How can we classify &amp;ldquo;mood stabilizers&amp;rdquo; with different properties?

Kondo, Tsuyoshi

doi:10.5234/cnpt.2.12

Cited by 2 publications

(2 citation statements)

References 63 publications

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“…First, antidepressants, especially as monotherapy, should be avoided in mixed depression since these drugs often worsen irritability, agitation and impulsivity, and increase risky behavior [16,18]. Second, instead of antidepressants, mood stabilizers possessing predominantly antimanic properties, such as valproate, carbamazepine and lithium, should be primarily used in depressive mixed state, especially in relapse prevention as opposed to acute-phase therapy, whereas monotherapy with a predominantly antidepressive mood stabilizers such as lamotrigine are not generally recommended [19,20]. Third, atypical antipsychotics, like olanzapine, quetiapine and aripiprazole, may be considered for the urgent stabilization of depressive mixed state, especially in acute-phase therapy [19][20][21].…”

Section: Therapeutic Considerations In Depressive Mixed Statementioning

confidence: 99%

Diagnostic and Therapeutic Considerations in Depressive Mixed State

Kondo

Shinzato

Koda

2016

CNPT

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Although the definition of depressive mixed state, more commonly known as mixed depression, is still controversial, about one-third of major depressive episodes are held to contain mixed components. The most frequent manifestations of mixed depression are irritability, distractibility and psychomotor agitation, although these symptoms are not included in the mixed features during a major depressive episode according to the DSM-5 criteria, which is therefore unlikely to cover the full scope of mixed depression in real-world settings. Mixed depression often accompanies risky behavior including impulsive suicide attempts. The early detection and treatment of these unstable conditions is therefore necessary. Also, sufficiently sensitive and specific screening methods for depressive mixed state are needed to avoid both under-and over-diagnosis. Antidepressants should be avoided since these drugs often worsen irritability, agitation and impulsivity, and increase risky behavior. Instead, combination therapy with mood stabilizer(s) to prevent the relapse of the depressive mixed state and atypical antipsychotics for rapid stabilization in the acute phase should be considered. Because there is very little evidence for effective pharmacotherapy in mixed depression, the efficacy of various mood-stabilizing agents, either as monotherapy or in combination therapies, should be extensively examined in the future using quantitative assessments of the psychopathology of mixed depression in patients with confirmed diagnoses of mixed depression.

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Section: Therapeutic Considerations In Depressive Mixed Statementioning

confidence: 99%

Diagnostic and Therapeutic Considerations in Depressive Mixed State

Kondo

Shinzato

Koda

2016

CNPT

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“…Some studies that aimed to determine which agents meet the definition of MS reported that only LIT fulfilled the above definition and some have arguably achieved it prematurely [ 27 , 28 ]. More recent studies have expanded the definition of MSs to include some AAPs [ 26 , 29 , 30 ]. The results from this study could be interpreted as supporting the latter contention.…”

Section: Discussionmentioning

confidence: 99%

Korean Medication Algorithm Project for Bipolar Disorder 2022, Fifth Revision: An Executive Summary

Woo¹,

Bahk²,

Jeong³

et al. 2022

Clin Psychopharmacol Neurosci

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Objective: We revised the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP), first published in 2002 and revised in 2006, 2010, 2014, and 2018, to reflect recent progress in the treatment of bipolar disorder. Methods: The questionnaires consisted of 56 items for adult patients and 7 items for child/adolescent patients, and were used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of bipolar disorder. The review committee included 87 Korean psychiatrists and 40 child and adolescent psychiatry experts. Results: For treatment of manic episodes, a combination of a mood stabilizer (MS) and atypical antipsychotics (AAP), or monotherapy with MS or AAP were recommended as first-line treatments. Combinations of MS and AAP, or AAP and lamotrigine (LMT) were recommended as first-line treatments for depressive episodes regardless of the severity. Monotherapy with MS, AAP, or LMT were also first-line treatments for mild to moderate depressive episodes. For mixed features, a combination of MS and AAP, or monotherapy with AAP or MS were recommended as first-line treatments, and a combination of AAP and LMT, or MS and LMT were the first-line treatments for depressive mixed state. Conclusion: The recommendations of the KMAP-BP 2022 have changed from the previous version, to reflect the evolution of the social culture and healthcare system in Korea and recent evidence regarding pharmacotherapy of bipolar disorder. The KMAP-BP 2022 provides clinicians with a wealth of information regarding appropriate strategies to treat patients with bipolar disorder.

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How can we classify “mood stabilizers” with different properties?

Cited by 2 publications

References 63 publications

Diagnostic and Therapeutic Considerations in Depressive Mixed State

Diagnostic and Therapeutic Considerations in Depressive Mixed State

Korean Medication Algorithm Project for Bipolar Disorder 2022, Fifth Revision: An Executive Summary

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