1,721,014 research outputs found
Curare il disturbo bipolare. Manuale clinico della terapia interpersonale e dei ritmi sociali
No full textLa Cyclothymia, una malattia circolare dell’Umore. Translation from German and Commentary of: Die Cyclothymie, eine circuläre Gemüthserkrankung von Edwald Hecker
No full textThree-year, naturalistic, mirror-image assessment of adding memantine to the treatment of 30 treatment-resistant patients with bipolar disorder
No full textBACKGROUND: Developing safe and effective long-term treatments for bipolar
disorder remains a major challenge. Given available treatments, patients with
bipolar disorder remain unwell in half of long-term follow-up, mostly in
depression. As memantine, an N-methyl-D-aspartate (NMDA)-glutamate receptor
antagonist used to treat dementia, has been proposed for testing in bipolar
disorder, we carried out a 3 + 3-year, mirror-image, chart-review study of the
effects of adding memantine to stably continued, but insufficiently effective,
ongoing mood-stabilizing treatments.
METHOD: Outpatients diagnosed with DSM-IV-TR bipolar disorder (I or II), followed
intensively at the Lucio Bini Mood Disorder Center, Rome, Italy, had responded
consistently unsatisfactorily to standard treatments (lithium, anticonvulsants,
antipsychotics, antidepressants, and electroconvulsive therapy) for ≥ 3 years
(2005-2013). Memantine (20-30 mg/d) was added clinically to otherwise stable
regimens for another 3 years. On the basis of chart review, we compared morbidity
measures and Clinical Global Impressions scale for Bipolar Disorder (CGI-BP)
score before versus during memantine treatment.
RESULTS: The 30 bipolar I (n = 17) and II (n = 13) subjects showed consistent
morbidity for 3 years before memantine, but improved progressively (r = 0.28, P <
.01) over 3 years with memantine (23 ± 4.8 mg/d). Markedly decreased (all P
values ≤ .01) were (1) percentage of time ill (total, mania, or depression;
averaging -75.0%), (2) CGI-BP severity scores (-67.8%), (3) duration of new
episodes (-58.6%), and (4) episodes/year (-55.7%). Subjects with previous rapid
or continuous cycling were particularly improved (t = 2.61, P = .016). Adverse
effects were mild and rare.
CONCLUSIONS: Memantine added substantial long-term benefits by preventing or
ameliorating depressive as well as mania-like morbidity in previously
consistently poorly responsive patients with bipolar disorder. Further testing in
randomized, controlled trials is required
The Ring of Fire, Childhood Trauma, Emotional Reactivity, and Mixed States in Mood Disorders
No full textChildhood trauma (CT) is strongly associated with bipolar disorder, possibly through emotional hyperreactivity (EH). Mixed symptoms/states (MSs) are associated with increased illness severity. The authors tested through a systematic review the association between CT and MSs. The authors systematically looked for studies exploring associations between MSs and CT, CT and EH, and EH and MSs. Most literature agrees that MSs are associated with CT; the latter was found to be associated to EH, which is in turn associated with MSs. The literature supports an association between CT and later development of MSs, possibly mediated through EH
Melancholia agitata and mixed depression
Full text linkOBJECTIVE:
The diagnostic entity of major depressive episode includes both simple and agitated or mixed depression. Mixed depression is characterized by a full depressive episode with several symptoms of excitatory nature. Mixed depressions worsen if treated with antidepressants.
METHOD:
We have reviewed the clinical charts of the 2141 patients treated at the Centro Lucio Bini of Rome from January 1999 to June 2006. These patients were diagnosed according to DSM-IV criteria. Research diagnostic criteria were applied for agitated depression with motor agitation and Author's diagnostic criteria for agitated depression without motor agitation.
RESULTS:
One thousand and twenty-six patients had a depressive episode as index episode. Three hundred and forty six (33%) were mixed depressive states. One hundred and thirty eight (44%) of them were spontaneous; in 173 cases, the onset of the mixed depression was associated with antidepressants.
CONCLUSION:
Psychic and motor agitation are considered equally important for the definition of agitated depression. Treating agitated depression with antidepressants worsens the clinical picture. The use of Electroconvulsive Therapy (ECT), neuroleptics and anticonvulsants are recommended. The term Melancholia Agitata is proposed for agitated (mixed) depression
Antimanic and mood-stabilizing effect of memantine as an augmenting agent in treatment-resistant bipolar disorder
Full text linkMemantine is a selective, uncompetitive N-methyl-
D-aspartate (NMDA) receptor antagonist, currently
used in the treatment of Alzheimers disease.
Many clinical trials have demonstrated its tolerability
and safety. We have suggested that antidepressants
induce mania and rapid cycling by sensitizing
dopamine D2 receptors and demonstrated that
the sensitization induced by antidepressants requires
the stimulation of NMDA receptors. It is
tempting to suggest that the phenomenon of sensitization
could underlie the spontaneous development
and the course of mania as well
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