C L Bowden

..The anticonvulsant lamotrigine has demonstrated efficacy for relapse prevention in bipolar disorder, but its possible mood-stabilizing properties on a day-to-day or week-to-week basis have not previously been investigated...

..The utility of lamotrigine in acute bipolar depression and major depressive disorder is modest...

..STEP-BD has established procedures that are relevant to future collaborative research programs aimed at the systematic study of the complex, intrinsically important elements of bipolar disorders...

..To evaluate the efficacy and tolerability of quetiapine monotherapy versus placebo for the treatment of mania associated with bipolar disorder...

..Some findings have been unexpected. Mixed mania did not predict different maintenance response to divalproex or lithium but predicted more side effects with either drug, and reduced efficacy of olanzapine or lamotrigine...

..This study assessed weight changes in a large cohort of patients with bipolar disorder who were treated with randomly assigned maintenance monotherapies...

..Combination therapy (risperidone and a mood stabilizer) for patients with a history of bipolar disorder (DSM-IV) and hospitalized for treatment of a manic episode was assessed in a 13-week study...

..Adverse events were reported in 44% of patients in both groups. Valproate and lithium showed comparable efficacy and tolerability in the treatment of acute mania over 12 weeks...

..Agents should be added carefully, with continued monitoring of adverse effects. Physicians should give patients only as much medication as needed...

..In general, VPA provides a well-tolerated treatment that is efficacious for a broad spectrum of manic states and improves outcomes during maintenance treatment...

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..Awareness of these distinctions can greatly improve diagnosis of bipolar disorder and provide an opportunity for effective therapeutic intervention...

..The atypical antipsychotics also have relatively mild side effect profiles, although augmentation therapy with some antipsychotics and mood stabilizers has been associated with excessive weight gain...

..anxiety, psychosis, impulsivity, elevated psychomotor and cognitive processing speed, rather than strictly depressive or manic syndromes can provide more homogeneous samples for study, and increase the focus of experimental hypotheses...

..A post-hoc, descriptive analysis was undertaken to assess the tolerability of and changes in psychiatric rating scales with lamotrigine (LTG) administered concomitantly with commonly prescribed bipolar medications...

..Valproate appears useful in other disorders that have behavioral dimensions inclusive of the domains that valproate benefits in bipolar disorders, such as schizophrenia...

..The efficacy and safety of divalproex sodium extended release (divalproex ER) were evaluated in patients hospitalized for acute mania associated with bipolar I disorder, manic or mixed type (DSM-IV-TR criteria)...

..To review the literature on the effectiveness of anticonvulsant drugs in the management of bipolar disorder...

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..These findings - considered in the context of data showing lamotrigine to be effective for bipolar depression - establish lamotrigine as a well-tolerated addition to the psychotropic armamentarium...

..This study compared the efficacy of divalproex, lithium, and placebo as prophylactic therapy...

..To evaluate the efficacy and safety of ziprasidone adjunctive to a mood stabilizer for the maintenance treatment of bipolar mania...

..Adverse events were reported in 42.8% of patients in the lithium group and 41.5% in the valproate group. Valproate and lithium showed comparable efficacy and tolerability in the treatment of acute mania over 12 weeks...

..This article summarizes the role of valproate as a treatment for bipolar disorder and related conditions...

..Systematic studies are needed to clarify treatment guidelines for youth with bipolar disorder, and for other special populations, e.g. pregnant women and the elderly...

..We report the rationale, format, reliability and initial validity studies of the Bipolar Inventory of Symptoms Scale (BISS), a 44-item scale designed to encompass the spectrum of behavioral disturbances in BDs...

..Several other drugs that were reported as beneficial in various facets of bipolar disorder in open trials have not differed from placebo when studied in randomised, placebo-controlled trials...

..It is important that clinicians be alert to any hint of bipolarity developing in the course of antidepressant therapy, especially among patients with first-episode major depression...

..Both lithium and divalproex appear beneficial in prevention of relapse, although recent studies indicate more modest effects for lithium than did early studies from the 1970s...

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..The study assessed the efficacy and safety of risperidone as an adjunctive agent to mood stabilizers in the treatment of acute mania...

..Patients unresponsive to a single agent may show improvement with combined regimens, though this impression is based more on clinical experience than controlled randomized assignment...

..One study demonstrated statistically significant improvements in mania symptoms compared to placebo, while an earlier study did not. Results of the earlier study are presented here...

..This study compared demographic and phenomenological variables between bipolar patients with and without rapid cycling as a function of bipolar I versus bipolar II status...

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

..We investigated the structure of manic episodes by determining whether there was evidence for distinct groups of patients differing in clinical characteristics and course of illness...

..The objective of this report was to determine rash rates in clinical trials of lamotrigine in DSM-IV unipolar depression or bipolar disorder...

..To examine the potential impact of recovery from substance use disorder (SUD) on the course of bipolar disorder among patients diagnosed with both bipolar and substance use disorders according to DSM-IV criteria...

..Combination therapy may provide more efficacious treatment for many patients with bipolar disorder...

..The guidelines for evaluating possible medications, the criteria for selection and ranking, and the updated algorithms are described...

..No published studies have statistically evaluated the relationship between the outcomes in maintenance treatment and the principal acute agent...

..To investigate whether the cox-2 inhibitor celecoxib has antidepressant effects in bipolar disorder (BD) patients during depressive or mixed phases...

..The results also support the utility of a comprehensive BD symptom scale in distinguishing primary clinical states of BD...

..This study examined whether caregivers' health is associated with changes in suicidal ideation and depressive symptoms among bipolar patients observed over one year...

..Despite the common occurrence of anxiety in BD, it has not been identified in most prior factor analyses, in part due to limited coverage of anxiety symptoms in the source scales...

..Little is known about the factors contributing to mental illness stigma among caregivers of people with bipolar disorder...

..The U.S. Systematic Treatment Enhancement Program for Bipolar Disorder compared one-year outcomes for bipolar I or II disorder from each of these racial-ethnic groups...

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..Poor adherence to medication treatment can have devastating consequences for patients with mental illness. The goal of this project was to develop recommendations for addressing adherence problems to improve patient outcomes...

..Future directions include factor analysis and sensitivity to change from treatment studies...

..Maintenance pharmacotherapy can reduce rates of future episodes, and subsequently, the associated risks, functional disability and economic burden of bipolar illness...

..Lamotrigine appears not to have acute antimanic properties. A small number of studies suggest a broader spectrum of efficacy, including in some axis I disorders that are comorbidly associated with bipolar disorder...

..Dysphoric mania appeared to predispose patients to more side effects when treated with either divalproex or lithium during maintenance therapy...

..This study compared illness characteristics, treatment history, and overall functioning in a sample of European American, African American, and Latino patients with bipolar disorder...

..We aimed to see whether topiramate was more effective than placebo as a treatment for alcohol dependence...

..e. effect motor activity and depressed mood, and paroxetine to reduce global severity and anxiety. The study shows the VIBES to be capable of uncovering behavioural mechanisms underlying AD's capacity to resolve depressive disorder...

..To document educational attainment in relation to IQ in patients with bipolar disorder, in order to establish guidelines for matching patients with appropriate comparison subjects...

..7% (11/30) among Lam + Div patients (χ(2)  = 7.89, df = 1, P = 0.005). Conclusion:  Lam + Div generally provided greater maintenance efficacy than Lam alone for depressive indices in recently depressed BD patients...

..To describe the frequency and correlates of lamotrigine therapy among the first 500 patients enrolled into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study...

..These findings suggest that personality, at least to some extent, mediates the comorbidity phenomena in bipolar disorder...

..Recent data indicate that lithium use for bipolar disorder has declined over the last decade and that lithium largely has been replaced with alternate, commercially promoted medications that may or may not result in better outcomes...

..Thus, the Brief MV, in uncovering underlying behavioural actions, represents an important addition to the current unidimensional HAMD approach in drug research...

..Clinicians must consider the existing evidence on the long-term efficacy of various pharmacologic and psychosocial interventions for preventing and treating bipolar mood episodes...

..The results are plausible, based on prior studies of circadian abnormalities. As replications have not been attempted uniformly, we evaluated representative, common polymorphisms in all three disorders...

..This article discusses these four areas and presents the consensus of the panel participants...

..We sought to ascertain the profile of cognitive impairment in patients with bipolar disorder and to determine whether a distinct profile of cognitive deficits characterizes bipolar patients with a history of psychosis...

..Symptoms of bipolar disorder are increasingly recognized among children and adolescents, but little is known about the course of bipolar disorder among adults who experience childhood onset of symptoms...

..Clinicians must take steps to differentiate bipolar depression from other depressive disorders. Screening for manic/hypomanic symptoms during index episodes of depression can help in this endeavor...

..Early drug-specific behavioral changes were highly predictive of ultimate clinical response to the different ADs, results that could eventually be applied directly to clinical practice...

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..We assessed impulsivity in depressed and euthymic bipolar and unipolar patients and healthy controls. We hypothesized that bipolar subjects would have higher levels of trait impulsivity than the comparison groups...

..These results indicate that bipolar disorder met-carriers have abnormal energy metabolism in the left dorsolateral prefrontal cortex...

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

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..These data suggest that there are naturalistic subtypes of manic episodes with different responses to treatment...

..CONCLUSION: Compared with the use of valproate or lithium alone, the addition of olanzapine provided superior efficacy in the treatment of manic and mixed bipolar episodes...

..To evaluate the efficacy of divalproex for the treatment of posttraumatic stress disorder (PTSD) hyperarousal symptom cluster...

..Aims To evaluate whether olanzapine plus either lithium or valproate reduces the rate of relapse, compared with lithium or valproate alone...

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..In a placebo-controlled, double-blind study, the authors investigated the efficacy and safety of olanzapine as monotherapy in relapse prevention in bipolar I disorder...

..Our study was designed to determine whether adjunctive antidepressant therapy reduces symptoms of bipolar depression without increasing the risk of mania...

..Little is known about the effects of lithium on suicidal ideation or about the possible antisuicidal effects of divalproex, second-generation antipsychotics, or antidepressants among persons with bipolar disorder...

..However, few studies have examined the outcomes of patients with co-occurring manic and depressive symptoms who are treated with antidepressants plus mood stabilizing drugs...

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

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

..Combinations of olanzapine and carbamazepine are often used in clinical practice in the management of mania...

..The development of lamotrigine provides one example of the importance of prescience, patience and persistence in bringing a novel idea to clinical fruition...

..CONCLUSIONS: Very early or early onset of bipolar disorder might herald a more severe disease course in terms of chronicity and comorbidity. Whether early intervention might modify this risk merits further investigation...

..Two clinical trials, prospectively designed for combined analysis, compared placebo, lithium, and lamotrigine for treatment of bipolar I disorder in recently depressed or manic patients...

..Sub-syndromal symptoms in bipolar disorder impair functioning and diminish quality of life...

..abstract not provided ..