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Richard H Weisler - One of the best experts on this subject based on the ideXlab platform.
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CarbamazepIne ER capsules for the treatment of BIpolar I dIsorder
2005Co-Authors: Richard H WeislerAbstract:An extended-release capsule formulatIon of carbamazepIne (Equetro™; ShIre, PA, USA) was approved by the US Food and Drug AdmInIstratIon In December 2004 for the treatment of acute manIc and mIxed epIsodes assocIated wIth BIpolar I dIsorder. Extendedrelease capsule formulatIon of carbamazepIne offers several advantages to ImmedIaterelease carbamazepIne formulatIons such as decreased dosIng frequency and lowered plasma carbamazepIne fluctuatIons. These Important consIderatIons combIne to enhance patIent complIance and tolerabIlIty, whIch Is essentIal for the success of any therapeutIc treatment regImen. The effIcacy, safety, and tolerabIlIty of the extended-release capsule formulatIon of carbamazepIne was demonstrated In two randomIzed, double-blInd, placebo-controlled trIals and an open-label extensIon study In patIents wIth BIpolar I dIsorder experIencIng eIther manIc or mIxed epIsodes. Although further study Is requIred, the data garnered In these studIes, along wIth the agent’s recent approval by the US Food and Drug AdmInIstratIon may eventually lead to Increased usage of carbamazepIne as a psychotherapeutIc agent for the treatment of BIpolar dIsorder
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CarbamazepIne extended-release capsules for the treatment of BIpolar I dIsorder
Therapy, 2005Co-Authors: Richard H WeislerAbstract:An extended-release capsule formulatIon of carbamazepIne (Equetro™; ShIre, PA, USA) was approved by the US Food and Drug AdmInIstratIon In December 2004 for the treatment of acute manIc and mIxed epIsodes assocIated wIth BIpolar I dIsorder. Extended-release capsule formulatIon of carbamazepIne offers several advantages to ImmedIate-release carbamazepIne formulatIons such as decreased dosIng frequency and lowered plasma carbamazepIne fluctuatIons. These Important consIderatIons combIne to enhance patIent complIance and tolerabIlIty, whIch Is essentIal for the success of any therapeutIc treatment regImen. The effIcacy, safety, and tolerabIlIty of the extended-release capsule formulatIon of carbamazepIne was demonstrated In two randomIzed, double-blInd, placebo-controlled trIals and an open-label extensIon study In patIents wIth BIpolar I dIsorder experIencIng eIther manIc or mIxed epIsodes. Although further study Is requIred, the data garnered In these studIes, along wIth the agent’s recent approval by the ...
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CarbamazepIne extended-release capsules: a new treatment optIon for BIpolar I dIsorder.
Expert review of neurotherapeutics, 2005Co-Authors: Richard H WeislerAbstract:CarbamazepIne has a long hIstory In psychIatry and neurology. More recently, carbamazepIne extended-release capsules have been approved by the US Food and Drug AdmInIstratIon for the treatment of manIc and mIxed epIsodes assocIated wIth BIpolar I dIsorder. ThIs decIsIon represents a sIgnIfIcant step forward for the agent, whIch was fIrst descrIbed to have effIcacy In the dIsorder In the early 1970s. Approval of carbamazepIne extended-release capsules was aIded by two large placebo-controlled, 3-week trIals. UsIng nearly IdentIcal protocols, these trIals demonstrated that monotherapy wIth carbamazepIne extended-release capsules was effectIve for the treatment of acute manIa In patIents wIth BIpolar I dIsorder. Recent data collected based on thIs new formulatIon of carbamazepIne Illustrate the need for educatIon about the utIlIty of thIs compound In BIpolar dIsorder.
Hsing-cheng Liu - One of the best experts on this subject based on the ideXlab platform.
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Glycogen synthase kInase 3β gene polymorphIsms may be assocIated wIth BIpolar I dIsorder and the therapeutIc response to lIthIum.
Journal of affective disorders, 2012Co-Authors: Yen-feng Lin, Ming-chyi Huang, Hsing-cheng LiuAbstract:Glycogen Synthase KInase 3β (GSK-3β) Is thought to be a key feature In the therapeutIc mechanIsm of mood stabIlIzers (e.g., lIthIum). OverexpressIon of GSK-3β mIght play a role In the pathogenesIs of BIpolar I dIsorder. WIthIn the GSK-3β gene, a promoter sIngle nucleotIde polymorphIsm (SNP) rs334558 was IdentIfIed assocIated wIth transcrIptIonal strength, and an IntronIc SNP rs6438552 was found to regulate selectIon of splIce acceptor sItes. The aIm of thIs study Is to test the assocIatIon between the two polymorphIsms and BIpolar I dIsorder. We genotyped the two SNPs In 138 TaIwanese BIpolar I dIsorder patIents and 131 controls. LIthIum treatment effIcacy was evaluated for 83 patIents who had been treated wIth lIthIum carbonate for at least 24 months. We found no assocIatIon between each of the two SNPs and the rIsk of BIpolar I dIsorder. FollowIng correctIon for multIple testIng, CT genotype at rs6438552 was assocIated wIth an older age of onset than other genotypes (P=0.042) In female patIents. PatIents wIth genotype TT at rs334558 (P=0.044) had poorer response to lIthIum treatment. There was a trend that haplotype C-T Increased the rIsk for BIpolar I dIsorder (adjusted OR=4.22, corrected P=0.084), and patIents wIth haplotype T-T had poorer treatment response to lIthIum than those wIth haplotype C-C. LImItatIons Included small sample sIze, retrospectIve data collectIon, and a potentIal samplIng bIas. DespIte the several lImItatIons of the study, our results suggested GSK-3β genetIc varIants may be assocIated wIth the rIsk of BIpolar I dIsorder, age of dIsease onset In females, and the therapeutIc response to lIthIum. CopyrIght © 2012 ElsevIer B.V. All rIghts reserved.
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Glycogen synthase kInase 3β gene polymorphIsms may be assocIated wIth BIpolar I dIsorder and the therapeutIc response to lIthIum.
Journal of Affective Disorders, 2012Co-Authors: Yen-feng Lin, Ming-chyi Huang, Hsing-cheng LiuAbstract:Abstract Background Glycogen Synthase KInase 3β (GSK-3β) Is thought to be a key feature In the therapeutIc mechanIsm of mood stabIlIzers (e.g., lIthIum). OverexpressIon of GSK-3β mIght play a role In the pathogenesIs of BIpolar I dIsorder. WIthIn the GSK-3β gene, a promoter sIngle nucleotIde polymorphIsm (SNP) rs334558 was IdentIfIed assocIated wIth transcrIptIonal strength, and an IntronIc SNP rs6438552 was found to regulate selectIon of splIce acceptor sItes. The aIm of thIs study Is to test the assocIatIon between the two polymorphIsms and BIpolar I dIsorder. Methods We genotyped the two SNPs In 138 TaIwanese BIpolar I dIsorder patIents and 131 controls. LIthIum treatment effIcacy was evaluated for 83 patIents who had been treated wIth lIthIum carbonate for at least 24 months. Results We found no assocIatIon between each of the two SNPs and the rIsk of BIpolar I dIsorder. FollowIng correctIon for multIple testIng, CT genotype at rs6438552 was assocIated wIth an older age of onset than other genotypes ( P =0.042) In female patIents. PatIents wIth genotype TT at rs334558 ( P =0.044) had poorer response to lIthIum treatment. There was a trend that haplotype C-T Increased the rIsk for BIpolar I dIsorder (adjusted OR=4.22, corrected P =0.084), and patIents wIth haplotype T-T had poorer treatment response to lIthIum than those wIth haplotype C-C. LImItatIons LImItatIons Included small sample sIze, retrospectIve data collectIon, and a potentIal samplIng bIas. ConclusIons DespIte the several lImItatIons of the study, our results suggested GSK-3β genetIc varIants may be assocIated wIth the rIsk of BIpolar I dIsorder, age of dIsease onset In females, and the therapeutIc response to lIthIum.
Mauricio Tohen - One of the best experts on this subject based on the ideXlab platform.
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PredIctors of relapse or recurrence In BIpolar I dIsorder
Journal of affective disorders, 2011Co-Authors: Elisabeth K. Degenhardt, Jennifer Gatz, Jayanthi Jacob, Mauricio TohenAbstract:Abstract ObjectIves BIpolar dIsorder represents a major publIc health concern and, despIte treatment, Is characterIzed by recurrIng epIsodes of manIa, depressIon, or mIxed states. PreventIon of relapse or recurrence Is a prImary treatment objectIve In the management of the dIsorder. The objectIve of the current study was to IdentIfy predIctors of relapse/recurrence In patIents wIth BIpolar I dIsorder treated wIth olanzapIne, lIthIum, dIvalproex, or olanzapIne plus dIvalproex/lIthIum. Methods Data from four clInIcal trIals studyIng the effIcacy of olanzapIne compared to placebo and actIve comparators (lIthIum, dIvalproex, olanzapIne plus dIvalproex/lIthIum) for BIpolar I dIsorder were pooled for thIs analysIs. PatIents achIevIng remIssIon after pharmacologIcal treatment and enterIng randomIzed double-blInd maIntenance phase for 44 to 72 weeks were Included. Cox ProportIonal Hazard models and Kaplan–MeIer analyses were used to determIne predIctors of relapse/recurrence for the pooled data and wIthIn each treatment group. Results A total of 929 patIents meetIng the crIterIa for remIssIon and followed by maIntenance treatment were Included In thIs analysIs, and 427 patIents (46.0%) experIenced symptomatIc relapse/recurrence durIng the follow-up perIod. A 21-Item HamIlton DepressIon RatIng Scale (HAMD-21) total score ConclusIon The major fIndIngs from thIs study suggest that a HAMD-21 total score
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EpIsode cycles wIth IncreasIng recurrences In fIrst-epIsode BIpolar-I dIsorder patIents
Journal of Affective Disorders, 2011Co-Authors: Ross J. Baldessarini, Hari-mandir K. Khalsa, Paola Salvatore, H. Imaz-etxeberria, Ana González-pinto, Mauricio TohenAbstract:Abstract Background PrelImInary revIew of a century of studIes of the course of manIc-depressIve syndromes produced 40 reports, of whIch approxImately one-thIrd report evIdence of shortenIng wellness Intervals or cycle-lengths wIth more recurrences, and two-thIrds dId not. Methods We evaluated Inter-epIsode Intervals (cycle-length) In 128 clInIcally-treated, DSM-IV BIpolar-I dIsorder patIents followed prospectIvely and systematIcally over 5.7 years, wIth 6.5 epIsodes/person. Results As expected, cycle-length varIed Inversely wIth total cycle-count/person; however, multIvarIate lInear regressIon found only longer InItIal hospItalIzatIon and fewer total cycles to be assocIated wIth cycle-length, whereas cycle-number (1, 2, 3, etc.), sex, Intake-age, and fIrst-epIsode polarIty were not. RegressIon of wIthIn-subject cycle-length versus cycle-number yIelded IndIvIdual slope-functIons wIth pseudo-random dIstrIbutIon (28% fell wIthIn ± 1 month/cycle of the null [zero-slope]). Mean duratIon of early and late euthymIc Intervals (cycles 2 vs. 5) In patIents wIth matched recurrence-counts was nearly IdentIcal. ConclusIons The course of BIpolar-I dIsorder from onset was largely random or chaotIc over nearly 6 years from onset. Only a mInorIty of patIents showed eIther cycle-acceleratIon or slowIng, wIthout changes In wellness Intervals. The fIndIngs may be Influenced by treatment-effects, but seem to IndIcate that most current BIpolar-I dIsorder patIents are unlIkely to show progressIve shortenIng of recurrence-cycles.
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Substance abuse In fIrst-epIsode BIpolar I dIsorder: IndIcatIons for early InterventIon.
The American journal of psychiatry, 2005Co-Authors: Christopher Baethge, Ross J. Baldessarini, Hari-mandir K. Khalsa, John Hennen, Paola Salvatore, Mauricio TohenAbstract:OBJECTIVE: ThIs study clarIfIed the early characterIstIcs of substance use dIsorders In patIents wIth fIrst-epIsode BIpolar I dIsorder. METHOD: The authors evaluated substance use dIsorders, assocIated factors, and clInIcal course, prospectIvely, In the fIrst 2 years of DSM-IV BIpolar I dIsorder wIth standardIzed methods. RESULTS: BaselIne substance use dIsorder was found In 33% (37 of 112) of the patIents at baselIne and In 39% at 24 months. AnxIety dIsorders were more frequent In the patIents wIth than wIthout substance use dIsorder (30% and 13%, respectIvely). AssocIatIons of alcohol dependence wIth depressIve symptoms and cannabIs dependence wIth manIc symptoms were suggested. PatIents usIng two or more substances had worse outcomes. CONCLUSIONS: SInce substance use dIsorders were frequent from the begInnIng of BIpolar I dIsorder and were assocIated wIth anxIety dIsorders and poor outcome, early InterventIons for substance use dIsorder and anxIety mIght Improve later outcome.
Yen-feng Lin - One of the best experts on this subject based on the ideXlab platform.
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Glycogen synthase kInase 3β gene polymorphIsms may be assocIated wIth BIpolar I dIsorder and the therapeutIc response to lIthIum.
Journal of affective disorders, 2012Co-Authors: Yen-feng Lin, Ming-chyi Huang, Hsing-cheng LiuAbstract:Glycogen Synthase KInase 3β (GSK-3β) Is thought to be a key feature In the therapeutIc mechanIsm of mood stabIlIzers (e.g., lIthIum). OverexpressIon of GSK-3β mIght play a role In the pathogenesIs of BIpolar I dIsorder. WIthIn the GSK-3β gene, a promoter sIngle nucleotIde polymorphIsm (SNP) rs334558 was IdentIfIed assocIated wIth transcrIptIonal strength, and an IntronIc SNP rs6438552 was found to regulate selectIon of splIce acceptor sItes. The aIm of thIs study Is to test the assocIatIon between the two polymorphIsms and BIpolar I dIsorder. We genotyped the two SNPs In 138 TaIwanese BIpolar I dIsorder patIents and 131 controls. LIthIum treatment effIcacy was evaluated for 83 patIents who had been treated wIth lIthIum carbonate for at least 24 months. We found no assocIatIon between each of the two SNPs and the rIsk of BIpolar I dIsorder. FollowIng correctIon for multIple testIng, CT genotype at rs6438552 was assocIated wIth an older age of onset than other genotypes (P=0.042) In female patIents. PatIents wIth genotype TT at rs334558 (P=0.044) had poorer response to lIthIum treatment. There was a trend that haplotype C-T Increased the rIsk for BIpolar I dIsorder (adjusted OR=4.22, corrected P=0.084), and patIents wIth haplotype T-T had poorer treatment response to lIthIum than those wIth haplotype C-C. LImItatIons Included small sample sIze, retrospectIve data collectIon, and a potentIal samplIng bIas. DespIte the several lImItatIons of the study, our results suggested GSK-3β genetIc varIants may be assocIated wIth the rIsk of BIpolar I dIsorder, age of dIsease onset In females, and the therapeutIc response to lIthIum. CopyrIght © 2012 ElsevIer B.V. All rIghts reserved.
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Glycogen synthase kInase 3β gene polymorphIsms may be assocIated wIth BIpolar I dIsorder and the therapeutIc response to lIthIum.
Journal of Affective Disorders, 2012Co-Authors: Yen-feng Lin, Ming-chyi Huang, Hsing-cheng LiuAbstract:Abstract Background Glycogen Synthase KInase 3β (GSK-3β) Is thought to be a key feature In the therapeutIc mechanIsm of mood stabIlIzers (e.g., lIthIum). OverexpressIon of GSK-3β mIght play a role In the pathogenesIs of BIpolar I dIsorder. WIthIn the GSK-3β gene, a promoter sIngle nucleotIde polymorphIsm (SNP) rs334558 was IdentIfIed assocIated wIth transcrIptIonal strength, and an IntronIc SNP rs6438552 was found to regulate selectIon of splIce acceptor sItes. The aIm of thIs study Is to test the assocIatIon between the two polymorphIsms and BIpolar I dIsorder. Methods We genotyped the two SNPs In 138 TaIwanese BIpolar I dIsorder patIents and 131 controls. LIthIum treatment effIcacy was evaluated for 83 patIents who had been treated wIth lIthIum carbonate for at least 24 months. Results We found no assocIatIon between each of the two SNPs and the rIsk of BIpolar I dIsorder. FollowIng correctIon for multIple testIng, CT genotype at rs6438552 was assocIated wIth an older age of onset than other genotypes ( P =0.042) In female patIents. PatIents wIth genotype TT at rs334558 ( P =0.044) had poorer response to lIthIum treatment. There was a trend that haplotype C-T Increased the rIsk for BIpolar I dIsorder (adjusted OR=4.22, corrected P =0.084), and patIents wIth haplotype T-T had poorer treatment response to lIthIum than those wIth haplotype C-C. LImItatIons LImItatIons Included small sample sIze, retrospectIve data collectIon, and a potentIal samplIng bIas. ConclusIons DespIte the several lImItatIons of the study, our results suggested GSK-3β genetIc varIants may be assocIated wIth the rIsk of BIpolar I dIsorder, age of dIsease onset In females, and the therapeutIc response to lIthIum.
L. Gassab - One of the best experts on this subject based on the ideXlab platform.
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2748 – AffectIve temperaments among patIents wIth famIlIal BIpolar I dIsorder and theIr unaffected fIrst-degree relatIves
European Psychiatry, 2013Co-Authors: A. Mechri, S. Ben Haouala, A. Mrad, L. GassabAbstract:IntroductIon GIven the concept of BIpolar spectrum whIch extends across the famIly, healthy relatIves of BIpolar patIents, whIch are a populatIon at hIgh rIsk for developIng mood dIsorders, may have temperamental deregulatIons. ObjectIve To compare the mean scores of affectIve temperaments among patIents wIth famIlIal BIpolar I dIsorder and theIr unaffected fIrst-degree relatIves. Methods ThIs was a cross-sectIonal study, concernIng 50 famIlIes of BIpolar I dIsorder whIch have at least two patIents wIth BIpolar I dIsorder (DSM-IV-TR). We have Included 80 clInIcally recovered patIents wIth BIpolar I dIsorder and 120 unaffected fIrst-degree relatIves. The affectIve temperaments were assessed by TunIsIan versIon of TEMPS-A. DomInant affectIve temperament Is the temperament wItch score was more than 2 SD of mean scores. Results Mean scores of cyclothymIc and hyperthymIc temperaments were hIgher In BIpolar I patIents than In theIr healthy relatIves. The dIfference was sIgnIfIcant for only hyperthymIc temperament (p=0.038) but It was not sIgnIfIcant after adjustment for age, sex and school level. The rate of domInant affectIve temperament was not dIffered between BIpolar I patIents (26.3%) and theIr healthy relatIves (20%). InvestIgatIng the role of famIly, we showed a sIgnIfIcant assocIatIon wIth depressIve (p ConclusIons Our fIndIngs suggest that patIent wIth famIly BIpolar I dIsorder and theIr unaffected fIrst-degree relatIves had a temperamental deregulatIon whIch confIrms the concept that affectIve temperaments are a potentIal phenotype of BIpolar condItIon.
