Early improvement of psychotic symptoms with lithium monotherapy as a predictor of later response in mania
Carregando...
Citações na Scopus
10
Tipo de produção
article
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
PERGAMON-ELSEVIER SCIENCE LTD
Autores
BUSNELLO, Joao V.
ZARATE JR., Carlos A.
Citação
JOURNAL OF PSYCHIATRIC RESEARCH, v.46, n.12, p.1564-1568, 2012
Resumo
Although lithium has been the first line agent in the treatment of bipolar disorder (BD), few studies have evaluated lithium's efficacy in mania with psychosis and its association with later response. Furthermore, given the widespread concern about antipsychotic side effects, answering a question about whether lithium alone can manage to treat both psychotic and non-psychotic mania seems a very relevant one. The present study addresses the antipsychotic efficacy of lithium monotherapy in acute mania and early improvement of psychotic symptoms as a predictor of later response of manic symptoms. Forty-six patients presenting a manic episode (32 with psychotic features and 14 subjects without psychotic features) were treated for 4 weeks with lithium monotherapy and evaluated weekly using the Young Mania Rating Scale (YMRS). Subjects with rapid cycling, substance abuse/dependence, or mixed episodes were excluded. The overall antimanic efficacy of lithium in psychosis vs. non-psychosis groups was evaluated. In addition, early improvement of psychotic symptoms and its prediction of subsequent response (>50% decrease in total YMRS scores) or remission were evaluated. Lithium showed a similar efficacy in both psychosis and non-psychosis mania. Early improvement of psychotic symptoms was associated with clinical response and remission at endpoint.
Palavras-chave
Psychosis, Mania, Lithium, Early improvement, Monotherapy
Referências
- Bora E, 2010, J AFFECT DISORDERS, V127, P1, DOI 10.1016/j.jad.2010.02.117
- Bowden CL, 2005, J CLIN PSYCHIAT, V66, P111
- Coryell W, 2001, J AFFECT DISORDERS, V67, P79, DOI 10.1016/S0165-0327(99)00024-5
- First M.B., 2001, STRUCTURED CLIN INTE
- Goodwin GM, 2009, J PSYCHOPHARMACOL, V23, P346, DOI 10.1177/0269881109102919
- Grandjean EM, 2009, CNS DRUGS, V23, P225, DOI 10.2165/00023210-200923030-00004
- Houston John P, 2010, BMC Res Notes, V3, P276, DOI 10.1186/1756-0500-3-276
- Keck PE, 2009, J AFFECT DISORDERS, V112, P36, DOI 10.1016/j.jad.2008.05.014
- Keck PE, 2003, COMPR PSYCHIAT, V44, P263, DOI 10.1016/S0010-440X(03)00089-0
- Kemp DE, 2011, J CLIN PSYCHIAT, V72, P1236, DOI 10.4088/JCP.09m05874yel
- Kemp DE, 2011, J AFFECT DISORDERS, V130, P171, DOI 10.1016/j.jad.2010.10.026
- Ketter TA, 2010, J PSYCHIATR RES, V44, P8, DOI 10.1016/j.jpsychires.2009.07.006
- Kinon BJ, 2008, SCHIZOPHR RES, V102, P230, DOI 10.1016/j.schres.2008.02.021
- Machado-Vieira R, 2008, J CLIN PSYCHIAT, V69, P1237
- Malhi GS, 2009, ACTA PSYCHIAT SCAND, V119, P27, DOI 10.1111/j.1600-0447.2009.01383.x
- McElroy SL, 1996, J CLIN PSYCHIAT, V57, P14
- POPE HG, 1978, ARCH GEN PSYCHIAT, V35, P811
- PRIEN RF, 1972, ARCH GEN PSYCHIAT, V26, P146
- SMALL JG, 1995, PSYCHOPHARMACOL BULL, V31, P265
- Swann AC, 2002, NEUROPSYCHOPHARMACOL, V26, P530, DOI 10.1016/S0893-133X(01)00390-6
- Swann AC, 2004, J CLIN PSYCHIAT, V65, P825
- Szegedi A, 2009, J CLIN PSYCHIAT, V70, P344
- TOHEN M, 1990, ARCH GEN PSYCHIAT, V47, P1106
- Yatham LN, 2009, BIPOLAR DISORD, V11, P225, DOI 10.1111/j.1399-5618.2009.00672.x
- YOUNG RC, 1978, BRIT J PSYCHIAT, V133, P429, DOI 10.1192/bjp.133.5.429