The neurocognitive performance of drug‐free and medicated euthymic bipolar patients do not differ

Goswami, Utpal; Sharma, Arpita; Varma, Anjali; Gulrajani, Chinmoy; Ferrier, I. N.; Young, Allan H.; Gallagher, Peter; Thompson, Jessica; Moore, P. A.

doi:10.1111/j.1600-0447.2009.01390.x

Cited by 67 publications

(52 citation statements)

References 21 publications

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“…While a small study has led to suggestions that medicated patients who are euthymic do perform similarly to those not receiving treatment,846 other naturalistic trials point towards the potential negative impact of several medications, with the effects of antipsychotics being the most significant 845. Lithium can also lead to impairment in processing speed and memory, which patients may find distressing,847 although recent randomized controlled data suggest lithium is superior to quetiapine in this regard 329.…”

Section: Safety and Monitoringmentioning

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

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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.

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Section: Safety and Monitoringmentioning

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

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“…In summary, only antipsychotics seem to have a negative effect on cognitive performance in BD. However, cognitive dysfunctions cannot fully be explained by drug side effects because even in medication-free euthymic BP, neurocognition is impaired (Bourne et al, 2013;Goswami et al, 2009).…”

Section: Introductionmentioning

confidence: 98%

Evidence for cognitive subgroups in bipolar disorder and the influence of subclinical depression and sleep disturbances

Volkert

Kopf

Kazmaier

et al. 2015

European Neuropsychopharmacology

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“…Another limitation is that all participants with BD were undergoing pharmacological therapy during the research and these treatments may have influenced our study results (we could not stop medications for ethical reasons); however, according to Ancín et al (2010), cognitive alterations in patients with BD cannot be explained by medication because most changes remained after statistically controlling for medication in several studies (Fleck, Sax, & Strakowski, 2001). The same was true for drug-free patients with BD during euthymic states (Goswami et al, 2009).…”

Section: Discussionmentioning

confidence: 61%

Relationship between neuropsychological and clinical aspects and suicide attempts in euthymic bipolar patients

Moraes¹,

Neves²,

Vasconcelos³

et al. 2013

Psicol. Reflex. Crit.

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Some studies have investigated the possible relationship between suicide attempts and impulsivity in patients with bipolar disorder. The objective of this study was to assess the relationship between neuropsychological and clinical aspects and suicide behavior in euthymic bipolar patients. The Iowa Gambling Task and the Conner's Continuous Performance Test evaluated impulsivity in 95 euthymic bipolar patients -42 suicide attempters and 115 normal control participants. A factorial analysis evaluated the adequacy of the instruments. Furthermore, a multiple regression analysis was done in order to develop a model to predict suicide attempts. Our results point to a specific type of impulsivity related to making decisions, lack of planning and borderline personality disorder comorbidity. This type of impulsivity is a risk factor for suicide attempts in patients with bipolar disorder. Keywords: Impulsivity, suicidal behavior, bipolar disorder, decision making. ResumoAlguns estudos investigaram a possível relação entre tentativas de suicídio e impulsividade em pacientes com transtorno bipolar. O objetivo do estudo foi avaliar a relação entre características neuropsicológicas e clínicas e o comportamento suicida em pacientes bipolares eutímicos. Utilizamos o Iowa Gambling Task e o Conner's Continuous Performance Test para avaliar a impulsividade em 95 pacientes eutímicos com transtorno bipolar (42 com tentativas de suicídio) e 155 controles normais. Uma análise fatorial avaliou a adequação dos instrumentos e foi criado um modelo para previsão do número de tentativas de suicídio usando regressão linear múltipla. Nossos resultados apontam para um tipo específico de impulsividade relacionada à tomada de decisões, falta de planejamento e para a comorbidade Transtorno de Personalidade Borderline. A impulsividade por não planejamento é um fator de risco para tentativas de suicídio em pacientes com Transtorno Bipolar. Palavras-chaves: Impulsividade, suicídio, transtorno bipolar, tomada de decisão.

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The neurocognitive performance of drug‐free and medicated euthymic bipolar patients do not differ

Abstract: Medications did not have any significant influence on neurocognitive performance, suggesting that neurocognitive deficits are an integral part of bipolar disorder.

Cited by 67 publications

References 21 publications

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

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

Evidence for cognitive subgroups in bipolar disorder and the influence of subclinical depression and sleep disturbances

Relationship between neuropsychological and clinical aspects and suicide attempts in euthymic bipolar patients

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