Have antipsychotics a different speed of action in the acute treatment of mania? A single-blind comparative study

Abstract

Available antipsychotics show different efficacy on manic symptoms of bipolar patients, but few studies have investigated the speed of action of the various compounds. For this reason, purpose of the present paper was to compare antipsychotic mono-therapies in terms of speed of action in a sample of manic bipolar patients. In total, 155 bipolar patients, treated with antipsychotic mono-therapy and followed-up in Inpatient Psychiatry Clinic of University of Milan, were included in this single-blind comparative study. Clinical response was defined as a reduction of Young Mania Rating Scale (YMRS) scores ⩾50%, while remission as a YMRS score <10. After 4 days patients who had been treated with asenapine, were more likely to have achieved a clinical response than those in treatment with haloperidol ( p = 0.001). After 7 days, a more frequent clinical response was achieved by patients treated with asenapine than those who had been treated with haloperidol ( p < 0.001) or olanzapine ( p = 0.047). Asenapine appears to be faster in determining treatment response in manic patients compared with haloperidol and less markedly with olanzapine.

Which Clinical and Biochemical Parameters Are Associated with Lifetime Suicide Attempts in Bipolar Disorder?

“…Obesity was defined as a body mass index (BMI) ≥30 [ 39 ]. Treatment response was defined as a reduction in the YMRS or HAM-D scores ≥50%, and remission as a YMRS score <10 and a HAM-D score <8, similar to the previous researches performed by our group [ 38 , 40 ] and according to the previous literature [ 41 , 42 ].…”

Are There Any Differences in Clinical and Biochemical Variables between Bipolar Patients with or without Lifetime Psychotic Symptoms?

“…-Demographic and clinical variables: age, gender, age at onset, duration of untreated illness in years (defined as the time between the onset of the disorder and the prescription of an adequate treatment) [8], duration of illness (years), duration of the current hospitalization (days), number of lifetime hospitalizations, number of lifetime mood episodes, type of current episode (mania or major depressive episode), type of last episode (manic, hypomanic, depressive episodes), current mixed features, lifetime history of substance or alcohol use disorders, presence of lifetime history of poly-substance use disorders, lifetime history of mixed features, lifetime history of psychotic symptoms, lifetime presence of rapid cycles, lifetime presence of seasonality, family history for single or multiple psychiatric disorders, main treatment at the time of hospitalization, poly-therapy at the time of admission, psychiatric comorbidity, comorbidity with personality disorders, type of personality disorder, presence of lifetime suicidal attempts (defined as self-harm combined with the intent to die) [31], number of lifetime suicidal attempts, current smoking status, number of cigarettes/day, number of depressive episodes lifetime and in the last year, number of manic episodes lifetime and in the last year, number of hypomanic episodes lifetime and in the last year, number of total mood episodes lifetime and in the last year, number of lifetime episodes induced from substance abuse, obstetric complications, presence of a medical comorbidity, comorbidity with thyroid disorders, comorbidity with diabetes, comorbidity with obesity (defined as a body mass index (BMI) ≥ 30) [31], BMI, comorbidity with hypercholesterolemia, presence of multiple medical comorbidities, current treatment with statin, current treatment with levotiroxine, response to therapy in the last episode (defined as a reduction of at least 50% of the baseline total rating scale scores) [32,33], remission in the last episode (defined as an endpoint HAM-D score < 8 and a YMRS score < 10) [32,34], and treatment response and remission during the current hospitalization, and scores of Young Mania Rating Scale (YMRS) [33], Hamilton Depression Rating Scale (HAM-D) [35], Montgomery and Åsberg Depression Rating Scale (MADRS) [36], Hamilton Anxiety Rating Scale (HAM-A) [37], and Global Assessment of Functioning (GAF) [38]. -Biochemical parameters: number of red blood cells (RBC) (10 12 /L), mean corpuscular volume (MCV) (fL), hemoglobin (HB) (g/dL), number of white blood cells (WBC) (10 9 /L), number of lymphocytes (10 9 /L), number of neutrophils (10 9 /L), neutrophil/lymphocyte ratio (NLR), number of platelets (10 9 /L), mean platelet volume (MPV) (fL), pseudocholinesterase (PCHE) (U/L), total plasmatic proteins (g/dL), albumin (g/dL), bilirubin (mg/dL), creatinine (mg/dL), uric acid (mg/dL), cholesterol (mg/dL), low-density lipoproteins (LDL) (mg/dL), high-density lipoproteins (HDL) (mg/dL), glycaemia (mg/dL), urea (mg/dL), creatine phosphokinase (CPK) (U/L), thyroid-stimulating hormone (TSH) (mcU/mL), transaminases (aspartate transaminase-AST and alanine transaminases-ALT) (UI/L), gamma-glutamyl-transferase (G...…”

Long-term sustained release Poly(lactic-co-glycolic acid) microspheres of asenapine maleate with improved bioavailability for chronic neuropsychiatric diseases

“…Furthermore, it has been found that more than 45% of patients do not show therapeutic effects after treated with ASM, indicating poor compliance (Vieta & Montes, 2018 ). The market product of ASM that approved in Europe (Sycrest ® ) and United States (Saphris ® ) is the twice-daily administrated sublingual tablets, which is not very convenient for clinical use (Buoli et al., 2017 ).…”