World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Bipolar Disorders, Part I: Treatment of Bipolar Depression

Grunze, Heinz; Kasper, Siegfried; Goodwin, Guy M.; Bowden, Charles L.; Baldwin, David S.; Licht, Rasmus Wentzer; Vieta, Eduard; Möller, Hans‐Jürgen

doi:10.3109/15622970209150612

Cited by 169 publications

(93 citation statements)

References 64 publications

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“…1,3,12,13 It is not known if the depressive episodes in BPD II respond to medications the same way as in BPD I. 2 There are no controlled studies about the management of depression in bipolar II patients, and open studies are still scarce in the literature.…”

Section: Discussionmentioning

confidence: 99%

A lamotrigina pode induzir virada maníaca?

Cheniaux

Dias

Lessa

et al. 2005

Rev. psiquiatr. Rio Gd. Sul

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Em ensaios clínicos controlados com pacientes bipolares, a lamotrigina tem demonstrado eficácia no tratamento da fase aguda da depressão e, principalmente, na prevenção de novos episódios depressivos. É relatado o caso de um paciente bipolar tipo II, ciclador rápido, que, durante um episódio depressivo, fez uso dessa substância, em monoterapia, e passou a apresentar um quadro maníaco disfórico. Este remitiu logo após a retirada da medicação e foi sucedido por um novo episódio depressivo. Essa ocorrência foi bastante inesperada diante dos dados clínicos da literatura científica, os quais associam a lamotrigina a uma taxa muito baixa de virada para a mania.

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Section: Discussionmentioning

confidence: 99%

A lamotrigina pode induzir virada maníaca?

Cheniaux

Dias

Lessa

et al. 2005

Rev. psiquiatr. Rio Gd. Sul

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“…However, in recent years bipolar disorder has received increasing attention from clinicians, researchers and society as a whole. This upsurge of interest is exemplified by the appearance of the first issue of Bipolar Disorders (a peer-reviewed publication specializing in bipolar disorders) in September 1999 [16], 1999 also being the beginning of the publication of all but two of the Medline-cited guidelines for treating bipolar disorder in adults (Medline search with bipolar disorder as MeSH term, search restricted to major topic headings only, practice guideline as publication type) [17,18,19,20,21,22,23,24,25,26,27]. …”

Section: Bipolar Disorder – An Upswing In Researchmentioning

confidence: 99%

Bipolar (Spectrum) Disorder and Mood Stabilization: Standing at the Crossroads?

Fruyt

Demyttenaere²

2007

Psychother Psychosom

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Diagnosis and treatment of bipolar disorder has long been a neglected discipline. Recent years have shown an upsurge in bipolar research. When compared to major depressive disorder, bipolar research still remains limited and more expert based than evidence based. In bipolar diagnosis the focus is shifting from classic mania to bipolar depression and hypomania. There is a search for bipolar signatures in symptoms and course of major depressive episodes. The criteria for hypomania are softened, leading to a bipolar prevalence that now equals that of major depressive disorder. Anti-epileptics and atypical antipsychotics have joined lithium in the treatment of bipolar disorder. Fortunately, mood stabilization has become the core issue in bipolar disorder treatment. In contrast with recent trends in the diagnosis of bipolar disorder, treatment research remains more focused on classic mania than depression or hypomania. This leaves the clinician with the difficult task of diagnosing ‘new bipolar patients’ for whom no definite evidence-based treatment is available. An important efficacy-effectiveness gap further compromises the translation of the evidence base on bipolar disorder treatment into clinical practice. The recent upsurge of research on bipolar disorder is to be applauded, but further research is needed: for bipolar disorder in general, and for bipolar depression and the long-term treatment specifically. Given the complexity of the disorder and the many clinical uncertainties, effectiveness studies should be installed.

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“…1 These drugs show high efficacy, and relatively few adverse reactions compared with the previously used tricyclic antidepressants, even though their mechanism of action is not entirely understood yet. However, these drugs are effective in only about two-thirds of depressed patients.…”

Section: Introductionmentioning

confidence: 99%

The pharmacogenomics of selective serotonin reuptake inhibitors

Serretti

Artioli

2004

Pharmacogenomics J

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The introduction of selective serotonin (5-HT) reuptake inhibitors (SSRIs) has significantly improved the pharmacological treatment of a range of psychiatric disorders. Nevertheless, despite the undoubted advantages of antidepressant treatment in terms of improved tolerability to therapy while maintaining a high level of efficacy, not all patients benefit from it; an appreciable proportion do not respond adequately, while others may show adverse reactions. The necessary change of the initial treatment choice often requires extended periods for the remission of symptomatology. Such difficulties could be avoided if it should be possible to determine more quickly the most suitable drug. Several factors have been thought to influence the outcome of antidepressant therapy. Among the factors influencing the interindividual variability in response to treatment with SSRI, differences in genetic features may play a significant role. Several genetic polymorphisms have been associated with therapeutic SSRI response, including genetic variants of the 5-HT transporter, 5-HT-2A-receptor, tryptophan hydroxylase, brain-derived neurotrophic factor, G-protein beta3 subunit, interleukin-1beta and angiotensin-converting enzyme, although with conflicting results; also cytochrome P450 drug-metabolising enzymes may bear a particular importance, although further corroboration of the findings is necessary, and further key participating genes remain to be identified. The hope is that the identification of these genetic components will eventually facilitate the development of a customised SSRI treatment. 1 These drugs show high efficacy, and relatively few adverse reactions compared with the previously used tricyclic antidepressants, even though their mechanism of action is not entirely understood yet. However, these drugs are effective in only about two-thirds of depressed patients.2 The necessary change of the initial treatment choice often requires extended periods for the remission of symptomatology. Such difficulties could be avoided if it would be possible to determine more quickly the most suitable drug for each subject. Several factors have been thought to influence the outcome of antidepressant therapy and efficient clinical predictors have not been yet identified, but there is some evidence suggesting that genetic factors play a substantial role.

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World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Bipolar Disorders, Part I: Treatment of Bipolar Depression

Abstract: Summary

Cited by 169 publications

References 64 publications

A lamotrigina pode induzir virada maníaca?

A lamotrigina pode induzir virada maníaca?

Bipolar (Spectrum) Disorder and Mood Stabilization: Standing at the Crossroads?

The pharmacogenomics of selective serotonin reuptake inhibitors

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