Bipolar spectrum disorder: What evidence for pharmacological treatment? A systematic review

Hede, Vincent; Favre, Sophie; Aubry, Jean‐Michel; Richard-Lepouriel, Hélène

doi:10.1016/j.psychres.2019.112627

Cited by 5 publications

(6 citation statements)

References 68 publications

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“…Although it has tacitly accepted the existence of a bipolar spectrum by including BP-II disorder, mixed episodes, cyclothymia, and antidepressant-induced mania and hypomania as a part of BD, it has stopped short of including other categories from this spectrum. This is contrary to the evidence supporting a wider spectrum of BDs[ 128 - 132 ]. This evidence indicates that bipolar spectrum disorders are possibly more common than BP-I and BP-II disorders[ 133 - 136 ].…”

Section: Summary Of the Changes Madecontrasting

confidence: 99%

“…However, the ICD-11 draft chose not to include these disorders. This was because of the concerns about the uncertain boundaries of spectrum disorders and the risk of overdiagnosis and inappropriate treatment[ 132 - 135 ]. The relative lack of external validators, the problems with diagnostic and prognostic validity, and the absence of controlled data on treatment also proved problematic.…”

Section: Summary Of the Changes Madementioning

confidence: 99%

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Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness

Chakrabarti¹

2022

World J Psychiatry

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The World Health Organization’s 11 th revision of the International Classification of Diseases (ICD-11) including the chapter on mental disorders has come into effect this year. This review focuses on the “Bipolar or Related Disorders” section of the ICD-11 draft. It describes the benchmarks for the new version, particularly the foremost principle of clinical utility. The alterations made to the diagnosis of bipolar disorder (BD) are evaluated on their scientific basis and clinical utility. The change in the diagnostic requirements for manic and hypomanic episodes has been much debated. Whether the current criteria have achieved an optimum balance between sensitivity and specificity is still not clear. The ICD-11 definition of depressive episodes is substantially different, but the lack of empirical support for the changes has meant that the reliability and utility of bipolar depression are relatively low. Unlike the Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5), the ICD-11 has retained the category of mixed episodes. Although the concept of mixed episodes in the ICD-11 is not perfect, it appears to be more inclusive than the DSM-5 approach. Additionally, there are some uncertainties about the guidelines for the subtypes of BD and cyclothymic disorder. The initial results on the reliability and clinical utility of BD are promising, but the newly created diagnostic categories also appear to have some limitations. Although further improvement and research are needed, the focus should now be on facing the challenges of implementation, dissemination, and education and training in the use of these guidelines.

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Section: Summary Of the Changes Madecontrasting

confidence: 99%

Section: Summary Of the Changes Madementioning

confidence: 99%

Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness

Chakrabarti¹

2022

World J Psychiatry

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“…This effect would be not apparently related to the high number of stimuli but to a possible incorrect diagnosis of MDD. Given these findings, it is highly recommended that patients with bipolar disorder, who are experiencing a depressive episode, may be treated with a mood stabilizer in combination to rTMS while patients diagnosed with MDD reevaluated to consider the possibility that they might suffer from bipolar disorder, before rTMS treatment is initiated (Hede et al, 2019;Godman et al, 2019;Yee et al, 2019). In case treatment-emergent hypomania or mania occurs, rTMS discontinuation should be considered, while continuing mood-stabilizing medications.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

Effects of repetitive transcranial magnetic stimulation on suicidal behavior: A systematic review

Serafini

Canepa

Aguglia

et al. 2021

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Bipolar disorder (BD) is a major psychiatric disorder characterized by mood cycles, with depressive and high-energy episodes (hypomanic or manic), and is associated with multiple psychiatric and medical comorbidities and a high risk of suicide [1][2][3]. BD is a spectrum of diagnosis based on the intensity, duration and frequency of mood episodes [4][5][6]. First symptoms appear during adolescence or in young adults but diagnosis may take up to 10 years after illness onset [7,8].…”

Section: Introductionmentioning

confidence: 99%

Deficient LEF1 expression is associated with lithium resistance and hyperexcitability in neurons derived from bipolar disorder patients

et al. 2021

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Bipolar disorder (BD) is a psychiatric condition characterized by depressive and manic episodes that affect 2% of the world population. The first-line long-term treatment for mood stabilization is lithium (Li). Induced pluripotent stem cell modeling of BD using hippocampal dentate gyrus-like neurons derived from Li-responsive (LR) and Li-non-responsive (NR) patients previously showed neuronal hyperexcitability. Li treatment reversed hyperexcitability only on the LR neurons. In this study we searched for specific targets of Li resistance in NR neurons and found that the activity of Wnt/β-catenin signaling pathway was severely affected, with a significant decrease in expression of LEF1. Li targets the Wnt/βcatenin signaling pathway by inhibiting GSK-3β and releasing β-catenin that forms a nuclear complex with TCF/LEF1, activating the Wnt/β-catenin transcription program. Therefore, we propose that downregulation of LEF1 may account for Li resistance in NR neurons. Our results show that valproic acid (VPA), a drug used to treat NR patients that also acts downstream of GSK-3β, upregulated LEF1 and Wnt/β-catenin gene targets, increased transcriptional activity of complex β-catenin/TCF/LEF1 and reduced excitability in NR neurons. Additionally, decreasing LEF1 expression in control neurons using shLEF1 caused hyperexcitability, confirming that the impact of VPA on excitability in NR neurons was connected to changes in LEF1 and in the Wnt/β-catenin pathway. Our results suggest that LEF1 may be a useful target for the discovery of new drugs for BD treatment.

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Bipolar spectrum disorder: What evidence for pharmacological treatment? A systematic review

Cited by 5 publications

References 68 publications

Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness

Bipolar disorder in the International Classification of Diseases-Eleventh version: A review of the changes, their basis, and usefulness

Effects of repetitive transcranial magnetic stimulation on suicidal behavior: A systematic review

Deficient LEF1 expression is associated with lithium resistance and hyperexcitability in neurons derived from bipolar disorder patients

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