the authors and can, therefore, depend on their interpretation of the available scientific evidence. Combining both methodologies (CBG and EBG) enables us to meet the complete definition of evidence-based medicine.
Source: Comprehensive Psychiatry - November 15, 2012 Category: Psychiatry Authors: Ludovic Samalin, Sebastien Guillaume, Philippe Courtet, Mocrane Abbar, Sylvie Lancrenon, Pierre-Michel Llorca Source Type: research
The LITFL Review 104
Welcome to the 104th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
Emergency Physicians Monthly
Top spot goes to Emergency Physicians Monthly with a thought provoking and awe inspiri...
Source: Life in the Fast Lane - May 21, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder.
CONCLUSIONS: Although major advances have been made since the first edition of this guideline in 2004, there are still areas of uncertainty, especially the prevention of depressive episodes and optimal long-term treatment of Bipolar II patients.
PMID: 23480132 [PubMed - in process]
Source: The World Journal of Biological Psychiatry - April 1, 2013 Category: Psychiatry Authors: Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Möller HJ, Kasper S, WFSBP Task Force on Treatment Guidelines for Bipolar Disorders Tags: World J Biol Psychiatry Source Type: research
The LITFL Review 104
Welcome to the 104th edition!
The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.
The Most Fair Dinkum Ripper Beaut of the Week
Emergency Physicians Monthly
Top spot goes to Emergency Physicians Monthly with a thought provoking and awe inspiri...
Source: Life in the Fast Lane - May 21, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education eLearning Emergency Medicine Featured Health Intensive Care LITFL review LITFL R/V Source Type: blogs
A systematic review of the evidence for the treatment of acute depression in bipolar I disorder.
Abstract
In this article, we examined evidence for the acute treatment of depression in bipolar I disorder, focusing on double-blind, placebo-controlled studies with a definite primary outcome measure and published in peer review journals. Quetiapine and olanzapine/fluoxetine are currently approved by the FDA for the treatment of bipolar depression, and a number of additional agents (including other atypical antipsychotics, mood stabilizers, antidepressants, and novel compounds) have been studied with varying degrees of efficacy. The medication with the most evidence for efficacy in bipolar depression is quetiapin...
Source: CNS Spectrums - March 18, 2013 Category: Neurology Authors: Cerullo MA, Strakowski SM Tags: CNS Spectr Source Type: research
Impact of psychotropic drugs on suicide and suicidal behaviors
ConclusionsThe available evidence for the impact of psychotropics on suicidal risk in patients with bipolar disorder is largely methodologically flawed and, except for a few instances, clinically not useful at this point. Adequately powered, prospective randomized controlled studies are needed to assess the impact of each class of psychotropic and each psychotropic as well as common combination therapies. Until such studies have been carried out, clinicians are urged to exercise caution in using these drugs and rely on the traditional means of carefully assessing and monitoring patients with bipolar disorder who are at high risk for suicide.
Source: Bipolar Disorders - June 1, 2013 Category: Psychiatry Authors: Boghos I Yerevanian, Young Mee Choi Tags: Review Article Source Type: research
Psychiatrists: the drug pushers
Is the current epidemic of depression and hyperactivity the result of disease-mongering by the psychiatric profession and big pharma? Does psychiatry have any credibility left at all?A psychiatrist who once "treated" me used to recite this rueful little mantra: "They say failed doctors become psychiatrists, and that failed psychiatrists specialise in drugs." By drugs this psychiatrist meant drugs of addiction – and his "treatment" of me consisted of prescribing Temgesic, a synthetic opiate, as a substitute for the heroin I was more strongly inclined to take. So, he undertook this role: actin...
Source: Guardian Unlimited Science - August 3, 2013 Category: Science Authors: Will Self Tags: The Guardian Mental health Culture Health, mind and body Society Books Drugs Features Science Source Type: news
Review: lithium reduces the risk of suicide compared with placebo in people with depression and bipolar disorder
Question Question: Does lithium prevent suicide and self-harm in people with unipolar depression and bipolar disorder? Outcomes: Suicide, deliberate self-harm (DSH) and all-cause mortality. DSH was defined as a non-fatal outcome following a deliberately initiated behaviour (such as self-cutting) or ingestion of a toxic substance or object with the intention of causing self-harm, irrespective of motivation. Suicidal ideation alone was not considered as an outcome. Methods Design: Systematic review and meta-analysis. Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO and CENTRAL were searched up to January 2013. This was supple...
Source: Evidence-Based Mental Health - October 24, 2013 Category: Psychiatry & Psychology Authors: Young, A. H. Tags: Clinical trials (epidemiology), Epidemiologic studies, Editor's choice, Neurology, Drugs: psychiatry, Bipolar disorder, Depressive disorder, Schizophrenia spectrum, Suicide (psychiatry), Epidemiology Pharmacotherapy Source Type: research
White matter alterations in bipolar disorder: potential for drug discovery and development
ConclusionsPathways leading to WM alterations in bipolar disorder represent potential targets for the development and discovery of new drugs. Myelin damage in bipolar disorder suggests that the effects of existing pro‐myelinating drugs should also be evaluated to improve our understanding and treatment of this disease.
Source: Bipolar Disorders - September 1, 2013 Category: Psychiatry Authors: Emeline Marlinge, Frank Bellivier, Josselin Houenou Tags: Review Article Source Type: research
Review of nutritional supplements for the treatment of bipolar depression
Many patients view psychotropics with skepticism and fear and view nutritional supplements as more consistent with their values and beliefs. The purpose of this review was to critically evaluate the evidence base for nutritional supplements in the treatment of bipolar depression (BD). A literature search for all randomized, controlled clinical trials using nutritional supplements in the treatment of BD was conducted via PubMed and Ovid MEDLINE computerized database. The studies were organized into essential nutrients/minerals, nonessential nutrients, and combinations of nutritional products. Among essential nutrients/miner...
Source: Depression and Anxiety - December 1, 2013 Category: Psychiatry Authors: Jeffrey J. Rakofsky, Boadie W. Dunlop Tags: Review Source Type: research
Aripiprazole alone or in combination for acute mania.
CONCLUSIONS: Aripiprazole is an effective treatment for mania in a population that includes adults, children and adolescents, although its use leads to gastrointestinal disturbances and movement disorders. Comparative trials with medicines other than haloperidol and lithium are few, so the precise place of aripiprazole in therapy remains unclear.
PMID: 24346956 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 17, 2013 Category: Journals (General) Authors: Brown R, Taylor MJ, Geddes J Tags: Cochrane Database Syst Rev Source Type: research
End-stage renal disease associated with prophylactic lithium treatment
Abstract: The primary aim of this study was to estimate the prevalence of lithium associated end-stage renal disease (ESRD) and to compare the relative risk of ESRD in lithium users versus non-lithium users. Second, the role of lithium in the pathogenesis of ESRD was evaluated. We used the Swedish Renal Registry to search for lithium-treated patients with ESRD among 2644 patients with chronic renal replacement therapy (RRT)—either dialysis or transplantation, within two defined geographical areas in Sweden with 2.8 million inhabitants. The prevalence date was December 31, 2010. We found 30 ESRD patients with a history of...
Source: European Neuropsychopharmacology - February 5, 2014 Category: Psychiatry & Psychology Authors: Harald Aiff, Per-Ola Attman, Mattias Aurell, Hans Bendz, Staffan Schön, Jan Svedlund Tags: Clinical Science Source Type: research
Formic Acid and Acetic Acid Induce a Programmed Cell Death in Pathogenic Candida Species.
In conclusion, our results show that a low concentration of formic acid induces apoptosis-like programmed cell death in the Candida yeast and has a minimal effect on the survivability of mammalian cells, suggesting potential applications in the treatment of these infections.
PMID: 24752490 [PubMed - as supplied by publisher]
Source: Current Microbiology - April 22, 2014 Category: Microbiology Authors: Lastauskienė E, Zinkevičienė A, Girkontaitė I, Kaunietis A, Kvedarienė V Tags: Curr Microbiol Source Type: research
Clinical decision making in the treatment of mixed states.
Conclusions. There is a lack of studies designed to address the efficacy of medications in mixed affective symptoms. Guidelines do not fully reflect the current evidences.
PMID: 24824425 [PubMed - as supplied by publisher]
Source: The World Journal of Biological Psychiatry - May 14, 2014 Category: Psychiatry Authors: Grunze H, Azorin JM Tags: World J Biol Psychiatry Source Type: research
