Article

A European perspective on the Canadian guidelines for bipolar disorder

Bipolar Disorders Program, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain.
Bipolar Disorders (Impact Factor: 4.89). 02/2005; 7 Suppl 3(s3):73-6. DOI: 10.1111/j.1399-5618.2005.00221.x
Source: PubMed

ABSTRACT Vieta E, Nolen WA, Grunze H, Licht RW, Goodwin G. A European perspective on the Canadian guidelines for bipolar disorder. Bipolar Disord 2005: 7 (Suppl. 3): 73–76. © Blackwell Munksgaard, 2005

Download full-text

Full-text

Available from: Heinz Grunze, Aug 28, 2015
0 Followers
 · 
118 Views
  • Source
    Psychiatry 12/2006; 3(12):23-33.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Manic-depression or bipolar disorder (BD) is a multi-faceted illness with an inevitably complex treatment. This article summarizes the current status of our knowledge and practice of its treatment. It is widely accepted that lithium is moderately useful during all phases of bipolar illness and it might possess a specific effectiveness on suicidal prevention. Both first and second generation antipsychotics are widely used and the FDA has approved olanzapine, risperidone, quetiapine, ziprasidone and aripiprazole for the treatment of acute mania. These could also be useful in the treatment of bipolar depression, but only limited data exists so far to support the use of quetiapine monotherapy or the olanzapine-fluoxetine combination. Some, but not all, anticonvulsants possess a broad spectrum of effectiveness, including mixed dysphoric and rapid-cycling forms. Lamotrigine may be effective in the treatment of depression but not mania. Antidepressant use is controversial. Guidelines suggest their cautious use in combination with an antimanic agent, because they are supposed to induce switching to mania or hypomania, mixed episodes and rapid cycling. The first-line psychosocial intervention in BD is psychoeducation, followed by cognitive-behavioral therapy. Other treatment options include Electroconvulsive therapy and transcranial magnetic stimulation. There is a gap between the evidence base, which comes mostly from monotherapy trials, and clinical practice, where complex treatment regimens are the rule.
    Annals of General Psychiatry 02/2007; 6(Suppl 1):27. DOI:10.1186/1744-859X-6-27 · 1.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bipolar depression is associated with significant morbidity, high risk of suicide and substantial impairment of health-related quality of life (QOL), which adversely affects family/social relationships and occupational functioning. Depressive symptomatology is the primary determinant of quality of life, and there is a paucity of clinical trial data on how treatments affect quality of life. This 8-week, randomized, double-blind, parallel-group, placebo-controlled study in 542 patients with bipolar I or II depression used the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire to assess the effect of quetiapine monotherapy, 300 or 600 mg/day, on quality of life. Quality of sleep was also measured using the Pittsburgh Sleep Quality Index. Both doses of quetiapine significantly improved quality of life over baseline values in comparison with placebo, which was evident at first assessment (week 4) and continued up to week 8. The improvement in quality of life was consistent over the majority of the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire domains, and was evident in patients classified as responders on the basis of clinical efficacy measures. Quetiapine therapy also effected a significant improvement in quality of sleep compared with placebo. Improved quality of life may enhance patient compliance, and assessment of quality of life should be incorporated into future clinical trials in bipolar depression.
    International Clinical Psychopharmacology 02/2007; 22(1):29-37. · 3.10 Impact Factor
Show more