1,721,132 research outputs found
Should the term antipsychotic be changed to 'multidimensional stabiliser' in bipolar disorder? Towards a new denomination for atypical antipsychotics
No full textTranscranial Brain Stimulation Techniques For Major Depression : Should We Extend TMS Lessons to tDCS?
Full text linkTranscranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that, by means of magnetic fields and low intensity electrical current, respectively, aim to interefere with and modulate cortical excitability, at the level of dorsolateral prefrontal cortex, in patients with major depression and poor response to standard antidepressants. While the clinical efficacy of TMS in major depression has been extensively investigated over the last 10 years, tDCS has attracted research interest only in the last years, with fewer randomized clinical trials (RCTs) in the field. Nevertheless, in spite of the different rationale and mechanism of action of the two techniques, tDCS recent acquisitions, in relation to the treatment of major depression, seem to parallel those previously obtained with TMS, in terms of treatment duration to achieve optimal benefit and patient's history of drug-resistance. After briefly introducing the two techniques, the article examines possible common pathways of clinical use for TMS and tDCS, emerging from recent RCTs and likely orienting future investigation with non invasive brain stimulation for the treatment of major depression
Prevalent burdensome mental disorders remain untreated for years : manifesto for early diagnosis and treatment
No full textFactors that affect duration of untreated illness in pregnant women with bipolar disorder
No full textPsychiatric conditions in Parkinson disease: a comparison with classical psychiatric disorders
No full textPsychiatric conditions often complicate the outcome of patients affected by Parkinson disease (PD), but they differ from classical psychiatric disorders in terms of underlying biological mechanisms, clinical presentation, and treatment response. The purpose of the present review is to illustrate the biological and clinical aspects of psychiatric conditions associated with PD, with particular reference to the differences with respect to classical psychiatric disorders. A careful search of articles on main databases was performed in order to obtain a comprehensive review about the main psychiatric conditions associated with PD. A manual selection of the articles was then performed in order to consider only those articles that concerned with the topic of the review. Psychiatric conditions in patients with PD present substantial differences with respect to classical psychiatric disorders. Their clinical presentation does not align with the symptom profiles represented by Diagnostic and Statistical Manual for Mental Disorders and International Classification of Diseases. Furthermore, psychiatry treatment guidelines are of poor help in managing psychiatric symptoms of patients with PD. Specific diagnostic tools and treatment guidelines are needed to allow early diagnosis and adequate treatment of psychiatric conditions in comorbidity with PD
Paliperidone palmitate depot in the long-term treatment of psychotic bipolar disorder : A case series
No full textObjectives: The treatment of bipolar disorder (BD) cannot be limited to the remission of acute phases but includes the long-term treatment in order to prevent relapses, poor outcome, and chronicity. The purpose of this article is to present 3 cases of severe psychotic bipolar patients treated with monthly injection of paliperidone pamoate.
Methods: Three poor-compliant severe psychotic BD patients were initiated to paliperidone palmitate (100–150 mg monthly), and they were followed up for 12 months. Young Mania Rating Scale and Hamilton Depression Rating Scale were administered at baseline and during monthly follow-up visits.
Results: None of patients presented recurrences or relapses during the 12-month follow-up period. The patients did not develop adverse effects or significant changes in metabolism.
Conclusions: These preliminary results indicate that paliperidone palmitate (100–150 mg monthly) may be a therapeutic option for long-term treatment of psychotic BD, particularly for poor-compliant severe patients. These results have to be confirmed in double-blind studies with bipolar patients not necessarily belonging to psychotic subtype
Use of atypical antipsychotics as mono-poly therapy with mood stabilizers for the treatment of bipolar disorder an update
No full textOver the last decade, the class of the atypical antipsychotics has become the gold standard for the treatment of bipolar disorder (BD), at least for its manic/mixed phases. This phenomenon has different explanations: first, the number of compounds with formal approvals for BD is higher in comparison with other mood-stabilizers including lithium and anticonvulsants. Second, the sample size of randomized controlled trials assessing the efficacy and safety of different pharmacological treatments is usually larger for most recently approved compounds (i.e., atypical agents for the treatment of BD). If the role of atypical antipsychotics is well-established in the treatment of BD, doubts still persist about their optimal efficacy as monotherapy vs combination treatment with other mood-stabilizers, in particular. In addition, a possible superiority in terms of efficacy for polytherapy needs to be balanced in relation to tolerability issues. The present article was aimed to review the state of the art in the field reviewing the latest evidence arising from international guidelines recommendations and meta-analyses
Long-term Effects of Vagus Nerve Stimulation in Treatment- resistant Depression : a 5-years Follow up Cases Series
No full textBiological aspects and candidate biomarkers for rapid-cycling in bipolar disorder : A systematic review
No full textRapid-cycling bipolar disorder represents a frequent severe subtype of illness which has been associated with poor response to pharmacological treatment. Aim of the present article is to provide an updated review of biological markers associated with rapid-cycling bipolar disorder. A research in the main database sources has been conducted to identify relevant papers about the topic. Rapid-cycling bipolar disorder patients seem to have a more frequent family history for bipolar spectrum disorders (d range: 0.44-0.74) as well as an increased susceptibility to DNA damage or mRNA hypo-transcription (d range: 0.78-1.67) than non rapid-cycling ones. A susceptibility to hypothyroidism, which is exacerbated by treatment with lithium, is possible in rapid-cycling bipolar disorder, but further studies are needed to draw definitive conclusions. Rapid-cycling bipolar patients might have more insuline resistance as well as more severe brain changes in frontal areas (d range: 0.82-0.94) than non rapid-cycling ones. Many questions are still open about this topic. The first is whether the rapid-cycling is inheritable or is more generally the manifestation of a severe form of bipolar disorder. The second is whether some endocrine dysfunctions (diabetes and hypothyroidism) predispose to rapid-cycling or rapid-cycling is the consequence of drug treatment or medical comorbidities (e.g. obesity)
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