Mania From Dose-Related Ziprasidone Augmentation of an SSRI

Privitera, Michael R.; Maharaj, Kumar

doi:10.4088/jcp.v64n1116d

Cited by 11 publications

(6 citation statements)

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“…BP-II patients could be at the highest risk [44]. The concomitant use of an antimanic agent (SGA or anticonvulsant) may protect against switching or mixed symptoms, but this does not always happen [355,405]. On the contrary, in patients who are more prone to experience depressive episodes, the continuation treatment with antidepressants might be beneficial [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

117

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Section: Discussionmentioning

confidence: 99%

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Fountoulakis

Kasper

Andreassen

et al. 2012

Eur Arch Psychiatry Clin Neurosci

117

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“…Bipolar II patients could be at the highest risk . The concomitant use of an antimanic agent (atypical antipsychotic or anticonvulsant) may protect against switching or mixed symptoms, but this does not always happen Privitera and Maharaj, 2003). However, on the contrary, in patients more prone to experience depressive episodes the continuation of treatment with antidepressants might be beneficial (Altshuler et al, , 2003.…”

Section: Discussionmentioning

confidence: 99%

Treatment of bipolar disorder: a systematic review of available data and clinical perspectives

Fountoulakis¹,

Vieta²

2008

Int. J. Neuropsychopharm.

153

105

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This paper is a systematic review of the available data concerning the treatment of bipolar disorder: a systematic Medline search concerning treatment guidelines and clinical trials. The search for treatment guidelines returned 583 articles and 913 papers for RCTs. The search was last performed on 1 March 2008. An additional search included repositories of clinical trials and previous systematic reviews in order to trace especially older trials. The literature suggests that lithium is useful during the acute manic and the maintenance phase. Both first- and second-generation antipsychotics are efficacious in the treatment of acute mania. Quetiapine and the olanzapine-fluoxetine combination are also effective for treating bipolar depression, while olanzapine, quetiapine and aripiprazole are effective during the maintenance phase. Anticonvulsants, particularly valproate and carbamazepine have antimanic properties, whereas lamotrigine may be preferably effective in the treatment of depression but not mania. Antidepressants should always be used in combination with an antimanic agent because they were reported to induce switching to mania or hypomania, mixed episodes, and rapid cycling when given as monotherapy. The best evidence-based psychosocial interventions for bipolar disorder are group- and family-focused psychoeducation. Electroconvulsive therapy is an option for refractory patients. Although a variety of treatment options for bipolar disorder is currently available, their effectiveness is far from satisfactory, especially against bipolar depression and maintenance. Combination therapy may improve treatment outcome but it also carries the burden of more side-effects. Further research as well as the development of better guidelines and algorithms for step-by-step rational treatment are necessary.

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“…Therefore, in patients treated with lumateperone, especially those with bipolar depression episodes, the emergence of symptoms such as insomnia and agitation warrants a careful reevaluation of its use in this cohort. The induction of elevated mood symptoms could be attributed to the modulation of neurotransmitters associated with lumateperone, particularly its high affinity for 5-HT2A or the elevated 5-HT2A/D2 ratio ( Lu et al, 2002 ; Privitera and Maharaj, 2003 ; Khalil and Baddoura, 2012 ). Additionally, the concurrent use of other medications, age at first episode, and family history are also contributing factors to the induction of mania or hypomania ( Ramasubbu, 2001 ; Amsterdam et al, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

Post-marketing safety concerns with lumateperone: a pharmacovigilance analysis based on the FDA adverse event reporting system (FAERS) database

Zhao,

Zhang,

Liu

et al. 2024

Front. Pharmacol.

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ObjectiveLumateperone, a novel antipsychotic drug that was granted by the Food and Drug Administration (FDA) approval in December 2019, remains insufficiently explored for its adverse event profile. This study used the FDA Adverse Event Reporting System (FAERS) database to explore its potential safety issues.MethodsThis study conducted a retrospective analysis of FAERS data from the fourth quarter of 2019 to the third quarter of 2023, extracting reports related to lumateperone. Disproportionality analysis using Reporting Odds Ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) algorithms was employed to detect signals of adverse events (AEs).ResultsOur research processed 4,777 pertinent AE disclosures related to lumateperone, unveiling 125 signals that satisfied both ROR and BCPNN evaluative benchmarks across 26 System Organ Classes (SOCs). Intriguingly, 108 of these signals were categorized as unanticipated, spotlighting notable psychiatric manifestations such as mania (ROR = 73.82, 95% CI = 57.09–95.46; IC = 6.16, IC025 = 4.49), and hypomania (ROR = 34.74, 95% CI = 15.54–77.64; IC = 5.10, IC025 = 3.43), alongside non-psychiatric phenomena like urinary retention (ROR = 3.59, 95% CI = 1.80–7.19; IC = 1.84, IC025 = 0.18) and serotonin syndrome (ROR = 8.69, 95% CI = 4.81–15.72; IC = 3.11, IC025 = 1.45).ConclusionThis research provides real-world safety data on lumateperone post-marketing and is an important supplement to the information from clinical trial studies. Healthcare professionals should be vigilant for the risk of a manic switch in patients with bipolar depression who are administered lumateperone. More epidemiological studies are needed in the future to explore and further evaluate the risk-benefit issue of lumateperone.

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Mania From Dose-Related Ziprasidone Augmentation of an SSRI

Cited by 11 publications

References 0 publications

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry

Treatment of bipolar disorder: a systematic review of available data and clinical perspectives

Post-marketing safety concerns with lumateperone: a pharmacovigilance analysis based on the FDA adverse event reporting system (FAERS) database

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