Second generation antipsychotics in the treatment of bipolar depression: a systematic review and meta-analysis

Fruyt, Jürgen De; Deschepper, Ellen; Audenaert, Kurt; Constant, Éric; Floris, Michel; Pitchot, William; Sienaert, Pascal; Souery, Daniel; Claes, Stephan

doi:10.1177/0269881111408461

Cited by 87 publications

(43 citation statements)

References 47 publications

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“…In these studies, efficacy was evaluated using the MADRS and the CGI-BP, as was done in this study. In addition, a meta-analysis demonstrated the efficacy of olanzapine for improving the MADRS total score [12]. The pharmacological mechanism of action of olanzapine for treating depression is thought to be based on an increase in dopamine and noradrenaline release in the prefrontal cortex [13] and on 5-HT2A and 5-HT2C receptor antagonistic activity [14].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

Kirino

2014

CNPT

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Purpose:We administered olanzapine to 24 outpatients with bipolar disorder who had experienced a depressive or mixed episode as their most recent episode to evaluate the efficacy and safety of olanzapine in clinical practice. Methods: The duration of study treatment was 8 weeks. Symptoms in each subject were assessed using the Montgomery Åsberg Depression Rating Scale (MADRS) and the Clinical Global Impressions-Severity of Illness, Bipolar Version (CGI-BP) at the start of treatment with olanzapine and at Week 4 and Week 8 of treatment. Results: A total of 17 subjects underwent the assessments at Week 4, and 13 subjects completed the 8-week treatment regimen and the assessments at Week 8. The mean total score and each individual item score of the MADRS were significantly improved at Week 4 and Week 8 compared to those at the start of treatment. The mean CGI-BP Depression and CGI-BP Overall scores were significantly improved at Week 4 and Week 8, while the mean CGI-BP Mania score was not significantly different at Week 4 or Week 8 compared to that at the start of treatment. Adverse drug reactions were reported in 3 subjects during the study: hyperphagia in 2 subjects and light-headed feeling in 1 subject. No manic switches were observed. Discussion: The results of this study confirmed the efficacy and safety of olanzapine in outpatients with bipolar depression in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

Kirino

2014

CNPT

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“…38 Atypical antipsychotics have been investigated in bipolar depression with variable results. 39 Treatment with quetiapine leads to more symptomatic improvement in patients with bipolar depression than do placebo, paroxetine, and lithium. 39 Some evidence exists of a reduced risk of recurrence in patients who respond to acute-phase treatment and continue quetiapine rather than switch to placebo; thus, continuation could be of benefit in patients who can tolerate the drug's adverse effects, including sedation and weight gain.…”

Section: Treatment Of Bipolar Depressionmentioning

confidence: 99%

“…Emerging evidence suggests that lurasidone might also be efficacious, whereas aripiprazole does not seem to be so. 39,42 The transdiagnostic benefits of a drug like quetiapine, which is antipsychotic, antimanic, and antidepressant in both unipolar and bipolar depression, emphasises the importance of the investigation of treatment effects across conventional diagnostic boundaries. 9,40,43 However, this nonspecificity and scarcity of convincing evidence of long-term disease modification by known mechanisms suggests that the effects are mediated by short-term alleviation of symptoms.…”

Section: Treatment Of Bipolar Depressionmentioning

confidence: 99%

The Treatment of Bipolar Disorder

Möller¹,

Nasrallah²

2017

Oxford Medicine Online

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We review recent developments in the acute and long-term treatment of bipolar disorder and identify promising future routes to therapeutic innovation. Overall, advances in drug treatment remain quite modest. Antipsychotic drugs are effective in the acute treatment of mania; their efficacy in the treatment of depression is variable with the clearest evidence for quetiapine. Despite their widespread use, considerable uncertainty and controversy remains about the use of antidepressant drugs in the management of depressive episodes. Lithium has the strongest evidence for long-term relapse prevention; the evidence for anticonvulsants such as divalproex and lamotrigine is less robust and there is much uncertainty about the longer term benefits of antipsychotics. Substantial progress has been made in the development and assessment of adjunctive psychosocial interventions. Long-term maintenance and possibly acute stabilisation of depression can be enhanced by the combination of psychosocial treatments with drugs. The development of future treatments should consider both the neurobiological and psychosocial mechanisms underlying the disorder. We should continue to repurpose treatments and to recognise the role of serendipity. We should also investigate optimum combinations of pharmacological and psychotherapeutic treatments at different stages of the illness. Clarification of the mechanisms by which different treatments affect sleep and circadian rhythms and their relation with daily mood fluctuations is likely to help with the treatment selection for individual patients. To be economically viable, existing psychotherapy protocols need to be made briefer and more efficient for improved scalability and sustainability in widespread implementation.

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“…The natural compounds containing the quinolin-2-one nucleus such as flindersine, dictamnine as well as their synthetic analogues are found to possess pharmacological activity and therapeutic utility [2][3][4][5]. Clinical significance of quinolin-2-one is well established and documented in the form of treatment of psychosis, as a β-blocker in an ophthalmic preparation, as an antacid and in congestive cardiac failure [6][7][8][9]. Literature reviews have indicated linomide ( fig.…”

Section: Introductionmentioning

confidence: 99%

Synthesis, Characterization and Evaluation of 4-Hydroxy-1-Phenyl/Methyl-3-(3-Substituted-1-(Substitutedimino) Propyl) Quinoline-2(1h)-One Derivatives and 4-Hydroxy-1-Phenyl/Methyl-3-(1-(Substituedimino) Ethyl) Quinoline-2(1h)-One Derivatives as Possible Anticancer Agents

Desai¹,

Priolkar²,

Karmali³

et al. 2017

Int J Pharm Pharm Sci

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Objective: Synthesis, characterization and evaluation of quinolin-2-one derivatives as possible anticancer agents. Methods:A series of novel 4-hydroxy-1-phenyl/methyl-3-(3-substituted-1-(substitutedimino)propyl)quinolin-2(1H)-one derivatives IIa(1-5)/IIb(1-5) and 4-hydroxy-1-phenyl/methyl-3-(1-(substituedimino)ethyl)quinolin-2(1H)-one derivatives IIIa(1-3)/IIIb(1-3) were synthesised by nucleophilic addition of substituted anilines on 3-acetyl-4-hydroxy-1-phenyl/methylquinolin-2(1H)-one (a/b) and 4-hydroxy-3-(3-substitutedpropanoyl)-1-phenyl/methyl quinolin-2(1H)-one (Ia/Ib); respectively. The synthesised derivatives were characterised by spectral analysis and were tested for their in vitro anticancer activity against K562 and Hep 3b cell lines by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method.Results: The compounds were tested for their in vitro anticancer activity against K562 and Hep 3b cell lines at 10, 20, 25, 30 and 50 µg/ml concentration using MTT assay method. The compound 4-hydroxy-3-(3-morpholino-1-(phenylimino)propyl)-1-phenylquinolin-2(1H)-one (IIa-1) showed anticancer activity with IC50 value 20 µg as compared to the control against K562 cell lines. The compound 4-hydroxy-1-phenyl-3-(1-(phenylimino) ethyl) quinolin-2(1H)-one (IIIa-1) showed anticancer activity with IC50 value less than 10 µg. Conclusion:The proposed method for the synthesis of novel derivatives is convenient and gives a good yield. Some of the synthesised compounds showed promising anticancer activity against K562 and Hep 3b cell lines. Compound IIa-1 (R=-C6H5; R1= morpholine; R2= C6H5-NH-) exhibited most potent activity against K562 cell lines. Compound IIIa-1 (R=-C6H5; R3= C6H5-NH-) has been proved to be the most cytotoxic compound among the other derivatives against Hep 3b cell lines.

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Second generation antipsychotics in the treatment of bipolar depression: a systematic review and meta-analysis

Cited by 87 publications

References 47 publications

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

Efficacy of Olanzapine for Treating Depressive Episodes in Bipolar Disorder

The Treatment of Bipolar Disorder

Synthesis, Characterization and Evaluation of 4-Hydroxy-1-Phenyl/Methyl-3-(3-Substituted-1-(Substitutedimino) Propyl) Quinoline-2(1h)-One Derivatives and 4-Hydroxy-1-Phenyl/Methyl-3-(1-(Substituedimino) Ethyl) Quinoline-2(1h)-One Derivatives as Possible Anticancer Agents

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