Tag Archives: Divalproex

Management of Bipolar Disorder

Antipsychotics are frequently used in the treatment of bipolar disorder. Most patients started on antipsychotics as adjunctive treatment for manic episodes continue these agents beyond 6 months, even in the absence of conclusive data on the long-term efficacy of most antipsychotics in maintenance treatment. Typical antipsychotics are effective antimanic agents but appear less effective than… Read More »

Bipolar Depression: Treatment Acute Pharmacotherapy

Lithium For many years, lithium was considered to be the standard treatment for bipolar depression. Improvement rates of 80% have been reported in nine placebo-controlled studies, conducted mostly in the 1970s. Response rates for lithium were equivalent to those for tricyclic antidepressants (tricyclic antidepressants). A recent study of outpatients with bipolar depression compared the efficacy… Read More »

Bipolar Depression: Antidepressants

Tricyclic Antidepressants Literature is sparse on controlled studies of tricyclic antidepressants for bipolar depression. Tricyclic antidepressants are more effective in the treatment of unipolar depression than in bipolar depression. The risk of switching patients from bipolar depression to mania and of shortening cycle lengths makes tricyclic antidepressants unattractive choices for the treatment of bipolar depression.… Read More »

Treatment of Anxiety in the Medically Ill

Psychotherapy An overemphasis on psychopharmacology in the care of medically ill patients may result in overlooking the value of psychotherapy. The first step in the treatment of anxiety is to spend time listening to and talking with the patient. Just as in psychotherapy with any patient, empathic listening is a powerful tool to relieve distress.… Read More »

Information about Bipolar Disorder for Patients and Families

Bipolar disorder, also called manic-depressive disorder, is a recurrent illness in which the individual’s mood cycles between depression and mania with periods of normality. The illness is a mood disorder. The individual’s moods may swing from manic euphoria, with boundless energy in pursuit of grandiose plans, to depths of depression, with feelings of despair and… Read More »

Information about Alzheimer’s Disease for Patients and Families

Alzheimer’s disease is the most common and well-known form of degenerative dementia. By definition, dementia is a syndrome, a cluster of symptoms, of impaired memory and cognition. Dementia is a cognitive disorder that impairs an individual’s memory and ability for reasoning, awareness, and judgment. Cognitive impairment in Alzheimer’s disease may involve disturbance of language (aphasia),… Read More »

Drug Treatment Of Mania: Assessing the Evidence

To prove that a drug is efficacious in a psychiatric condition, it is essential to show that it is superior to placebo, by conducting randomized double-blind placebo-controlled trials. The challenges of conducting such trials in mania have only been met in recent years, in the course of developing novel anticonvulsant and atypical antipsychotic treatments. These… Read More »

Adjunctive Pharmacotherapy and Related Issues

Managing antipsychotic side effects. Antipsychotic drugs produce problematic side effects in many individuals (see Table Side Effects of Typical Antipsychotic Drugs). A major category of side effects results from neurotransmitter dysregulation of the extra-pyramidal motor system. It is thought that these side effects are the result of an imbalance of dopaminergic and acetylcholinergic activity in… Read More »

Use Of Atypical Antipsychotics In Aggressive Behavior

Maladaptive aggression accompanies different forms of psychopathology Affective disorders (depression, bipolar disorders), PPD, mental retardation, psychosis, PTSD, ADHD, and others can produce maladaptive aggression. The Treatment Recommendations for the use of Antipsychotics for Aggressive Youth (TRAAY) developed by the Center for the Advancement of Children’s Mental Heath and the New York State Office of Mental… Read More »

Clinical Use of Antipsychotic Medications: Medication Monitoring

Vinks and Walsons (2003) indications for therapeutic drug monitoring are listed in TABLE Factors to Attend to in Medication Monitoring. TABLE Factors to Attend to in Medication Monitoring Inadequate response Higher than standard dose required Serious and persistent side effects Suspected toxicity Suspected noncompliance Suspected drug-drug interactions New preparations, changing brands Emerging illnesses Presence of… Read More »