DSM-5 mixed specifier for manic episodes: Evaluating the effect of depressive features on severity and treatment outcome using asenapine clinical trial data

McIntyre, Roger S.; Tohen, Mauricio; Berk, Michael; Zhao, Jun; Weiller, Emmanuelle

doi:10.1016/j.jad.2013.04.025

Cited by 54 publications

(61 citation statements)

References 15 publications

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“…Asenapine acted as a partial 5-HT 1A and 5-HT 1B receptor agonist, which enhanced 5-HT neurotransmission. Together, these results provide further insight in the long-term effects of asenapine administration on therapeutically relevant targets, and could contribute to a better understanding of the neural mechanisms by which asenapine improves negative symptoms in schizophrenia (Buchanan et al, 2012) and exerts greater alleviation of depressive scores in bipolar patients with mixed features (McIntyre et al, 2013).…”

Section: Effect Of Asenapine On the 5-ht Systemmentioning

confidence: 79%

Asenapine alters the activity of monoaminergic systems following its subacute and long-term administration: An in vivo electrophysiological characterization

Oosterhof

Mansari

Blier

2015

European Neuropsychopharmacology

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Section: Effect Of Asenapine On the 5-ht Systemmentioning

confidence: 79%

Asenapine alters the activity of monoaminergic systems following its subacute and long-term administration: An in vivo electrophysiological characterization

Oosterhof

Mansari

Blier

2015

European Neuropsychopharmacology

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“…[13][14][15][16][17] Three studies assessed the efficacy of treatment of manic/hypomanic episodes with mixed features with 2 post-hoc analyses assessing olanzapine and asenapine for mania with mixed features and 1 RCT assessing adjunctive quetiapine for hypomania with mixed features. [18][19][20] Treatment of mania with mixed features…”

Section: Search Resultsmentioning

confidence: 99%

“…18,19 Both studies were post-hoc analyses identifying subjects with mania with mixed features retrospectively. McIntyre et al 18 conducted a post-hoc analysis using data from 2 identically designed 3-week, randomized, double-blind, flexible dose, placebo-and olanzapine referenced clinical trials (NCT00159744; NCT00159796) in patients with bipolar I disorder (BD-I).…”

Section: Search Resultsmentioning

confidence: 99%

“…18,19 One small RCT suggested that adjunctive quetiapine for hypomania with mixed features improved symptoms of depression; however, it did not have a significant improvement in symptoms of hypomania compared to the placebo group. 20 For bipolar depression with mixed features, post-hoc analyses suggested antidepressant efficacy of olanzapine, OFC, and lurasidone compared to placebo.…”

Section: Resultsmentioning

confidence: 99%

“…[9][10][11][12] Given the relative recency of this new nosological entity (May 2013), only a limited number of studies has directly examined the efficacy of treatments for mood states with DSM-5-defined mixed features. [13][14][15][16][17][18][19][20][21][22] Further, to date, only the Florida Medicaid Guidelines have specifically addressed the treatment of mixed features. 23 At the current time, inadequate evidence exists to adequately inform evidencebased treatment guidelines for mixed features in BD, as randomized controlled trials (RCTs) assessing the efficacy of various treatments specifically for BD mood episodes with mixed features have yet to be conducted.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of mixed features in bipolar disorder

Rosenblat

McIntyre

2016

CNS Spectr.

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Mood episodes with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-defined mixed features are highly prevalent in bipolar disorder (BD), affecting~40% of patients during the course of illness. Mixed states are associated with poorer clinical outcomes, greater treatment resistance, higher rates of comorbidity, more frequent mood episodes, and increased rates of suicide. The objectives of the current review are to identify, summarize, and synthesize studies assessing the efficacy of treatments specifically for BD I and II mood episodes (ie, including manic, hypomanic, and major depressive episodes) with DSM-5-defined mixed features. Two randomized controlled trials (RCTs) and 6 post-hoc analyses were identified, all of which assessed the efficacy of second-generation antipsychotics (SGAs) for the acute treatment of BD mood episodes with mixed features. Results from these studies provide preliminary support for SGAs as efficacious treatments for both mania with mixed features and bipolar depression with mixed features. However, there are inadequate data to definitively support or refute the clinical use of specific agents. Conventional mood stabilizing agents (eg, lithium and divalproex) have yet to have been adequately studied in DSM-5-defined mixed features. Further study is required to assess the efficacy, safety, and tolerability of treatments specifically for BD mood episodes with mixed features.

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Reliability and validity of clinically useful depression outcome scale identifying mixed features in patients with manic episode

Fei

Huang

et al. 2021

Brain and Behavior

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Objectives: This study aims to explore the reliability, validity, and feasibility of Clinically Useful Depression Outcome Scale (CUDOS) in screening mixed features in patients diagnosed with mania. Methods: A total of 109 patients with (hypo-) manic episode were recruited. The reliability of Chinese version of CUDOS (CUDOS-C) were analyzed with Cronbach's alpha and intraclass correlation coefficient (ICC). Spearman correlation coefficient was used to analyze the validity by comparing the correlation between CUDOS-C and Patient Health Questionnaire-9 (PHQ-9), 32-item Hypomania Checklist (HCL-32). The score of MINI (hypo-) manic episode with mixed features-DSM-5 Module-Chinese version(MINI-M-C) ≥ 2 was considered as the gold standard of mixed features, and the receiver operating characteristic (ROC) curve analysis was used to calculate the optimal cut-off values of CUDOS-C score.Results: The Cronbach's alpha value of CUDOS-C was 0.898, and the ICC of CUDOS-C test-retest was 0.880 (95% CI: 0.812-0.923, p < .05).The CUDOS-C score was significantly correlated with PHQ-9 score (r = 0.893, p = .000), but not with HCL-32 score(r = 0.088, p = .364).The area under ROC curve was 0.909 (95% CI: 0.855 to 0.963, p < .001) for CUDOS-C identifying mixed features in mania. The optimal cut-off value was 11 with a sensitivity of 0.854 and a specificity of 0.868. The CUDOS-C (score ≥ 12) identified 40.4% of the patients with mixed features, which was higher than those diagnosed by clinicians (18.3%) and screened using MINI-M-C (37.6%).This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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DSM-5 mixed specifier for manic episodes: Evaluating the effect of depressive features on severity and treatment outcome using asenapine clinical trial data

Cited by 54 publications

References 15 publications

Asenapine alters the activity of monoaminergic systems following its subacute and long-term administration: An in vivo electrophysiological characterization

Asenapine alters the activity of monoaminergic systems following its subacute and long-term administration: An in vivo electrophysiological characterization

Treatment of mixed features in bipolar disorder

Reliability and validity of clinically useful depression outcome scale identifying mixed features in patients with manic episode

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