Indução de mania durante o tratamento com antidepressivos no transtorno bipolar

Tamada, Renata Sayuri; Lafer, Beny

doi:10.1590/s1516-44462003000300010

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Several neurobiological factors have been described associated with mood episode switches 28 and the propensity to mood switches in bipolar patients have been described subjected to individual differences. 29 The treatment emergent affective switch has been broadly described: antidepressants have been associated with an increased risk of inducing mania 30 , 31 and may increase maniac symptom severity 32 in bipolar patients. However, the literature is controversial, that is, in some clinical trials the number of maniac switches was similar between placebo and antidepressant groups.…”

Section: Discussionmentioning

confidence: 99%

Role of Pharmacogenetics in Improving the Safety of Psychiatric Care by Predicting the Potential Risks of Mania in CYP2D6 Poor Metabolizers Diagnosed With Bipolar Disorder

Sánchez-Iglesias

García-Solaesa²,

García‐Berrocal

et al. 2016

Medicine

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One of the main concerns in psychiatric care is safety related to drug management. Pharmacogenetics provides an important tool to assess causes that may have contributed the adverse events during psychiatric therapy. This study illustrates the potential of pharmacogenetics to identify those patients for which pharmacogenetic-guided therapy could be appropriate. It aimed to investigate CYP2D6 genotype in our psychiatric population to assess the value of introducing pharmacogenetics as a primary improvement for predicting side effects.A broad series of 224 psychiatric patients comprising psychotic disorders, depressive disturbances, bipolar disorders, and anxiety disorders was included. The patients were genotyped with the AmpliChip CYP450 Test to analyzing 33 allelic variants of the CYP2D6 gene.All bipolar patients with poor metabolizer status showed maniac switching when CYP2D6 substrates such as selective serotonin reuptake inhibitors were prescribed. No specific patterns were identified for adverse events for other disorders.We propose to utilize pharmacogenetic testing as an intervention to aid in the identification of patients who are at risk of developing affective switching in bipolar disorder treated with selective serotonin reuptake inhibitors, CYP2D6 substrates, and inhibitors.

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