Low-Dose Buspirone, Melatonin and Low-Dose Bupropion Added to Mood Stabilizers for Severe Treatment-Resistant Bipolar Depression

Nierenberg, Andrew A.

doi:10.1159/000235985

Cited by 15 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Initially, 43 articles were screened for eligibility, of which 33 were excluded for the following reasons: 11 were excluded because they were review articles, 10,30–39 9 because they were case reports/series, 9,12,14,18,40–44 11 which did not compare changes in disease severity after bupropion treatment or differences in the treatment effect or drop-out or phase-shifting rates with bupropion and other treatments, 15,20,45–53 and 1 which was a meta-analysis. 54 The remaining 10 articles were then entered into the current meta-analysis (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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: 99%

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

“…Non-benzodiazepine anxiolytics (e.g., buspirone) may be relatively neutral relative to cognition (149), and as untreated anxiety symptoms may directly impair cognitive ability (150), its effective management may aid in the treatment of cognitive impairment.…”

Section: Other Agentsmentioning

confidence: 99%

Pharmacological approaches in bipolar disorders and the impact on cognition: a critical overview

Dias

Balanzá‐Martínez

Soeiro-de-Souza

et al. 2012

Acta Psychiatr Scand

120

View full text Add to dashboard Cite

Pharmacotherapies for BD should be chosen to minimize neurocognitive side-effects, which may already be compromised by the disease process itself. Neurocognitive evaluation should be considered in BD patients to better evaluate treatment impact on neurocognition. A comprehensive neuropsychological evaluation also addressing potential variables and key aspects such as more severe cognitive deficits, comorbidities, differential diagnosis, and evaluation of multiple cognitive domains in longitudinal follow-up studies are warranted.

show abstract

Potential Novel Therapeutics for Bipolar Disorders

Machado‐Vieira

Manji

Zarate

2010

Behavioral Neurobiology of Bipolar Disorder and Its Treatment

View full text Add to dashboard Cite

Existing pharmacological treatments for bipolar disorder (BPD), a severe recurrent mood disorder, are in general insufficient for many patients. Despite adequate doses and treatment duration, many individuals with this disease continue to experience mood episode relapses, residual symptoms, and functional impairment. This chapter reviews a number of targets/compounds that could result in putative novel treatments for BPD, including the dynorphin opioid neuropeptide system, the glutamatergic system, the purinergic system, the cholinergic system (muscarinic and nicotinic systems), the oxidative stress system, and the melatonergic system. The arachidonic acid cascade and intracellular signaling cascades (including glycogen synthase kinase 3 and protein kinase C) are also reviewed, as are agents that affect multiple targets (e.g., modafinil, Uridine RG2417). Further study of these and similar agents may improve our understanding of relevant drug targets and their clinical utility as potential therapeutics for this devastating disorder.

show abstract

Low-Dose Buspirone, Melatonin and Low-Dose Bupropion Added to Mood Stabilizers for Severe Treatment-Resistant Bipolar Depression

Cited by 15 publications

References 7 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

Pharmacological approaches in bipolar disorders and the impact on cognition: a critical overview

Potential Novel Therapeutics for Bipolar Disorders

Contact Info

Product

Resources

About