Bupropion as an Add-on Therapy in Depressed Bipolar Disorder Type I Patients With Comorbid Cocaine Dependence

Sepede, Gianna; lorio, Giuseppe Di; Lupi, M.; Sarchione, F.; Acciavatti, Tiziano; Fiori, Federica; Santacroce, Rita; Martinotti, Giovanni; Gambi, Francesco; Giannantonio, Massimo Di

doi:10.1097/wnf.0000000000000011

Cited by 14 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 141 BD patients who received bupropion and 271 who received other treatments including idazoxan, desipramine, sertraline, venlafaxine, and topiramate, were extracted from 6 articles. 3,4,13,55,57,58 We did not find any statistically significant differences in the treatment effect between the BD patients receiving bupropion and those receiving other treatments (ESs = 0.483, 95% CI: −0.288 to 1.253, P = 0.220) (Figure 2B). In addition, there was significant heterogeneity within these studies ( Q = 31.98, df = 5, I 2 = 84.37%, P < 0.001), and significant publication bias was detected using Egger's test ( t = 4.01, df = 4, 2-tailed P = 0.016).…”

Section: Resultsmentioning

confidence: 79%

“…54 The remaining 10 articles were then entered into the current meta-analysis (Table 1). 3,4,13,16,17,55–59 The average Jadad score was 0.9.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 109 BD patients who received bupropion were extracted from 5 studies (Table 1). 55–59 The treatment effect of bupropion in these BD patients significantly decreased disease severity (ESs = −0.021, 95% confidence interval [CI]: −0.033 to −0.010, P < 0.001) (Figure 2A). There was significant heterogeneity within these studies ( Q = 6429.82, df = 4, I 2 = 99.94%, P < .001).…”

Section: Resultsmentioning

confidence: 99%

“…10,11 In these studies, bupropion has been reported to be safe and to carry the least risk of phase shifting among other antidepressants based on current evidence. 11,38 However, an increasing number of studies have reported their clinical experience of bupropion usage in clinical practice 4,12,15,20,43,46,55 in recent years, and thus the safety of bupropion with regard to phase shifting needs to be seriously reconsidered. The present study provides up-to-date key information about the safety of bupropion in BD patients.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Significant Treatment Effect of Bupropion in Patients With Bipolar Disorder but Similar Phase-Shifting Rate as Other Antidepressants

Tseng

Chen

et al. 2016

Medicine

View full text Add to dashboard Cite

Bupropion is widely used for treating bipolar disorder (BD), and especially those with depressive mood, based on its good treatment effect, safety profile, and lower risk of phase shifting. However, increasing evidence indicates that the safety of bupropion in BD patients may not be as good as previously thought.The aim of this study was to summarize data on the treatment effect and safety profile of bupropion in the treatment of BD via a meta-analysis.Electronic search through PubMed and ClinicalTrials.gov was performed.The inclusion criteria were: (i) studies comparing changes in disease severity before and after bupropion treatment or articles comparing the treatment effect of bupropion in BD patients with those receiving other standard treatments; (ii) articles on clinical trials in humans. The exclusion criteria were (i) case reports/series, and (ii) nonclinical trials.All effect sizes from 10 clinical trials were pooled using a random effects model. We examined the possible confounding variables using meta-regression and subgroup analysis.Bupropion significantly improved the severity of disease in BD patients (P < 0.001), and the treatment effect was similar to other antidepressants/standard treatments (P = 0.220). There were no significant differences in the dropout rate (P = 0.285) and rate of phase shifting (P = 0.952) between BD patients who received bupropion and those who received other antidepressants.We could not perform a detailed meta-analysis of every category of antidepressant, nor could we rule out the possible confounding effect of concurrent psychotropics or include all drug side effects. Furthermore, the number of studies recruited in the meta-analysis was relatively small.Our findings reconfirm the benefits of bupropion for the treatment of bipolar depression, which are similar to those of other antidepressants. However, the rate of phase shifting with bupropion usage was not as low compared to other antidepressants as previously thought, which should serve to remind clinicians of the risk of phase shifting when prescribing bupropion to BD patients regardless of the suggestions of current clinical practice guidelines.

show abstract

Section: Resultsmentioning

confidence: 79%

“…54 The remaining 10 articles were then entered into the current meta-analysis (Table 1). 3,4,13,16,17,55–59 The average Jadad score was 0.9.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Significant Treatment Effect of Bupropion in Patients With Bipolar Disorder but Similar Phase-Shifting Rate as Other Antidepressants

Tseng

Chen

et al. 2016

Medicine

View full text Add to dashboard Cite

show abstract

“…Bupropion has anecdotal reports favouring efficacy in cocaine use disorders (level 4) 713. Citicoline improved depressive symptoms in patients with methamphetamine use disorder and bipolar depression 714…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Chronic Psychosis in Dual Disorder Heroin Use Disorder Patients

Maremmani¹,

Pacini²,

Maremmani³

2023

Dual Disorder Heroin Addicts

View full text Add to dashboard Cite

Bupropion as an Add-on Therapy in Depressed Bipolar Disorder Type I Patients With Comorbid Cocaine Dependence

Abstract: Our preliminary findings suggest that combining bupropion with mood stabilizers and atypical antipsychotics may be a good therapeutic option in short-term treatment of depressed BD-I patients with comorbid CDD.

Cited by 14 publications

References 34 publications

Significant Treatment Effect of Bupropion in Patients With Bipolar Disorder but Similar Phase-Shifting Rate as Other Antidepressants

Significant Treatment Effect of Bupropion in Patients With Bipolar Disorder but Similar Phase-Shifting Rate as Other Antidepressants

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Chronic Psychosis in Dual Disorder Heroin Use Disorder Patients

Contact Info

Product

Resources

About