Bipolar_disorder | CARLAT PUBLISHING

Antipsychotic Maintenance: How Long is Enough?

January 13, 2020

Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Atypical antipsychotics can work quickly in mood disorders, but their long-term risks give us pause. When is it safe to discontinue them? The answer, it turns out, depends on whether we look to industry-supported or industry-independent trials.

A Practical Guide to Light Therapy

November 15, 2019

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC.

Few natural therapies perform well when stacked head-to-head with medication. Light therapy is an exception. When used correctly, it can treat winter and non-winter depression and augment antidepressants. Learn which lightboxes work, how to use them, and a new light therapy protocol for bipolar depression.

A New Treatment for Bipolar Depression

August 1, 2019

With Vrylar’s new approval, there are now four atypicals antipsychotics with an indication in bipolar depression. Only two of these, however, are known to work in mania as well as depression. None of the atypicals stands out as the perfect choice for bipolar depression, but there are pros and cons to each that make them fitter better with certain patients.

Mood Stabilizers and Stroke Risk in Bipolar Disorder

July 3, 2019

Thomas Jordan, MD.

Thomas Jordan, MD. Dr. Jordan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity

Why does stroke matter in bipolar disorder? Because it’s the leading cause of death for these patients. Some mood stabilizers raise the stroke risk, while others do not.

Does Mania Follow the Sun?

February 1, 2019

Chris Aiken, MD.
Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

If dark nights can treat mania, can too much sunshine destabilize it? Yes and no. Mania is linked to rapid changes in sunlight, but not to the amount of light itself. Mania peaks in early spring when there’s a steep rise in sunlight. By the time the longest day of the year comes along in late June, there’s no longer a detectable increase in mania (Parker G et al, J Affect Disord 2018;226:72–76).

Evaluating and Treating Co-Occurring ADHD and Bipolar Disorder

November 1, 2018

Candace Good, MD

Candace Good, MD Child & adolescent psychiatrist, SunPointe Health, State College, PA, and a contributing writer for the Carlat newsletters. Dr. Good has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity

Early into the evaluation of a 10-year-old boy, you note the following symptoms: inattention, hyperactivity, impulsivity, sleep problems, racing thoughts, and moodiness. The boy’s parents came to your office convinced that their son has ADHD, but thinking through the case, you recognize that the same symptoms could signal bipolar disorder (BD).

Probiotics for Bipolar Disorder

November 1, 2018

Adam Strassberg, MD and Chris Aiken, MD

Adam Strassberg, MD Chris Aiken, MD Drs. Strassberg and Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Probiotics, the so-called “good” bacteria in the gut flora, have become popular as a natural treatment for various disorders. They are taken as capsules or through food sources like yogurt, vinegar, and fermented foods.

Treatment-Resistant Depression: Some Introductory Tips

July 1, 2018

Chris Aiken, MD

Chris Aiken, MD Editor-in-chief of The Carlat Psychiatry Report Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Treatment-resistant depression (TRD) has a fairly low barrier of entry. Failure of 2 full antidepressant trials—lasting 6 weeks at a minimally effective dose—is enough to qualify. In this month’s issue of TCPR, we’ll highlight pharmacologic advances that are underutilized and debunk a few that are unlikely to be effective for TRD.

Celecoxib as Adjunctive Treatment in Acute Mania

March 1, 2018

Thomas Jordan, MD

Thomas Jordan, MD Dr. Jordan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Emotional stress can trigger an inflammatory cascade response and increase blood levels of proinflammatory cytokines—including IL-1, IL-6, and tumor necrosis factor (TNF-α). These same inflammatory markers intensify in acute episodes of depression and mania.

Note From the Editor-in-Chief

January 1, 2018

Daniel Carlat, MD

Daniel Carlat, MD Editor-in-Chief, The Carlat Psychiatry Report

When I was training in the 1990s, diagnosing bipolar disorder seemed straightforward. These patients often came to our attention because of a flagrant manic episode. You may still remember the first time you treated a manic patient—I certainly do.