Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

Gomes, Fabiano A.; Almeida, Karla Mathias de; Magalhães, Pedro Vieira da Silva; Caetano, Sheila C.; Kauer-Sant’Anna, Márcia; Lafer, Beny; Kapczinski, Flávio

doi:10.1590/1516-4446-2011-0768

Cited by 35 publications

(30 citation statements)

References 43 publications

(45 reference statements)

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“…While there is consistent evidence showing the high prevalence of comorbid medical conditions in BD768, 769, 770, 771, 772, 773, 774 and the negative impact these diagnoses have on longevity,775, 776 these conditions frequently go undiagnosed or undertreated. In a large UK cross‐sectional analysis of electronic data sets involving 1.7 million patients in primary care, those diagnosed with BD, when compared with healthy controls, had lower rates of diagnoses (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.54‐0.63) and treatment of medical conditions, despite higher rates of one (OR 1.2, 95% CI 1.16‐1.39) or multiple illnesses (OR 1.44, 95% CI 1.3‐1.64) 769…”

Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

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Section: Specific Populationsmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

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“…25 Hence, it appears that this family carries simultaneously mild FH and some components of the MS, mainly carbohydrate dysregulation, expressed as abnormal fasting blood glucose levels and HOMA-IR indices. The MS is frequently observed in subjects with BD, [1][2][3][4] but the association between FH and BD has so far not been explored.…”

Section: Metabolic Profilementioning

confidence: 99%

“…A consistent finding is the high frequency of abnormal triglyceride and low HDL-c levels, as defined in the MS criteria. [1][2][3][4]7,8 As a matter of fact, this profile, along with abnormal WC and insulin levels, accounts for most of the metabolic differences observed between psychiatric and internal medicine patients. 26 Total and LDL-c levels are not formally included in the MS criteria and are often unreported, but they are among the strongest predictors of atherosclerosis and cardiovascular diseases.…”

Section: Metabolic Profilementioning

confidence: 99%

“…These include metabolic syndrome (MS), migraine, type 2 diabetes mellitus, thyroid disorders, chronic kidney disease, cancer, chronic pain, and obstructive airway disease, among many others. [1][2][3][4][5][6][7][8] Particular emphasis has been placed on characterizing the elevated frequency of MS among patients with BD 4,9 and the postulated role of psychotropic medication in its development and maintenance. 6,7,10,11 Even though a genetically-based predisposition to metabolic dysfunction in BD has been consistently suggested, 12 few studies have evaluated metabolic status in relatives of patients with BD.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Baptista¹,

Sandia²,

Fernández

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: Evidence points to a high prevalence of metabolic dysfunction in bipolar disorder (BD), but few studies have evaluated the relatives of subjects with BD. We conducted a cross-sectional study in an extended family of patients with BD type I. Methods: The available relatives of the same family were interviewed (DSM-IV-R) and assessed in fasting conditions for body mass index, constituent variables of the metabolic syndrome (MS), leptin levels, insulin resistance index, and single nucleotide polymorphisms (SNPs) for the leptin receptor and promoter and PPAR-c2 genes. The frequency of MS was compared with that recorded in the local general population. Results: Ninety-three relatives of three adults with BD were evaluated (30 aged , 18 years, 63 aged . 18 years). The frequency of MS was similar to that of the general population. Significantly higher frequencies of abnormal glucose, total and low density cholesterol (LDL-c) levels (all p , 0.05), waist circumference (p = 0.057), and leptin and insulin resistance values (in adults only) were observed in the family. Adults with the QQ genotype of the leptin receptor displayed higher LDL-c levels than carriers of the R allele. Conclusions: The associations among BD consanguinity, familial hypercholesterolemia, and leptin receptor SNPs reported herein should be replicated and extended in other pedigrees.

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“…Among these risk factors, rates of abdominal obesity are significantly higher in women than in men with bipolar disorder (Gomes et al, 2013).…”

Section: Downloaded By [Lakehead University] At 13:02 06 April 2015mentioning

confidence: 99%

Bipolar Disorder in Women

Miller

Ghadiali

LaRusso

et al. 2014

Health Care for Women International

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This article summarizes research pertinent to the clinical care of women with bipolar disorder. With bipolar disorder, female gender correlates with more depressive symptoms and different comorbidities. There is a high risk of symptom recurrence postpartum and possibly during perimenopause. Women with bipolar disorder have increased risk of sexually transmitted diseases, unplanned pregnancies, excessive weight gain, metabolic syndrome, and cardiovascular disease. Mood stabilizing medications, specific psychotherapies, and lifestyle changes can stabilize mood and improve functioning. Pharmacologic considerations include understanding interactions between mood stabilizing medications and contraceptive agents and risks and benefits of mood stabilizing medication during pregnancy and lactation.

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Cardiovascular risk factors in outpatients with bipolar disorder: a report from the Brazilian Research Network in Bipolar Disorder

Cited by 35 publications

References 43 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Bipolar Disorder in Women

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