Bipolar Disorder

Article

Equetro: New Name, Old Drug

Topics: Bipolar Disorder

Okay, we’ll lay our cards on the table right away. Rarely has TCR been as annoyed by the launch of a new medication as we are by the launch of Equetro. The last time the pharmaceutical industry embarrassed itself this much was when Eli Lilly launched “Sarafem,” calling it a “new” medication for PMDD when it was simply Prozac with a new name an

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Article

Antidepressants in Bipolar Disorder: The Controversy Continues

Topics: Antidepressants | Bipolar Disorder

There is a battle underway in the genteel circles of academic psychiatry. The disputed question is: Are antidepressants (ADs) good or bad for patients with bipolar disorder? The major figureheads in this drama are respected psychiatrists on opposite coasts. In the pro-AD corner, weighing in with an endowed chair and full professorship at UCLA, we hav

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Article

Lab Monitoring with Mood Stabilizers: Let’s Get Real

Topics: Bipolar Disorder

“Be careful, doctor. Don’t order lab tests that you don’t really need. You’re asking for trouble.” No, that’s not TCR talking. That’s none other than George Lundberg, M.D., former editor of JAMA. He made that statement in an editorial webcast in January 2005 on Medscape, where Dr. Lundberg is Editor-in-Chief (http://www.medscape. com/vi

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Expert Q&A

Ivan Goldberg, M.D., on Treating Bipolar Depression

Topics: Bipolar Disorder

TCR: Dr. Goldberg, I know you’ve spent a lot of time thinking about and treating bipolar disorder over the years, beginning when you were a researcher at NIMH, then on the faculty of Columbia University, and most recently in your private practice and your managing of Depression Central. I was hoping we could begin by discussing some of the tricky aspe

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Tales from the History of Psychiatry

A Sad and Strange Chapter

Topics: Bipolar Disorder

There have been many misguided treatments for bipolar disorder and other major mental illnesses throughout the history of psychiatry, but perhaps none has been as misguided--and as damaging--as the one practiced by Henry Aloysius Cotton, M.D. Once a student of Adolf Meyer, Emil Kraepelin, and Alois Alzheimer, he headed the New Jersey State Hospital in T

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Article

Atypicals for Bipolar: And Then There Were Five

Topics: Bipolar Disorder

We knew it was about to happen. We just didn’t know it would happen all at once. Between July and September of 2004, Seroquel, Geodon, and Abilify sequentially won approval for the treatment of manic episodes in bipolar disorder. Which means that now all of the newer atypical antipsychotics have been admitted to the bipolar club, which until December

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Article

Trileptal: Everyone’s Using It!

Topics: Bipolar Disorder

Suddenly, we all have a colleague who is prescribing Trileptal (oxcarbazepine) for bipolar disorder, and who is claiming to have fabulous success. Rarely has a medication generated so much enthusiasm on so little data. The reason is that Trileptal is blessed with extraordinary intuitive appeal. Approved by the FDA for epilepsy in 2000, it is such a c

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Expert Q&A

Dr. Claudia Baldassano on Interviewing Tips in Bipolar Disorder

Topics: Bipolar Disorder | Practice Tools and Tips

TCR: Dr. Baldassano, as the Director of the Bipolar Outpatient Clinic of U Penn, how many patients with bipolar disorder do you typically evaluate in a given week? Dr. Baldassano: About 80 patients a week, and that would include consultations, patients referred directly to me, and patients that I see in supervision with U Penn residents. TCR: Are mo

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Article

Bipolar Confusion: Diagnosis Hints

Topics: Bipolar Disorder

Suddenly, it seems that everybody and their cousin is asking us if they have bipolar disorder. A few years ago, bipolar disorder was the ignored orphan diagnosis in psychiatry. However, now that various patented molecules have been proven effective, industry money is flying into efforts to publicize the diagnosis, and it's clearly working. We are get

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Clinical Update

A Practical Guide to Light Therapy

Topics: Alternative treatments | Bipolar Disorder | Complementary treatments | Depression | Depressive Disorder | Light and Dark Therapy | Light therapy | Lightbox | natural treatments | Seasonal Affective Disorder

Outdoor living, morning light, evening darkness, and regular rhythms of sleep and waking all have one thing in common: They prevent depression. That’s the conclusion of many large epidemiologic studies, but for people who work indoors and wake up to dark winter mornings, this isn’t good news (Asai Y et al, J Affect Disord 2018;241:235–240). Here

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News of Note

A New Treatment for Bipolar Depression

Topics: Antipsychotics | Atypical Antipsychotics | Bipolar Depression | Bipolar Disorder | Depression | News of Note | Pharmacology | Psychopharmacology

On May 28, 2019, cariprazine (Vraylar) became the fourth atypical antipsychotic to receive FDA approval for bipolar depression. The approval was based on two randomized controlled trials involving 1,051 patients and lasting 6–8 weeks. These studies grouped patients into fixed doses from 0.75–3 mg/day. The sweet spot seems to be 1.5 mg/day, which was

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Research Update

Mood Stabilizers and Stroke Risk in Bipolar Disorder

Topics: Bipolar Disorder | Lithium | Medical Comorbidities | Mood Stabilizers | Pharmacology

Review of: Chen PH et al, Br J Psychiatry 2018;1–6. doi:10.1192/bjp.2018.203 Study Type: Case-crossover study People living with bipolar disorder already have a decreased life expectancy of 10+ years compared to the general population (Crump C et al, JAMA Psychiatry 2013;70:931–939). Most of these years of lost life have been attributed to cardiov

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Expert Q&A

Light and Darkness in Bipolar Disorder

Topics: Bipolar Disorder

Dr. Jim Phelps is the author of a textbook on bipolar spectrum disorders, A Spectrum Approach to Mood Disorders: Not Fully Bipolar But Not Unipolar—Practical Management (W. W. Norton & Company) as well as two self-help books on bipolar disorder. He conducted some of the early studies on dark therapy out of his private practice in Oregon, and we ca

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Article

Does Mania Follow the Sun?

Topics: Bipolar Disorder | Free Articles | Mania

TABLE : SPRINGTIME MANIA Click here for the full PDF table showing sunlight peaks.   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 longe

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Article

Evaluating and Treating Co-Occurring ADHD and Bipolar Disorder

Topics: ADHD | Bipolar Disorder | Child Psychiatry

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). You ha

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Research Update

Probiotics for Bipolar Disorder

Topics: Bipolar Disorder | Research Update

Review of: Dickerson F et al, Bipolar Disord 2018. doi:10.1111/bdi.12652 [Epub ahead of print] Type of study: Randomized double-blind placebo-controlled trial 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 yogu

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Article

Treatment-Resistant Depression: Some Introductory Tips

Topics: Antidepressants | Bipolar Disorder | Depressive Disorder | Registered Articles

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. But first, we

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Research Update

Celecoxib as Adjunctive Treatment in Acute Mania

Topics: Bipolar Disorder | Child Psychiatry | OCD | Research Update

Review of: Mousavi et al, J Child Adolesc Psychopharmacol 2017; 27(6):494–500 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. So, would

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Article

Note From the Editor-in-Chief

Topics: Bipolar Disorder

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. He was a man in his 20s with flowing red hair and a messianic beard, who was admitted after police found

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Article

The Bipolar Spectrum: Practical Tips for Diagnosis and Treatment

Topics: Bipolar Disorder | Free Articles

Bipolar disorder has long been controversial in the field. Is it overdiagnosed or underdiagnosed? Does a “bipolar spectrum” truly exist, or is it a marketing tool for pharmaceutical companies that want you to prescribe more atypical antipsychotics? At a minimum, the bipolar spectrum includes those patients who meet criteria for both bipolar I and

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