Neuroendocrine and stress pathways in bipolar disorders

Juruena, Mário F.; Cleare, Anthony J.; Young, Allan H.

doi:10.1016/b978-0-12-821398-8.00018-7

Cited by 1 publication

(1 citation statement)

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“…Such a situation was also reported in the nocturnal salivary cortisol level, in which a disturbance in the usual reduction of nocturnal cortisol was seen among patients with symptomatic bipolar disorder(Mukherjee et al., 2022 ). Based on the available evidence, HPA axis disturbance as the primary stress hormone system is also associated with resistance to treatment, increased relapse rates, worse outcomes, and the development of cognitive defects in patients with bipolar disorder (Juruena et al., 2022 ). Also, the use of glucocorticoid medication with an indirect effect on the HPA axis is associated with the occurrence of psychiatric symptoms such as mania (Alheira & Brasil, 2005 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar‐I disorder: A double‐blind, randomized, placebo‐controlled clinical trial

Zandifar,

Badrfam,

Gholamian

et al. 2023

Brain and Behavior

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IntroductionTreatment of mood and cognitive symptoms of patients with bipolar disorder is associated with many complications and is generally not associated with therapeutic satisfaction. In this clinical trial, we evaluated the effectiveness of spironolactone in controlling mood and cognitive symptoms, sleep quality, appetite, and body mass index in patients with bipolar disorder in manic episodes.MethodsSixty inpatients with bipolar disorder in manic episodes were treated with spironolactone/placebo in an 8‐week randomized, double‐blind, placebo‐controlled clinical trial. They were evaluated using the Young Mania Rating Scale (YMRS), mini‐mental state examination (MMSE), Pittsburgh sleep quality index, Simplified Nutritional Appetite Questionnaire, and body mass index in weeks 1, 4, and 8.ResultsFor cognitive impairment (MMSE), there were significant interaction effects of group and time at week 8 (B = −1.60, SE = 0.69, t = −2.33, p = .021) such that individuals in the spironolactone group experienced more improvement in their cognitive performance. For manic symptoms (YMRS), there were no significant interaction effects of group and time at week 8 (B = −2.53, SE = 1.46, t = −1.73, p = .085).ConclusionsConsidering the promising findings in this clinical trial, further study of spironolactone as adjunctive therapy in bipolar disorder in manic episodes with larger sample sizes, multicenter settings, and longer follow‐ups are recommended.

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Section: Discussionmentioning

confidence: 99%