Mood stabilizers in the prevention of recurrent affective disorders: a meta‐analysis

Davis, John M.; Janicak, Philip G.; Hogan, Diane

doi:10.1111/j.1600-0447.1999.tb10890.x

Cited by 112 publications

(66 citation statements)

References 80 publications

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“…In a meta-analysis, it was found out that 30% of patients had recurrence of episodes whilst prevention with lithium (Davis, Janicak, & Hogan, 1999). In this meta-analysis, it was also reported that there was no difference between lithium and carbamazepine maintenance in terms of recurrence risk.…”

Section: Discussionmentioning

confidence: 85%

Maintenance treatment trends, therapeutic outcomes and their association with clinical features in remitted bipolar disorder

Berkol¹,

Balcıoğlu²,

Kirlooglu³

et al. 2017

JNBS

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Özetİki uçlu bozuklukta uzun dönem tedavisine ilişkin kanıtlar yeterince tatmin edici değildir. İyilik döneminde başta lityum ve valproat olmak üzere, antipsikotik ve antikonvülzan ajanlar sürdürüm tedavisi seçeneklerindendir. Bu tedavilerle olumlu sonuçlar literatürde gösterilse de, farklı klinik özellikler gösteren hastaların farklı ajanlara yanıtlarına dair çalışmalar yetersizdir. Bu çalışmada, söz konusu ajanların duygudurum ataklarından koruyuculuğunu belirlemek ve daha uygun ilaç seçimi sağlamak için; ilaçların kullanım sıklıklarının, elde edilen yanıt düzeylerinin ve bunların klinik özellikler ile ilişkisinin araştırılması amaçlanmıştır. Haseki Eğitim ve Araştırma Hastanesi Psikiyatri Polikliniği'nde izlenmekte olan yüz seksen altı bipolar bozukluk tanılı hasta çalışmaya alınmıştır. Hastaların tümüne SCID-I (Structured Clinical Interview for DSM-IV); uygulanmış; İki uçlu bozukluğa eşlik eden ek psikiyatrik tanılar saptanmıştır. Her iki hasta grubunun sosyodemografik ve klinik özelliklerini ve yaşam boyu farmakolojik tedavilerini değerlendiren yarı yapılandırılmış görüşme çizelgesi doldurulmuştur. Bu çizelgeler klinik görüşme ile yeniden değerlendirilmiş ve gözden geçirilmiştir. Hastaların sürdürüm tedavisinde %71 lityum, %44 antikonvülzan, %18 antipsikotik monoterapileri ve %23 lityum-antikonvülzan, %15 lityum-antipsikotik, %25 antikonvülzan-antipsikotik kombine tedavilerinin hastalığın herhangi bir döneminde kullanıldığı belirlenmiştir. Lityum monoterapisi alan hastaların %61'inin, antikonvülzan monoterapisi alan hastaların %62'sinin tedaviye yanıt verdiği saptanmıştır. Antikonvülzan-antipsikotik kombine sürdürüm tedavisi alan hastalarda daha yüksek yanıt oranı bulunmuştur. Evli olmak, psikotik belirtilerin yokluğu, mevsimsellik ve atakların hafif seyretmesi lityum tedavisine yanıtın öngörücüleri olarak saptanmıştır. cevap vermiştir. Erkek, boşanmış, intihar girişimi olan ve duygudurum ataklarında karma AbstractThe evidence base data regarding long-term treatment of bipolar disorder (BD) is less than satisfactory. With the first-line rank of lithium and valproate; antipsychotics (AP) and anticonvulsants (AC) considered options for prolonged treatment in remitted bipolar patients. Literature demonstrates various treatment options in remitted patients with different clinical features. The aim of this study to present and assess clinical outcomes of maintenance treatment for BD with various clinical features. In total 186 bipolar patients in remission were enrolled in this study. All the patients were evaluated with SCID-I (Structured Clinical Interview for DSM-IV) ; and lifelong psychiatric comorbidities were determined. Sociodemographical and clinical features, and lifelong pharmacological treatment of the patients were assessed. Semi-structured interview schedules were filled. 71% lithium, 44% AC, 18% AP monotherapies and 23% lithium-AC, 15% lithium-AP, 25% AC-AP combination therapies were used as maintenance treatment. 61% and 62% of the patients were responders of lithium and AC monotherapies respectiv...

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Section: Discussionmentioning

confidence: 85%

Maintenance treatment trends, therapeutic outcomes and their association with clinical features in remitted bipolar disorder

Berkol¹,

Balcıoğlu²,

Kirlooglu³

et al. 2017

JNBS

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“…Prophylactic treatment with lithium prevents recurrences of depression and mania in a substantial proportion of patients with this disorder (Davis et al, 1999). Much research has shown that lithium regulates components of signal transduction pathways and their downstream gene transcription factors, an indication that changes in gene expression are likely to underlie the mechanism of action of the treatment (Manji and Zarate, 2002;Bezchlibnyk and Young, 2002).…”

Section: Introductionmentioning

confidence: 99%

Identification of Lithium-Regulated Genes in Cultured Lymphoblasts of Lithium Responsive Subjects with Bipolar Disorder

Sun

Young

Wang

et al. 2004

Neuropsychopharmacol

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Lithium, a common drug for the treatment of bipolar disorder (BD), requires chronic administration to prevent recurrences of the illness. The necessity for long-term treatment suggests that changes in genes expression are involved in the mechanism of its action. We studied effects of lithium on gene expression in lymphoblasts from BD patients, all excellent responders to lithium prophylaxis. Gene expression was analyzed using cDNA arrays that included a total of 2400 cDNAs. We found that chronic lithium treatment at a therapeutically relevant concentration decreased the expression of seven genes in lymphoblasts from lithium responders. Five of these candidate lithiumregulated genes, including alpha1B-adrenoceptor (a1B-AR), acetylcholine receptor protein alpha chain precursor (ACHR), cAMPdependent 3 0 ,5 0 -cyclic phosphodiesterase 4D (PDE4D), substance-P receptor (SPR), and ras-related protein RAB7, were verified by Northern blotting analysis in lithium responders. None of these genes were regulated by lithium in healthy control subjects. When we compared the expression of these five genes between bipolar subjects and healthy control subjects at baseline, prior to lithium administration, we found that a1B-AR gene expression was higher in bipolar subjects than in healthy control subjects. Our findings indicate that a1B-AR may play an important role in the mechanism of action of lithium treatment.

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“…It has been shown to be effective in a wide range of psychiatric disorders, including bipolar disorder (Davis et al, 1999;Burgess et al, 2001), treatment-resistant depression (Heit & Nemeroff, 1998) and recurrent depression (Greil et al, 1996;Davis et al, 1999). Some research has suggested that lithium reduces suicidality and admission rates in patients with bipolar disorder, although these findings have been disputed (Tondo et al, 1997;Burgess et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

How safe is lithium prescribing? Audit of a local prescribing framework and patient survey

Glover¹,

Lawley²

2005

Psychiatr. bull.

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Aims and MethodTo examine the standards of lithium monitoring in eastern Hull following the introduction of a local prescribing framework, we investigated the biochemistry records of patients currently prescribed lithium, identified from primary care computerised records. A survey of patients' knowledge about lithium therapy was also conducted.ResultsInadequate standards of lithium monitoring were demonstrated, with only 50% of patients having a level recorded during the preceding 3 months. Monitoring of thyroid and renal function was better, with two-thirds of patients tested in the past year. Patients' knowledge of the side-effects and risks of lithium was minimal; only 7 out of 27 patients questioned felt able to identify the signs of lithium toxicity; three-quarters of those surveyed felt they had not been given enough information about their medication.Clinical ImplicationsThe introduction of prescribing frameworks or other guidelines does not ensure good practice. Further actions may be needed to ensure lithium is prescribed safely, such as patient registers, monitoring cards and automatic recall systems. Education of patients and primary care staff about the safe use of psychotropic drugs needs to be an ongoing process.

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Mood stabilizers in the prevention of recurrent affective disorders: a meta‐analysis

Cited by 112 publications

References 80 publications

Maintenance treatment trends, therapeutic outcomes and their association with clinical features in remitted bipolar disorder

Maintenance treatment trends, therapeutic outcomes and their association with clinical features in remitted bipolar disorder

Identification of Lithium-Regulated Genes in Cultured Lymphoblasts of Lithium Responsive Subjects with Bipolar Disorder

How safe is lithium prescribing? Audit of a local prescribing framework and patient survey

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