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Journal, HEOR: Comparative effectiveness of mood stabilizers and antipsychotics in the prevention of hospitalization after lithium discontinuation in bipolar disorder. (Pubmed Central) - Aug 18, 2022
Of antipsychotic monotherapies, the use of long-acting injectable (LAI) antipsychotics (HR = 0.48, 95% CI = 0.26 - 0.88) and chlorprothixene (HR = 0.62, 95% CI = 0.44 - 0.88) were associated with lower risk and the use of quetiapine (HR = 1.26, 95% CI = 1.07 - 1.48) and oral olanzapine (HR = 1.23, 95% CI = 1.01 - 1.49) with higher risk of psychiatric hospitalizations than nonuse of antipsychotics...The results suggest that antipsychotic LAIs are especially effective in the prevention of psychiatric hospitalizations after lithium discontinuation. The need to alter used medications may be the lowest when lithium is restarted.
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Journal: Symptomatic versus disease-modifying effects of psychiatric drugs. (Pubmed Central) - Aug 17, 2022
Current psychopharmacology is limited mostly to symptomatic effects, not transformative treatments for the diseases underlying those symptoms. A change in approach is needed in psychopharmacology practice and research, focusing on long-term disease modification rather than short-term symptom improvement.
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Management Of Diabetes Insipidus Following Cardiac Surgery And Considerations For Perioperative Lithium Use (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_2519;
Initial management included 1:1 fluid replacement of urine output in addition to maintenance fluids and DDAVP...On POD 3, the episode of diabetes insipidus resolved. This case demonstrates the importance of evaluating the risks and benefits of lithium therapy perioperatively in a patient refractory to other treatment, and the difficulty in treating diabetes insipidus following a major, high-risk surgery.
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Differentiating Etomidate Induced Myoclonus From Seizure In A Patient Scheduled For Electroconvulsive Therapy (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_984;
Resolution was achieved with a total of 6 mg Ativan given intravenously...Follow-up EEG was negative for epileptiform activity suggesting against seizure. This case highlights the difficulty in distinguishing clinical signs and symptoms of etomidate induced myoclonus and seizure activity in patients undergoing ECT.
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Journal: Dose-dependent toxicity profile and genotoxicity mechanism of lithium carbonate. (Pubmed Central) - Aug 14, 2022
The frequency of these changes also increased depending on the LiCO dose. As a result, LiCO, which is one of the lithium compounds, and has become an important contaminant in the environment with increasing technological developments, caused a combined and versatile toxicity in Allium cepa L. meristematic cells, especially by causing deterioration in antioxidant/oxidant dynamics.
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Review, Journal: The impact of lithium on circadian rhythms and implications for bipolar disorder pharmacotherapy. (Pubmed Central) - Aug 11, 2022
However, much of this evidence is limited by cross-sectional analyses and/or imprecise proxy markers of clinical outcomes and circadian rhythms in BD patients, while mechanistic studies rely on inference from animals or small numbers of patient samples. Further study may clarify the essential mechanisms underlying lithium responsive BD, better characterize the longitudinal changes in circadian rhythms in BD patients and inform the development of therapeutic interventions targeting circadian rhythms.
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Journal: Lumateperone (Caplyta) for bipolar depression. (Pubmed Central) - Aug 11, 2022
Further study may clarify the essential mechanisms underlying lithium responsive BD, better characterize the longitudinal changes in circadian rhythms in BD patients and inform the development of therapeutic interventions targeting circadian rhythms. No abstract available
- |||||||||| Journal: Decreasing the Symptoms of Essential Tremor With Medical Painting Therapy. (Pubmed Central) - Aug 10, 2022
Conclusion The patient reported an increased quality of life (including emotional aspects) and a decrease in her ET, as evidenced by the patient's handwriting. Further research is needed to understand the strengths and limitations of this therapy for ET and related conditions.
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STATE OF THE ART SYMPOSIUM: PSYCHIATRIC AND SOMATIC MULTIMORBIDITY: RISING TO THE GLOBAL CHALLENGE (BHIRAJ HALL 1 - LIVE STREAMED) - Aug 9, 2022 - Abstract #WPA2022WPA_695;
In this symposium, we present three studies relevant to this theme, which between them (i) document the adverse physical health outcomes and poorer access to healthcare for people with severe mental illness, (ii) describe pharmacological interventions for tackling increased metabolic risks associated with antipsychotic use in this population, and (iii) review approaches to study multimorbidity. The symposium showcases a range of methods to study and address mental-physical multimorbidity, which will help to address the unacceptable gap in health and life expectancy for people with mental illness.
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LITHIUM USE IN BIPOLAR DISORDERS (AMBER 2-3 - LIVE STREAMED) - Aug 9, 2022 - Abstract #WPA2022WPA_508;
It is equaly efficacious in rapid and non-rapid cycling patients, in concomitant obsessive-compulsive symptoms, alcohol and substance abuse, the neurocognitive deficit, suicidal ideation and fatigue The current systematic review provided support for the usefulness of lithium against a broad spectrum of clinical issues in Bipolar disorder. Its efficacy is comparable to that of more recently developed agents
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Journal: Case Reports: Exposure to SARS-CoV-2, Acute Kidney Injury, and Lithium Toxicity. (Pubmed Central) - Aug 3, 2022
Exposure to SARS-CoV-2 or symptoms suggestive of COVID-19 should result in increased clinical monitoring of individuals taking lithium. Those taking lithium and providers are advised to have a low clinical threshold for requesting lithium levels and kidney function estimates for the duration of the COVD-19 pandemic.
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Retrospective data, Review: Lamotrigine and Lithium Combination for Treatment of Rapid Cycling Bipolar Disorder: Results From Meta-Analysis. (Pubmed Central) - Aug 3, 2022
We searched MEDLINE, EMBASE, Cochrane Library in English and CBM, CNKI, WANFANG, and CSSCI in Chinese to find literature from 1 January 2000 to 31 December 2020 related to the combination of lithium carbonate and lamotrigine for treatment of RCBD...The response rate of lamotrigine and lithium combination was significantly higher compare to that of monotherapy of lithium in patients with no treatment resistant (82 vs. 54%; OR = 4.26; 95% CI: 1.65~10.99; Z = 3.99, P 0.05, I = 0%). The combination of lithium and lamotrigine resulted in better improvement of psychotic symptoms and higher response rate in patients with RCBP with no treatment resistant.
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Polygenic Score Identifies Bipolar Patients Ultra-Responsive to Lithium Treatment (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_528;
Compared to bipolar patients in the 1st decile of the risk distribution, individuals in the 10th decile of the Li+PGS distribution have ~3.47(95%CI: 2.22-5.47) fold favourable response to lithium treatment. Li+PGS achieved a good prediction accuracy with an area under the receiver operating characteristic curve (AUC) of 0.62(0.56 - 0.68) in classifying bipolar patients as responders and non-responders to lithium treatment.
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Telomere Length in Major Depressive Disorder and Response to Non-Pharmacological Interventions (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_482;
In the second study, the difference in LTL between before and four weeks after psychotherapy (delta LTL: ((t2-t0)/t0)*100) was significantly larger in responders than in non-responders (model corrected for age, p=0.007; effect of treatment, p=0.054), an effect that appeared to be mediated by the presence of psychotic symptoms at baseline. Indeed, patients without psychotic symptoms in the responder group had significantly larger delta LTL compared to responders with psychotic symptoms and to non-responders (response*psychotic symptoms, p=0.002).
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Polygenic Predictors of Treatment Outcome Following Lithium Augmentation in Major Depression (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_368;
Polygenic scores for TRD (HR=0.97, 95% CI [0.75, 1.24], p=0.80) and MDD (HR=0.85, 95% CI [0.68, 1.07], p=0.17) did not significantly predict lithium response. Our preliminary results suggest that individuals with treatment-resistant MDD who carry a higher polygenic burden for SCZ and BIP are more likely to respond to lithium augmentation and that lithium treatment outcomes in MDD might be influenced by similar genetic factors as response to lithium in bipolar disorder.
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Epigenetic Markers in Peripheral Blood and Lithium Response in Patients With Bipolar Disorders (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_306;
Our results show DNA methylation differences in peripheral blood between Ex-Rp and non-Rp BD patients pointing to the importance of considering epigenetic markers when studying LR. These results should be further studied for a better understanding of LR and ultimately move towards a more effective and personalized treatment.
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Complement Factor C4 and Phenotypes in Bipolar Disorder (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_265;
Estimated C4A-expression was not associated with either affective psychosis, non-affective psychosis, or self-reported psychosis in the combined sample. However, secondary analysis revealed a positive association between affective psychosis in BDI, which survived Bonferroni correction (OR 1.503, 95% CI 1.166-1.938, p-value 0.0017).
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Cell Type Deconvolution of Bulk Blood RNA-Seq to Reveal Biological Insights of Psychiatric Disease (Spadolini Pavilion Hall A) - Jul 31, 2022 - Abstract #WCPG2022WCPG_185;
Furthermore, we ran separate eQTL analyses per cell type, finding 5,122 significant (FDR < 0.05) eGenes across all cell types, 1,210 of which are not found within the significant bulk eGenes. We use FUSION to assess the association of these eQTLs with loci for psychiatric phenotypes and find that using cell type specific expression gains an additional 573 gene associations with psychiatric phenotypes over bulk expression.
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Familial Traits and Subtypes of Bipolar Disorder: A Systematic Review and Meta-Analysis (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_54;
After assessing eligibility, 16 studies were included in this review. These studies indicated 11 potential subtypes of BD defined by: rapid cycling (OR = 4.95), age of onset (OR = 4.50), polarity at onset (OR = 1.17), psychotic features (OR = 2.68), mood-incongruent psychosis (OR = 2.52), suicide attempt (OR =1.04), panic disorder (OR = 2.69), alcoholism (OR = 1.53), puerperal psychosis (OR = 6.54), lithium treatment response (OR = 3.71), and bipolar type I versus type II (OR = 2.05).
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Improving Lithium Dose Prediction Using Population Pharmacokinetics and Pharmacogenomics (Spadolini Pavilion Main Floor) - Jul 31, 2022 - Abstract #WCPG2022WCPG_53;
Age, sex, eGFR, comedication with diuretics, and agents acting on the renin–aldosterone– angiotensin system were clinical predictors of CLLi. Notably, an association between CLLi and serum lithium was observed, with a lower CLLi being associated with higher serum lithium.
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Clinical, Journal: Pharmacologic Treatment and Management of Bipolar Disorder in Adolescents. (Pubmed Central) - Jul 31, 2022
Among the antipsychotics, quetiapine appeared to be minimally better than risperidone while risperidone was associated with greater adverse events...Use of antidepressants in bipolar depression is generally not recommended although it may be reasonable in specific clinical situations. The similarities between adolescent and adult outcomes suggest that it is reasonable to utilize adult data to aid with clinical decision making in adolescents with BD, especially when pediatric-specific data are unavailable.
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Review, Journal: WHAT AN ENDOCRINOLOGIST SHOULD KNOW FOR PATIENTS RECEIVING LITHIUM THERAPY. (Pubmed Central) - Jul 28, 2022
In conclusion, clinical assessment (goiter, diuresis) and biological monitoring of serum calcium, sodium creatinine, TSH and lithium are recommended in patients receiving Lithium therapy. The risk of Lithium discontinuation in case of side effects should be weighed against the psychological risk, and must be discussed with the psychiatrist.
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Can we improve cognition in schizophrenia and bipolar disorder? A practice orientated guide (Hall F2 [IN-PERSON, ONLINE]) - Jul 23, 2022 - Abstract #ECNP2022ECNP_134;
Even lithium, which is the gold standard medication for bipolar disorders, may have protective effects on cognitive functions.As well as information related to the nature and consequences of cognitive deficits, this session will cover putative pro-cognitive therapies for these illnesses, spanning pharmacological and non-pharmacological modalities. Across our illness domains of focus, these include cognitive remediation therapy, functional remediation, lurasidone, vortioxetine and more…. We consider when, as well as how, cognitive enhancement therapies should be implemented and the potential benefits of early cognitive intervention for people with psychotic and bipolar disorders.
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E07 – COG…..IGNITION! Can we jumpstart cognition in schizophrenia and bipolar disorder? (Hall F2 [IN-PERSON, ONLINE]) - Jul 23, 2022 - Abstract #ECNP2022ECNP_128;
Across our illness domains of focus, these include cognitive remediation therapy, functional remediation, lurasidone, vortioxetine and more….We consider when, as well as how, cognitive enhancement therapies should be implemented and the potential benefits of early cognitive intervention for people with psychotic and bipolar disorders.> The Educational Update Session is 80 minutes long: after an Introduction by the moderator (5 minutes), each of the 2 speakers has 30 minutes to present, followed by 5 minutes of Q&A. The last 5 minutes are for the final remarks.
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Bidirectional associations between COVID-19 and psychiatric disorders (Hall E1 [IN-PERSON, ONLINE]) - Jul 23, 2022 - Abstract #ECNP2022ECNP_55;
Phenytoin use was associated with a lower risk of brain fog after COVID-19 infection. I will highlight the key strengths and limitations of the data, and will also include Result s from an ongoing analysis exploring 2-year outcomes after COVID-19 and how they relate to the emergence of delta and omicron variants.
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Putative mechanisms of impaired neurocognition in schizophrenia and bipolar disorder (Hall F2 [IN-PERSON, ONLINE]) - Jul 23, 2022 - Abstract #ECNP2022ECNP_23;
Across our illness domains of focus, these include cognitive remediation therapy, functional remediation, lurasidone, vortioxetine and more…. We consider when, as well as how, cognitive enhancement therapies should be implemented and the potential benefits of early cognitive intervention for people with psychotic and bipolar disorders.
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Review, Journal: Lithium response in bipolar disorder: Genetics, Genomics, and beyond. (Pubmed Central) - Jul 23, 2022
GWAS based on larger sample sizes and non-European ancestries are likely to shed light on the genomic architecture of this trait. Furthermore, induced pluripotent stem cells, transcriptomics, epigenetics, the integration of multiple omics data, and their combination with advanced machine learning techniques hold promise for the understanding of the complex biological underpinnings of lithium treatment response.
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