Bipolar II (March)

Date of Issue: 03/01/2020 | Volume: 18 | Number: 3

Issue Links:Learning Objectives | Editorial Information

Is oxcarbazepine really a kinder, gentler mood stabilizer? We dig through the published and unpublished trials and talk with a psychiatrist who’s found a niche for the anticonvulsant. Plus, the sweet spot for antidepressant dosing, and a first look at two new medications: the antipsychotic lumateperone and the hypnotic lemborexant.

In This Issue

Clinical Update

Oxcarbazepine: Close, but no Cigar

Topics: Bipolar Disorder | Carbamazepine | Mania | Mood Stabilizers | Oxcarbazepine | Pharmacology | Psychopharm Myths | Psychopharmacology

Oxcarbazepine is thought of as a kinder, gentler cousin of carbamazepine, but it brings new safety issues of its own and does not fully escape the drug interactions that hinder carbamazepine. We pull on the published and unpublished trials to figure out where this anticonvulsant stands in bipolar disorder.

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Expert Q&A

Psychopharmacology in Bipolar II

Topics: Bipolar Disorder | Hypomania | Mania | Mixed Features | Mood Stabilizers

Bipolar II is a different illness from Bipolar I, but it’s in Bipolar I that most of the psychopharmacology research was undertaken. Dr. Kelly walks us through some of the nuances in applying that knowledge to Bipolar II, and shows us how to recognize the subtle traces of hypomania and mixed features that go along with Bipolar II depression.

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News of Note

Lumateperone and lemborexant

Topics: Antipsychotics | Belsomra | Caplyta | Dayvigo | Hypnotics | Lemborexant | Lumateperone | News of Note | Orexin | Pharmacology | Psychopharmacology | Suvorexant

The antipsychotic lumateperone (Caplyta) and the hypnotic lemborexant (Dayvigo) are the newest in their class. Both of them claim to improve on the safety of older medications, and we look at the data to see how those claims hold up.

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Research Update

Optimal Antidepressant Doses in Major Depression

Topics: Antidepressants | Bupropion | Citalopram | Depression | Depressive Disorder | Escitalopram | Fluoxetine | Mirtazapine | Paroxetine | Pharmacology | Pharmacology Tips | Research | Research Update | Sertraline | SSRIs | Venlafaxine | Wellbutrin

More is not necessarily better in psychopharmacology. Some medications have plateau effect, while others follow a “U-shaped curve,” causing more problems as the dose goes too high. This metaanalysis looked at 77 dose-response trials with antidepressants to quantify their optimal therapeutic window.

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Highlights

Highlight From This Issue

Topics: Bipolar Disorder | Carbamazepine | Mania | Mood Stabilizers | Oxcarbazepine | Pharmacology | Psychopharm Myths | Psychopharmacology

Quick summary of the issue.

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CME Post-Test

CME Post-Test - Bipolar II, TCPR, March 2020

Topics: CME Post-Test

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 1 CME credit.

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