Citalopram for Acute and Preventive Efficacy in Bipolar Depression (CAPE-BD)

Ghaemi, S. Nassir; Whitham, Elizabeth A.; Vöhringer, Paul A.; Barroilhet, Sergio; Amerio, Andrea; Sverdlov, Oleksandr; Patkar, Ashwin A.

doi:10.4088/jcp.19m13136

Cited by 19 publications

(7 citation statements)

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“…These authors also reported that there was no significant difference between antidepressant and mood stabilizer monotherapy in the prevention of new depressive episodes. On the other hand, Ghaemi et al 148 demonstrated that addition of citalopram to mood stabilizers did not have any clinically meaningful benefit for the maintenance treatment of bipolar depression. When these results and reproductive safety of antidepressants are considered, 65,149–151 we recommend that antidepressants (sertraline or venlafaxine during pregnancy and lactation) may be a pharmacological option in patients with predominantly depressive bipolar II disorder.…”

Section: Pharmacological Options In the Prevention Of New Mood Episodesmentioning

confidence: 99%

Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period

Uguz,

Sharma,

Boyce

et al. 2023

J Clin Psychopharmacol

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Many women with bipolar disorder experience episodes of illness or relapses over the perinatal period, especially in the immediate postpartum period. Risks associated with treated/untreated psychopathologies and fetal exposure to bipolar medications make the management of bipolar disorder during these periods challenging for clinicians and patients. In light of the available effectiveness and reproductive safety data, the current clinical update based on the opinions of a group of international perinatal psychiatry authors recommends general considerations and specific management strategies for each possible clinical scenario, including mixed features, predominant polarity, diagnosis of subtypes of bipolar disorder, severity of previous episodes, and risk of recurrence of mood episodes.

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Section: Pharmacological Options In the Prevention Of New Mood Episodesmentioning

confidence: 99%

Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period

Uguz,

Sharma,

Boyce

et al. 2023

J Clin Psychopharmacol

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“…8 Of our included studies including both RC and non-RC participants (irrespective of treatments), 4 reported a worse response in rapid cyclers, 9 identified non-significant differences between RC and non-RC participants, and 1 study found a better response in RC patients (to lithium and venlafaxine). The treatments/outcomes in the studies that reported a poorer outcome in RCBD versus non-rapid cycling subgroups were: 1) in mania following olanzapine and divalproex, 46 2) manic symptoms after citalopram, 55 3) depression after both olanzapine (with and without fluoxetine) and placebo 25 and 4) mania after both quetiapine and placebo. 26 Another study found a significant benefit of quetiapine over placebo for non-RC but not RC participants, although it is not clear whether this indicates a reduced response to quetiapine or increased placebo response in participants with RCBD.…”

Section: Rapid Cycling Versus Non-rapid Cycling; Differences In Treat...mentioning

confidence: 99%

A systematic review and meta‐analysis of treatments for rapid cycling bipolar disorder

Strawbridge

Kurana

Kerr-Gaffney

et al. 2022

Acta Psychiatr Scand

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Objectives: Rapid cycling is a common and disabling phenomenon in individuals with bipolar disorders. In the absence of a recent literature examination, this systematic review and meta-analysis aimed to synthesise the evidence of efficacy, acceptability and tolerability of treatments for individuals with rapid cycling bipolar disorder (RCBD).Method: A systematic search was conducted to identify randomised controlled trials assigning participants with RCBD to pharmacological and/or non-pharmacological interventions. Study inclusion and data extraction were undertaken by two reviewers independently. The primary outcome was continuous within-subject RCBD illness severity before and after treatment. Pre-post random effects meta-analyses were conducted for each outcome/intervention arm studied, generating a standardised effect size (hedge's g) and 95% confidence interval (CI). Results: A total of 34 articles describing 30 studies were included. A total of 16 separate pharmacological treatments were examined in contrast to 1 psychological therapy study. Only quetiapine and lamotrigine were assessed in >5 studies. By assessing 95% CI overlap of within-subject efficacy effects compared to placebo, the only interventions suggesting significant depression benefits (placebo g = 0.60) were olanzapine (with/without fluoxetine; g = 1.01), citalopram (g = 1.10) and venlafaxine (g = 2.48). For mania, benefits were indicated for quetiapine (g = 1.01), olanzapine (g = 1.19) and aripiprazole (g = 1.09), versus placebo (g = 0.33). Most of these effect sizes were from only one trial per treatment. Heterogeneity between studies was variable, and 20% were rated to have a high risk of bias.Conclusions: While many interventions appeared efficacious, there was a lack of robust evidence for most treatments. Given the limited and heterogeneous Rebecca Strawbridge and Suman Kurana jointly contributed as first author.

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“…Considering the risk of conversion to mania episodes, the use of antidepressants to treat patients with BD is cautioned. Ghaemi et al ( 70 ) indicated that, in adult patients with BD in an acute depression phase, the combination of mood stabilizers and citalopram did not affect treatment efficiency or exacerbate mania during acute mania episodes but that the addition of citalopram to rapid-cycling patients with BD exacerbated mania symptoms. Henry et al discussed risk factors leading BD conversion to hypomnia or mania including age, gender, diagnosis (type I or II), previous mania onset times, and therapy methods (electroconvulsive therapy vs. antidepressants such as selective serotonin reuptake inhibitors, types of mood stabilizer like lithium vs. anticonvulsants) and found that the total conversion rate to hypomania and mania was 27%.…”

Section: Medicationmentioning

confidence: 99%

Research Status in Clinical Practice Regarding Pediatric and Adolescent Bipolar Disorders

et al. 2022

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Bipolar disorders (BDs) have high morbidity. The first onset of 27.7% of BDs occurs in children under 13 years and of 37.6% occurs in adolescents between 13 and 18 years. However, not all of the pediatric and adolescent patients with BD receive therapy in time. Therefore, studies about pediatric and adolescent patients with disorders have aroused increased attention in the scientific community. Pediatric and adolescent patients with BD present with a high prevalence rate (0.9–3.9%), and the pathogenic factors are mostly due to genetics and the environment; however, the pathological mechanisms remain unclear. Pediatric and adolescent patients with BD manifest differently from adults with BDs and the use of scales can be helpful for diagnosis and treatment evaluation. Pediatric and adolescent patients with BDs have been confirmed to have a high comorbidity rate with many other kinds of disorders. Both medication and psychological therapies have been shown to be safe and efficient methods for the treatment of BD. This review summarizes the research status related to the epidemiology, pathogenic factors, clinical manifestations, comorbidities, diagnostic and treatment scales, medications, and psychological therapies associated with BDs.

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Citalopram for Acute and Preventive Efficacy in Bipolar Depression (CAPE-BD)

Cited by 19 publications

References 0 publications

Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period

Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period

A systematic review and meta‐analysis of treatments for rapid cycling bipolar disorder

Research Status in Clinical Practice Regarding Pediatric and Adolescent Bipolar Disorders

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