Ziprasidone as adjunctive treatment of bipolar disorder yields better efficacy than monotherapy and does not have the side effect of weight gain, according to researchers here at the 22nd European College of Neuropsychopharmacology (ECNP) Congress.
Eduard Vieta, MD, Bipolar Disorders Program, Clinical Institute of Neuroscience, Barcelona, Spain, and colleagues investigated the efficacy of combining ziprasidone with standard mood stabilisers. Because few bipolar patients experience adequate symptom control with long-term lithium or divalproex therapy, the use of adjunctive treatment with atypical antipsychotics is being investigated.
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Showing posts with label bipolar disorder (BPD). Show all posts
Showing posts with label bipolar disorder (BPD). Show all posts
Saturday, September 19, 2009
Thursday, July 2, 2009
Olanzapine Effective for Bipolar Disorder in Naturalistic Setting: Presented at WCBP
Olanzapine, as monotherapy or combination therapy, significantly improves symptoms in patients with manic or mixed episodes of bipolar affective disorder, according to data reported here at the 9th World Congress of Biological Psychiatry (WCBP) on June 29.
Pavel Vohlidka, MD, Eli Lilly and Company, Basingstoke, United Kingdom, presented 12-week outcomes in 251 patients who received olanzapine as acute-phase treatment either alone or in tandem with other antipsychotics, anticonvulsants and/or lithium, and antidepressants.
All patients were being treated for manic or mixed episodes of bipolar affective disorder and were enrolled in the 24-month Mania and Olanzapine Treatment (MANOLA) study, which examined patterns of clinical use of olanzapine in a natural setting over a recent 4-year period.
In the current analysis, about one-third of patients received olanzapine as monotherapy and about two-thirds received the agent as part of combination therapy. The groups were similar in terms of baseline demographic and clinical characteristics.
The primary objective of the analysis was to evaluate changes in mania symptoms in both groups on the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale: overall, mania, depression, hallucinations, delusions.
READ MORE @ DOCTOR'S GUIDE
Pavel Vohlidka, MD, Eli Lilly and Company, Basingstoke, United Kingdom, presented 12-week outcomes in 251 patients who received olanzapine as acute-phase treatment either alone or in tandem with other antipsychotics, anticonvulsants and/or lithium, and antidepressants.
All patients were being treated for manic or mixed episodes of bipolar affective disorder and were enrolled in the 24-month Mania and Olanzapine Treatment (MANOLA) study, which examined patterns of clinical use of olanzapine in a natural setting over a recent 4-year period.
In the current analysis, about one-third of patients received olanzapine as monotherapy and about two-thirds received the agent as part of combination therapy. The groups were similar in terms of baseline demographic and clinical characteristics.
The primary objective of the analysis was to evaluate changes in mania symptoms in both groups on the Clinical Global Impression-Bipolar Disorder (CGI-BP) scale: overall, mania, depression, hallucinations, delusions.
READ MORE @ DOCTOR'S GUIDE
Wednesday, April 1, 2009
Comorbidity in Bipolar Disorder The Complexity of Diagnosis and Treatment
The central tenet of clinical comorbidity, the occurrence of 2 syndromes in the same patient, presupposes that they are distinct categorical entities. By this definition, 2 or more coexisting syndromes do not negate one another, nor paradoxically does this coexistence negate the potential for one to influence the course, outcome, and treatment response of the other. Isolating a syndrome by characterizing it through a unique pathogenic process allows for diagnostic fidelity even while acknowledging overlapping phenotypes.
Bipolar disorder (BPD) is highly prevalent and heterogeneous. Its increasing complexity is often caused by the presence of comorbid conditions, which have become the rule rather than the exception. Lifetime prevalence of psychiatric comorbidity has been reported in community and clinical studies. Most (95%) of the respondents with BPD in the National Comorbidity Survey met criteria for 3 or more lifetime psychiatric disorders.1 In a Stanley Foundation Bipolar Treatment Outcome Network study of almost 300 patients, 65% met DSM-IV criteria for at least 1 comorbid Axis I disorder.2
Analogous to models in medicine (eg, cardiovascular disease), BPD incorporates psychiatric and medical comorbidities (Table) whose simultaneous treatment is equally pressing to the core mood disturbance.3 Checks and balances must be used to address the distressing comorbid condition (eg, anxiety) whose treatment with an SSRI or serotonin norepinephrine reuptake inhibitor (SNRI) may catalyze a round of mood cycling in an otherwise stable patient; a greater degree of protection via mood stabilizers may be warranted in such an individual to reduce this possibility.
Overall, the presence of comorbidities in BPD has negative prognostic implications for psychological health and for medical well-being and longevity.4-6 The most common comorbid conditions are reviewed below to help guide the clinician through this diagnostic maze and associated treatment considerations.
READ MORE @ PSYCHIATRIC TIMES
Bipolar disorder (BPD) is highly prevalent and heterogeneous. Its increasing complexity is often caused by the presence of comorbid conditions, which have become the rule rather than the exception. Lifetime prevalence of psychiatric comorbidity has been reported in community and clinical studies. Most (95%) of the respondents with BPD in the National Comorbidity Survey met criteria for 3 or more lifetime psychiatric disorders.1 In a Stanley Foundation Bipolar Treatment Outcome Network study of almost 300 patients, 65% met DSM-IV criteria for at least 1 comorbid Axis I disorder.2
Analogous to models in medicine (eg, cardiovascular disease), BPD incorporates psychiatric and medical comorbidities (Table) whose simultaneous treatment is equally pressing to the core mood disturbance.3 Checks and balances must be used to address the distressing comorbid condition (eg, anxiety) whose treatment with an SSRI or serotonin norepinephrine reuptake inhibitor (SNRI) may catalyze a round of mood cycling in an otherwise stable patient; a greater degree of protection via mood stabilizers may be warranted in such an individual to reduce this possibility.
Overall, the presence of comorbidities in BPD has negative prognostic implications for psychological health and for medical well-being and longevity.4-6 The most common comorbid conditions are reviewed below to help guide the clinician through this diagnostic maze and associated treatment considerations.
READ MORE @ PSYCHIATRIC TIMES
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