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Bipolar Disorder (Mania)

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A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.

Also Known As:

Mania; Manias; Manic Depressive Psychosis; Depression, Bipolar; Bipolar Disorders; Manic State; Manic Disorders; Psychoses, Manic-Depressive; Bipolar Affective Psychosis; Bipolar Depression; Disorder, Bipolar; Disorder, Manic; Manic States; Manic-Depressive Psychoses; Psychoses, Bipolar Affective; Psychoses, Manic Depressive; Psychosis, Bipolar Affective; Psychosis, Manic Depressive; State, Manic; States, Manic; Affective Psychosis, Bipolar; Manic Disorder; Manic-Depressive Psychosis; Psychosis, Manic-Depressive

Networked: 5955 relevant articles (822 outcomes, 1312 trials/studies) for this Disease, Comments

Relationship Network

Disease Context: Research Results

Mental Disorders: 1866
- Mood Disorders: 4428
  - Psychotic Affective Disorders: 136
    - Bipolar Disorder: 5955
      - Cyclothymic Disorder: 10

Related Diseases

1.	Bipolar Disorder (Mania)
2.	Schizophrenia (Dementia Praecox)
3.	Depressive Disorder (Melancholia)
4.	Mood Disorders (Mood Disorder)
5.	Psychotic Disorders (Schizoaffective Disorder)

Experts

1.	Vieta, Eduard: 78 articles (02/2010 - 06/2002)
2.	Calabrese, Joseph R: 77 articles (12/2009 - 01/2002)
3.	Keck, Paul E: 65 articles (07/2009 - 01/2002)
4.	Suppes, Trisha: 51 articles (02/2010 - 01/2002)
5.	Bowden, Charles L: 50 articles (03/2010 - 01/2002)
6.	Ketter, Terence A: 48 articles (03/2010 - 01/2002)
7.	Kato, Tadafumi: 44 articles (03/2010 - 06/2002)
8.	Tohen, Mauricio: 44 articles (12/2009 - 01/2002)
9.	McElroy, Susan L: 42 articles (02/2010 - 01/2002)
10.	Yatham, Lakshmi N: 42 articles (01/2010 - 01/2002)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Bipolar Disorder:

1.	LithiumIBA 02/16/2006 - "The mood stabilizing drug lithium is a highly effective treatment for bipolar disorder. " 01/01/2005 - "Lithium is best described as the bench mark treatment for bipolar disorder, rather than the gold standard, because only a minority of patients show major clinical benefit. " 08/01/2002 - "Lithium is also highly effective in the treatment of bipolar disorder, however, the mechanism of lithium action in the treatment of this psychiatric disorder is still unknown. " 01/01/2000 - "RESULTS: Lithium is currently the gold standard and most appropriate initial treatment for the depressive phase of bipolar disorder. " 09/01/1998 - "The data analyzed give strong support for lithium's being most effective in bipolar disorder, with minimal or no therapeutic effects in other neuropsychiatric disorders. " Order ALL the reference details at left...
2.	Valproic Acid (Valproate, Semisodium)FDA LinkGeneric 01/01/2007 - "Guidelines for the treatment of type I bipolar disorder in children and adolescents, with or without psychotic features, recommend valproate, alone or in combination with an atypical antipsychotic, as a first-line treatment option; however, most randomised and open-label studies investigating valproate in paediatric populations have only evaluated a small number of participants. " 06/01/2003 - "Valproate appears at best modestly effective for bipolar depression. " 10/01/2000 - "BACKGROUND: Sodium valproate is a highly effective treatment for bipolar disorder, but its mechanism of action remains poorly understood. " 10/01/2000 - "Divalproex has proven efficacy in the treatment of bipolar disorder. " 01/01/2000 - "Valproate has proven effective in treating bipolar disorder. " Order ALL the reference details at left...
3.	Antipsychotic Agents (Antipsychotics)IBA 01/01/2005 - "The atypical antipsychotics, with their proven efficacy against manic symptoms, are emerging as candidates for use against the depressive phase of bipolar disorder. " 01/01/2005 - "Atypical antipsychotics appear to have broadly similar efficacy against manic symptoms of bipolar disorder, but there are important differences in their tolerability profiles, which are likely to be of particular relevance during long-term treatment. " 01/01/2007 - "With mania or mixed presentation atypical antipsychotics produced significantly better rates of response and symptomatic remission than placebo, with NNTs of about 5 up to six weeks, and 4 at 6-12 weeks, but more adverse event withdrawals (NNH of about 22) in studies of 6-12 weeks. " 01/01/2005 - "Subgroup analyses from trials treating manic phase bipolar disorder, and an open-label study of rapid cycling, have suggested that atypical antipsychotics may be useful for the treatment of mixed states and rapid cycling. " 02/01/2008 - "All atypical antipsychotics caused a significantly greater incidence of somnolence than placebo in mania and depression, with NNTHs from 5 to 8 for mania and 2 to 6 for depression. " Order ALL the reference details at left...
4.	lamotrigine (Lamictal)FDA LinkGeneric 10/01/2002 - "Lamotrigine has undergone a remarkable series of systematic studies since 1994 that now establish it as an efficacious, well-tolerated treatment in bipolar disorder. " 05/01/2006 - "RESULTS: The base-case model for patients with a recent manic episode indicated that lamotrigine is the most effective treatment for avoiding both acute depression episodes and all types of acute episodes (depression and mania). " 01/01/2004 - "Lamotrigine is the most widely studied and is effective in treating and preventing bipolar depression, and it is the only anticonvulsant approved by the U.S. " 05/01/2000 - "Lamotrigine has the most evidence in favor of its efficacy, with two double-blind studies in which it was more efficacious than placebo in the treatment of bipolar depression. " 04/01/2003 - "BACKGROUND: Lamotrigine has been shown to be an effective treatment for bipolar depression and rapid cycling in placebo-controlled clinical trials. " Order ALL the reference details at left...
5.	Carbamazepine (Tegretol)FDA LinkGeneric 03/01/2005 - "CONCLUSION: Extended-release carbamazepine monotherapy had significantly greater efficacy compared with placebo in the treatment of acute mania in this large, randomized, double-blind, placebo-controlled trial." 01/01/2005 - "At study end, reductions from baseline in Young Mania Rating Scale scores were significantly greater with carbamazepine than with placebo (primary endpoint). " 04/01/1993 - "Although controlled trials have demonstrated the efficacy of carbamazepine for the treatment of rapid cycling bipolar disorder, the response to carbamazepine frequently deteriorates. " 02/01/2010 - "CONCLUSIONS: Carbamazepine is effective in treating symptoms of both mania and depression, and there are no significant differences in the relative efficacy of the IR or ERCC formulations." 01/01/2006 - "OBJECTIVES: Recently, two large, 3-week, randomised, double-blind, placebo-controlled trials using nearly identical protocols demonstrated that monotherapy with carbamazepine extended-release capsules (CBZ-ERC) was effective for the treatment of acute mania in patients with bipolar I disorder. " Order ALL the reference details at left...
6.	olanzapine (Zyprexa)FDA Link 05/01/2006 - "Olanzapine is most effective for avoiding acute mania episodes. " 11/01/2004 - "Olanzapine monotherapy significantly improved depressive symptoms compared with placebo in patients with bipolar disorder in an 8-week randomized, controlled clinical study, but the magnitude of the clinical effect was small. " 10/01/2007 - "RESULTS: The mean baseline-to-endpoint change in the Young Mania Rating Scale total score was significantly greater for patients receiving olanzapine relative to patients receiving placebo, and a greater proportion of olanzapine-treated patients met response and remission criteria (44.8% versus 18.5% and 35.2% versus 11.1%, respectively). " 09/01/2004 - "The olanzapine treatment group had significantly greater mean improvement of mania ratings and a significantly greater proportion of patients achieving protocol-defined remission. " 09/01/2004 - "RESULTS: Olanzapine-treated patients experienced modest but significant improvement in PANSS-Cognitive score (olanzapine: -4.25 n = 124; placebo: -1.69 n = 120, p < 01), regardless of age, gender, mania subtype (pure, mixed), course (rapid or non-rapid cycling), or the presence or absence of psychotic features. " Order ALL the reference details at left...
7.	Risperidone (Risperdal Consta)FDA LinkGeneric 02/01/2008 - "Although both hyperactive/impulsive (-7.5 +/- 5.5.6, p < 0.05) and inattentive (-6.8 +/- 5.0, p < 0.05) ADHD symptoms were significantly improved with risperidone, improvement was modest, and only 29% of subjects (N = 6) showed a 30% reduction in ADHD rating scale scores and had a CGI-I </= 2. CONCLUSIONS: These results suggest that that treatment with risperidone is associated with tangible but generally modest improvement of symptoms of ADHD in children with bipolar disorder." 01/01/2005 - "At week 3, mean Young Mania Rating Scale (YMRS) score reductions from baseline were significantly greater in patients receiving risperidone than placebo (p<0.001). " 06/01/2004 - "Improvement in mean Young Mania Rating Scale total score (adjusted for covariates) was significantly greater in the risperidone than in the placebo group at endpoint (mean change=-10.6 [SD=9.5] versus -4.8 [SD=9.5], respectively), with significant between-group differences seen as early as 3 days after start of treatment (change with risperidone: mean=-6.8 [SD=5.8]; change with placebo: mean=-4.0 [SD=5.8]) and continuing throughout all time points. " 05/01/2004 - "At double-blind endpoint, mean reductions in Young Mania Rating Scale (YMRS) scores were significantly greater in patients receiving risperidone plus mood stabilizer than in those receiving placebo plus mood stabilizer (-14.3 vs. -8.2, p <.001). " 02/01/2003 - "RESULTS: Young Mania Rating Scale (YMRS) scores improved rapidly with significantly greater reductions at week 1 in the risperidone group compared with the placebo group. " Order ALL the reference details at left...
8.	quetiapine (Seroquel)FDA Link 01/01/2007 - "RESULTS: Quetiapine as monotherapy, or in combination with Li or DVP, was a highly effective treatment for acute mania, as shown by overall change scores in the total YMRS. " 01/01/2007 - "CONCLUSIONS: Quetiapine was associated with significantly higher response and remission/euthymia rates compared with placebo with most criteria used, in patients with acute mania at the end of both 3 and 12 weeks." 12/01/2008 - "CONCLUSIONS: Quetiapine monotherapy is effective in improving impairment in important aspects of life that accompany improvements in depressive symptoms in patients with acute bipolar depression." 11/01/2009 - "The results of these data demonstrated quetiapine's efficacy in the treatment of depressive phases of bipolar disorder, including statistically significant improvement in the Montgomery-Asberg Depression Rating Scale (MADRS). " 01/01/2007 - "CONCLUSIONS: At Days 21 and 42, quetiapine combined with Li/DVP compared to Li/DVP monotherapy yielded significant, sustained improvements in the rate of clinical remission/euthymia in patients with bipolar mania. " Order ALL the reference details at left...
9.	Antidepressive Agents (Antidepressants)IBA 01/01/2008 - "Most of the standard randomized controlled trials report the efficacy of antidepressants in the acute phase of BPD, but the data also indicate higher switch rates to mania and acceleration of mood cycle with their use. " 10/01/2001 - "RESULTS: Thirty-five (37%) of the 95 acute treatment phases were associated with a much or very much improved rating in depression on the CGI-BP. Thirteen (14%) of these 95 acute trials of antidepressants as adjuncts to mood stabilizers were associated with switches, seven into hypomania and six into mania. " 02/01/1999 - "Currently available antidepressants may increase the risk of mania and rapid cycling, and mood stabilizers appear to be less effective in treating depression than mania. " 03/01/1992 - "Antidepressant drugs are effective in the acute treatment and prevention of depression only, and can even precipitate hypomanic or manic "switches," or "rapid cycling" between mania and depression. " 03/01/2007 - "Although more work is needed to establish the safety and efficacy of second-generation antidepressants in treating bipolar depression, the evidence from this study supports a favorable risk-benefit profile." Order ALL the reference details at left...
10.	Anticonvulsants (Antiepileptic Drugs)IBA 01/01/2003 - "However, the efficacy of antiepileptic drugs investigated in the treatment of bipolar disorder differs and most promising effects are seen in combination therapy with mood stabilizers. " 01/01/2005 - "Anticonvulsants and other mood stabilizers may be especially helpful in treating bipolar disorder with significant comorbidity." 01/01/2006 - "Other new antiepileptic drugs may also be effective in bipolar disorder but more solid evidence of their efficacy is needed." 01/01/2006 - "Data on the efficacy of old and new antiepileptic drugs in bipolar disorder obtained in controlled clinical trials are reviewed. " 09/01/2005 - "Randomized, double-blind, controlled data on the psychotropic efficacy of antiepileptic drugs are limited mainly to bipolar disorder." Order ALL the reference details at left...

Therapies and Procedures

1.	Drug Therapy (Chemotherapy) 10/01/2009 - "CONCLUSION: High-frequency supra-threshold right prefrontal rTMS in bipolar, mania patients was well tolerated and found to be effective as add-on to standard pharmacotherapy." 05/01/2008 - "Evidence suggests that adjunctive psychosocial interventions in bipolar disorder are clinically beneficial and cost effective when used in conjunction with pharmacotherapy. " 12/01/2009 - "Although pharmacotherapy is the mainstay of treatment for bipolar disorder, the combination of evidence-based psychological interventions and drug treatment enhances overall effectiveness, mostly by further protecting patients from relapse/recurrence. " 11/01/2008 - "OBJECTIVE: Psychotherapy has long been recommended as adjunctive to pharmacotherapy for bipolar disorder, but it is unclear which interventions are effective for which patients, over what intervals, and for what domains of outcome. " 12/01/2005 - "Although pharmacotherapy is the mainstay of treatment strategies for bipolar disorder, research over the last 5 years suggests that combining psychologic interventions with drug treatment increases overall effectiveness, mostly by further protecting from relapse or recurrence. " Order ALL the reference details at left...
2.	Therapeutics 08/01/2008 - "OBJECTIVE: The therapeutics for bipolar disorders are still far from adequate, and new options with improved effectiveness, safety, and tolerability in a wide range of patients are necessary. " 01/01/2002 - "Molecular and cellular mechanisms underlying mood stabilization in bipolar disorder: implications for the development of improved therapeutics." 08/01/2008 - "The present results strongly support the involvement of the purinergic system in the pathophysiology and therapeutics of bipolar disorder. " 05/01/2008 - "Creating novel therapeutics for bipolar disorder is urgently needed. " 01/01/2008 - "Basic scientific advances in understanding the neuropsychobiology of bipolar disorder have given us a multitude of opportunities to explore and exploit new avenues of therapeutics. " Order ALL the reference details at left...
3.	Phototherapy (Light Therapy) 01/01/2008 - ""Dark Therapy", in which complete darkness is used as a mood stabilizer in bipolar disorder, roughly the converse of light therapy for depression, has support in several preliminary studies. " 12/01/2007 - "OBJECTIVES: To perform a dose-ranging safety and efficacy study of bright light therapy for depression in women with bipolar disorder (BD). " 12/01/2007 - "Light therapy for bipolar disorder: a case series in women." 02/01/2001 - "CONCLUSIONS: Natural sunlight can be an underestimated and uncontrolled light therapy for bipolar depression. " 05/01/1995 - "Seven adolescents or young adults (aged 16 to 22 years) who met DSM-III-R criteria for bipolar disorder were treated for persistent depressive symptoms (greater than three weeks) with adjunctive light therapy (10,000 lux given twice per day). " Order ALL the reference details at left...
4.	Aftercare (After-Treatment) 01/01/2002 - "This study assessed whether therapist adherence to the family focused treatment model for patients with bipolar disorder and their relatives was associated with patient outcomes at one year after treatment entry. " 01/30/2010 - "To evaluate the clinical symptoms, we used the Young Mania Rating Scale at baseline and 6 weeks after treatment. " 06/01/2008 - "After treatment, the patients were evaluated using the Clinical Global Impression (CGI) scale and the Young Mania Rating Scale (YMRS) and genotyped for their DTNBP1 variants (rs3213207 A/G, rs1011313 C/T, rs2005976 G/A, rs760761 C/T and rs2619522 A/C). " 04/01/2007 - "Employee costs before and after treatment initiation for bipolar disorder." 05/01/2004 - "Symptom severity and functioning were evaluated before and after treatment using the severity scales of the Clinical Global Impression Scales for Bipolar Disorder (CGI-BP) and the Children's Global Assessment Scale (CGAS) respectively. " Order ALL the reference details at left...
5.	Injections 01/01/2008 - "DISCUSSION: This observational long-term study provides support to long-acting injectable risperidone being effective for the maintenance treatment of mania and improving treatment adherence, reducing relapses and re-hospitalization rates." 12/01/2009 - "OBJECTIVE: No large controlled trials have evaluated adjunctive maintenance treatment with long-acting injectable antipsychotics in patients with bipolar disorder. " 01/01/1989 - "In an open clinical multi-centre trial carried out in five Danish psychiatric departments, patients suffering from acute psychosis including mania or exacerbation of chronic psychosis were given injections of 5% zuclopenthixol acetate in 'Viscoleo'. " 06/01/2009 - "This article will provide a succinct review of the latest data on the use of long-acting injectable risperidone (LAR) during the maintenance-phase treatment of bipolar disorder. " 08/15/2007 - "Usefulness of long-acting injectable risperidone during 12-month maintenance therapy of bipolar disorder." Order ALL the reference details at left...

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