Laksami N Yatham

..These guidelines also discuss issues related to bipolar disorder in women and those with comorbidity and include a section on safety and monitoring...

..Clinicians may consider risperidone Consta as an option in patients with refractory bipolar illness, including those with a predominantly depressive course, and particularly in patients' nonadherence with prescribed medications...

..We identified several important avenues for future research, including a need for more assessment of QoL in hypo/manic patients, more longitudinal research and the development of a disease-specific measure of QoL for patients with BD...

..Olanzapine, another novel antipsychotic, is also effective against both manic and depressive symptoms and in the maintenance treatment as indicated by an open-label study. Data on other novel agents are more limited...

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..To examine the effects of treatment with valproate on brain 5-HT2A receptors in acute manic patients using positron emission tomography (PET) and [18F]-setoperone...

..Further studies should be conducted to examine these hypotheses...

..The atypical antipsychotics represent an effective and relatively safe addition to our armamentarium for the treatment of bipolar disorder...

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..Overall, the atypical antipsychotic agents as a group represent an effective and relatively safe addition to the armamentarium for the treatment of bipolar disorder...

..Hypomania will likely respond to monotherapy with antimanic agents. Adjunctive psychosocial treatments may provide additional benefit in patients with bipolar II disorder...

..Quetiapine, in combination with lithium or divalproex, is well tolerated and has superior efficacy to lithium or divalproex alone in the treatment of bipolar mania...

..Risperidone add-on does not induce depressive symptoms and, furthermore, risperidone may have efficacy in treating comorbid depressive symptoms in bipolar patients...

..The importance of comorbid psychiatric and medical conditions cannot be understated, and this update provides an expanded look at the prevalence, impact and management of comorbid conditions in patients with bipolar disorder...

..These data suggest that risperidone can be safely combined with either lithium or valproate, and that the efficacy is similar regardless of the mood stabilizer used...

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..To review the literature on efficacy of third generation anticonvulsants for treatment of bipolar disorder and provide clinical recommendations...

..To determine the impact of acute depression on quality of life (QOL) in patients with bipolar I disorder and to compare these results with published data on QOL in patients with unipolar depression...

..Few double-blind trials have examined the efficacy of a combination of a mood stabiliser and an atypical antipsychotic in acute mania...

..This article will review the results from open and double-blind studies with quetiapine, ziprasidone, risperidone and olanzapine in the management of bipolar disorder...

..This paper reviews controlled studies of bipolar depression, outlines criteria for choosing treatment, defines refractoriness in bipolar depression, and provides options for treatment of refractory bipolar depression...

..Overall, the combination of quetiapine with lithium or divalproex was well tolerated...

..Studies in first-episode (FE) manic patients have the potential to provide answers to these questions...

..This article summarizes current evidence from trials of anticonvulsants in bipolar disorder and makes recommendations for their clinical use...

..However, these reports are limited by retrospective or cross-sectional designs, and the assessment of patients with lengthy illnesses. Prospective data, and data on weight gain early in the course of BD, are lacking...

..More quality research is needed to delineate effective treatment strategies...

..However, there is a relative dearth of research on functional outcomes and their predictors in first-episode manic patients from prospective studies early in the course of bipolar disorder...

..To describe clinical characteristics, course, and outcome during a 1-year period after the first manic episode in patients with bipolar disorder (BD)...

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..Practical recommendations regarding titration and the management of rash are offered...

..This schema should be further informed by the treatment data for comorbid and accessory conditions. The authors propose a schema to provide the impetus for further work in the area...

..The purpose of this study was to further examine D(2) receptor density in a larger sample of nonpsychotic manic patients by using positron emission tomography (PET) and [(11)C]raclopride...

..In order to further elucidate the relationship between BD and work, we report here on a series of exploratory qualitative interviews undertaken to develop a disease-specific measure of quality of life in BD...

..The results demonstrated that the traits associated with seasonal and nonseasonal depression differ in degree, not kind...

..Our data provide in vivo neurochemical support for the lack of clinical efficacy following MP in PD patients and are also in keeping with reduced DA release following amphetamine in PD subjects...

..We report here on a series of in-depth qualitative interviews we conducted as part of the item generation phase for a disease-specific scale to assess QoL in BD...

..Similarly, the combination of lithium or valproate plus olanzapine seems to be more effective than monotherapy with a mood stabiliser in preventing manic episodes...

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..In this study, we compared the effects of combining citalopram and bupropion-SR versus switching to the other monotherapy in treatment-resistant depression...

..This study seeks to validate the Lam Employment Absence and Productivity Scale (LEAPS), a 10-item self-report questionnaire that takes 3-5 minutes to complete...

..This study aimed to compare baseline levels of negative life events (NLEs) and perceived social support (SS) in patients with seasonal and nonseasonal depression...

..Future research is required to determine whether perceived QoL is improved by treatment interventions for seasonal depression such as light therapy or antidepressant medication...

..We aimed to assess the impact of a time-limited psychoeducation (PE) group therapy upon perceived QoL among patients with BD...

..Although 5-hydroxytryptamine (5-HT) has been implicated in mania, the precise alterations in the 5-HT system remain elusive...

..Bipolar II disorder is frequently overlooked in treatment guidelines, but has an important clinical impact on patients' lives. This update provides an expanded look at bipolar II disorder...

..The purpose of this study was to determine whether neuropsychological impairments are present in clinically stable patients with bipolar disorder shortly after resolution of their first manic episode...

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..Positron emission tomography (PET) studies in individuals with depression confirmed that antidepressant medications reduce brain 5-HT(2) receptors, but the effects of ECT on these receptors in individuals with depression are unknown...

..CONCLUSION: OXC was effective and well-tolerated in refractory BD and schizoaffective disorder. These preliminary data are promising but controlled studies are needed to confirm its efficacy in refractory BD...

..The risk of antidepressant-associated mood elevations (AAME) in bipolar II disorder relative to bipolar I disorder and MDD is unknown...

..Obesity in the general population is also consistently associated with functional impairment, but the relationship between weight gain and functional outcomes in BD-I has received little attention...

..More well-designed studies with larger samples are needed to improve the evidence base for managing this disorder...

..Failure of inflammatory defences in the late stage of the disorder may account for reduction in BDNF and continued elevations in cytokines; thus these may have the potential to serve as markers of illness progression in BD...

..Further controlled studies are required to demonstrate the efficacy of mirtazapine in treatment-resistant depression...

..Cognitive impairment has been well documented in bipolar disorder. However, specific aspects of cognition such as emotional memory have not been examined...

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..None have specifically examined outcomes in patients with treatment-resistant depression (TRD)...

..In the present investigation, we conducted a meta-analysis of studies that evaluated markers of oxidative stress in individuals with BD, as compared to healthy controls...

..The etiology of winter depression (seasonal affective disorder, or SAD) is not known, but a number of studies have provided support for both photoperiod and neurotransmitter hypotheses...

..Typical experimental categorizations of treatment responses in bipolar disorder (BPD) patients may have limited relationship to clinical recovery or functional status, and there is inadequate research on such clinically important outcomes...

..The authors compared the efficacy of olanzapine and lithium in the prevention of mood episode relapse/recurrence...

..This study assessed the efficacy and tolerability of lamotrigine and lithium compared with placebo for the prevention of mood episodes in bipolar disorder...

..5-1.7, all P < 0.01). These well-powered comparisons of subgroups of interest indicate broad efficacy of olanzapine in the treatment of acute mania...

..To review new perspectives on diagnosis, clinical features, epidemiology, and treatment of bipolar II and related disorders...

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..Subsyndromal symptoms in bipolar disorder can cause significant functional impairment and are associated with relapse...

..We hypothesize that brain neurotransmitter dysregulation may be at the origin of both the mood disorder and retinal sensitivity change...

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..We report on the first controlled study comparing acute and continuous clinical outcomes in RC and non-RC manic patients treated with olanzapine...

..At the other end of the spectrum, the model attempts to operationalize treatment resistance. The utility of the model will need to be validated by empirical research...

..To review issues surrounding the diagnosis and validity of bipolar manic states...

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..The finding of this study suggests that lamotrigine in the dose used in this study does not appear to enhance GABA levels in humans...

..This study aimed to examine these outcomes in short- and long-term naturalistic follow-up of ECT conducted in a community hospital...