A Systematic Review of the Efficacy and Metabolic Profile of Lurasidone in the Treatment of Depression in Bipolar Disorder MSc in Psychiatry 2015 Dissertation by Giles Osborne BA BSc MA(Oxon) Department of Psychiatry, Cardiff Medical School, Cardiff, CF14 4XN Main Body Word Count 18,885 May 2015 DECLARATION / STATEMENTS PAGE DECLARATION This work has not previously been accepted in substance for any degree and is not concurrently submitted in candidature for any degree. Signed----------------------------- (G R Osborne) Date---------------------------------------- STATEMENT 1 This thesis is being submitted in partial fulfilment of the requirements for the degree of MSc (Psychiatry) Signed---------------------------- (G R …show more content…
Signed--------------------------- (G R Osborne) Date----------------------------------- ACKNOWLEDGEMENTS I would like to thank Mr Jon Ford BSc MSc and Dr Chris Lee MBBS PhD for the proofreading of this paper. I would particularly like to thank Dr Chris Lee for inspiring me to undertake this MSc. Dedicated to Obi, even though he may not have the cognitive construct of self. ABBREVIATIONS ADL: Activities of Daily Living AE: Adverse Event ANCOVA: Analysis of Covariance ANOVA: Analysis of Variance BDNF: Brain Derived Neurotrophic Factor BMI: Body Mass Index BPD: Bipolar Disorder CGI-BP: Clinical Global Impressions Scale CGI-BP-C: Clinical Global Impressions Scale - Bipolar-Change Scale CGI-BP-S: Clinical Global Impressions Scale - Bipolar-Severity Scale CI: Confidence Interval CVD: Cardiovascular Disease DB: Database df: Degrees of Freedom DSM IV/ 5: Diagnostic and Statistical Manual of Mental Disorders versions 4 or 5 EMA: European Medicines Agency EPSE: Extrapyramidal Side Effects EU: European Union FPG: Fasting Plasma Glucose FDA: Food and Drug Administration FDC: Fixed Dose Combination GLP: Good Laboratory Practice HAM-D: Hamilton Depression Rating Scale HR: Hazard Ratio ICD 10: International Classification of Diseases 10th Revision ICH-GCP: International Conference on Harmonisation Good Clinical Practices IFG: Impaired Fasting Glucose
Not taking medicine at all or taking the wrong medication will increase mood swings, lower the performance in school, work, and other activities, effect one’s social life. Medicines usually include mood stabilizer such as risperidone, anticonvulsant like lamictal. Some patients who is diagnosed with bipolar II may need antidepressant. The patient has to give the medicine time to work it may take four to six weeks. Along with medication, the patient needs psychotherapy. Therapy is constant help and support for the patients, which may help influence and help cope as well.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has a number of features. First of all, every disorder is identified using a name and a numerical code. In addition, the manual provides the criteria for diagnosing each disorder as well as establishes subtypes of a disorder and examples that would illustrate the disorder. The manual goes further by addressing the typical age of onset, culturally related information, gender-related information, prevalence of a disorder, typical clinical course of a disorder, typical predisposing factors of a disorder and genetic family patterns of a disease (Summers, 2009). The DSM-IV is a tool that is used by mental health practitioners and social service workers. As has been demonstrated
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), “the essential feature of
According to Lindamer et al. (2012), individuals with schizophrenia had 3 times the odds of being categorized as a high utilizer. Bipolar disorder and other psychotic disorders increased the odds of being a high utilizer by 90% (Lindamer et al., 2012). Being White, younger, female, homeless, and having Medicaid insurance also increased the odds for being a high utilizer in this sample. Similarly, Pasic et al. (2005) noted that high utilizers were more likely to be homeless, have developmental delays, have a history of voluntary and involuntary hospitalizations, have personality disorders, unreliable social support and a history of incarceration and detoxification.
Jann States that sufferers of BPD are three times more likely to suffer a depressive episode than a manic or hypomanic episode. (Jann, 2014) The Joanna Briggs institute Identified that the suicide rate for bipolar suffers are 15 times higher than that of non-affected individuals of the same age and sex. Eighty percent of these suicides occur during a depressive episode. (Hung Chu, 2016). Therefore appropriate pharmacological therapy not only during the maintenance period to reduce reoccurrence but also during these acute episodes is highly important. Pharmaceutical treatment includes the use of medication such as mood stabilizers, anti-psychotics and anti-depressants. The Joanna Briggs institute recommends that combination therapy involving both mood stabilizers such as Sodium valproate or lithium valproate and antipsychotics risperidone, olanzapine, quetiapine and haloperidol is best to treat acute mania associated with Bipolar. As it increases adherence to medication regime. (Tufanaru, 2016) The same institute encourages the use Olanzapine as a monotherapy or in combination with fluoxetine in the treatment of Depression associated with Bipolar disorder. (Hung chu, 2016) Lithium continues to be the first line mood stabilizer under current guidelines but may be used in conjunction with Carbamazepine where depression is evident. (Hung chu, 2016) The Australian and New Zealand Journal of Psychiatry 2015 also shows preference for combination therapy
Losing control of a person's emotions on a daily basis is devastating his or her mind. This disorder people go through is called bipolar. Bipolar disorder can be characterized as the inability to regulate emotions extreme happiness and sadness, also known as mania and depression. Bipolar disorder patients brains have impairments in the frontal cortex, limbic system and the amygdala. These parts of the brain focus on how a person reacts to situations and the biological effects to the body. People can get this disorder any times of their life, but most first episode can be seen in children and adolescents . Mania and depression are affected by different parts of the brain with different symptoms. There are few common symptoms that are similar
“Psychiatry.” Issues & Controversies, 08 Aug. 2008. FACTS.com. Facts on File News Services. NEMCC Lib., Booneville, MS. 29 Sept. 2008 <http://www2.nemcc.edu/library/
I declare that this assignment is my own work and has not been submitted in any form for another unit, degree or diploma at any university or other institute of tertiary education. Information derived from the published or unpublished work of others has been
Within the works of author Thomas Wheaton, who wants to remain discrete, defines Dipolar Disorder (BP) in his informative article Bipolar Disorder: The Agony and the Ecstasy as a psychiatric disorder categorized by periods of gushing euphoria and draining depression; affecting more than 5.7 million Americans over the age of 18. Furthermore, BP is illustrated as an overall condition which is subcategorized into three distinct categories defined by the DSM (Diagnostic and Statistical Manual) as Bipolar 1; exhibiting signs of mania, Bipolar 2; alternating mood swings by intensity and Cyclothymic disorder; milder but frequent mood swings, BP 1 being the worst. In addition to arbitrary mood swings BP also requires a multidisciplinary treatment which
DSM-IV TR, which stands for Diagnostic and Statistical Manual of Mental Disorders (4th edition), Text Revision was published by the American Psychiatric Association in 2000 and serves as a guide book for many health professionals to diagnose a patient with a mental disorder. It also helps health professionals to determine what types of treatment could be carried out to help the patient. The latest DSM is widely used, especially in the USA and many European countries.1However, it may not be completely followed by health professionals as they know that there are some weaknesses of the latest version of DSM as well. This essay will discuss the strengths and
This research was supported by The Encyclopedia of Health, Psychological Disorders and Their Treatment. New, NY: Patrick Young; 1991.
Another study that was conducted on the treatment of bipolar disorder was “Metabonomic analysis identifies molecular changes associated with the pathophysiology and drug treatment of bipolar disorder”. The point of this study was to observe a spectroscopy-based metabonomic analysis in order to identify molecular changes in the post-mortem brain tissue of patients who have died from bipolar effective disorder (Lan, 2008, p.1). This is the first conducted study to observe post-mortem bipolar human brain tissue and is the first to compare the changes in a diseased brain with the changes that occur in rat brain after a mood stabilizer treatment. This study was conducted in laboratories in order to observe the whole process. There was seventy-eight