- |||||||||| duloxetine / Generic mfg.
[VIRTUAL] Apnea every 5 minutes () - May 17, 2021 - Abstract #SLEEP2021SLEEP_1079;
She was on bupropion, duloxetine, lithium carbonate, lamotrigine, olanzapine, and levothyroxine...There was no improvement in her EDS, and Armodafinil was prescribed for wake promotion...The decision to do so depends on perceived benefit and harm of continuing VNS therapy. This case highlights the importance of re-evaluation of causes and treatment strategies when the standard of care is ineffective.
- |||||||||| lithium carbonate ER / Generic mfg., lurasidone / Generic mfg.
[VIRTUAL] A Case of Parasomnia Overlap Disorder in a Patient on Lithium () - May 17, 2021 - Abstract #SLEEP2021SLEEP_1074;
His other medications included propranolol 40mg BID, lithium 900mg/1200mg, oxcarbazepine 600mg bid, lamictal 225mg bid, lurasidone 80mg qday, and benztropine 2mg bid...His workup and treatment is still ongoing, but he has continued on clonazepam 2mg but taken 2 hours earlier, and has started a new APAP. Because of the severity of his bipolar disorder (including severe suicidal ideation), he is not a candidate to tapering the lithium or to taking serotonergic antidepressants.
- |||||||||| lithium carbonate ER / Generic mfg.
Biomarker, Journal: Peripheral biomarkers of mitochondrial dysfunction in adolescents with bipolar disorder. (Pubmed Central) - May 15, 2021
These preliminary results indicate that elevated lactate is observed even among adolescents early in their course of BD, that the association between lactate and ccf-mtDNA appears to be specific to BD, and that ccf-mtDNA is potentially associated with depression symptoms in adolescent BD. In addition, the effect of psychotropic medications used in the treatment of BD on peripheral lactate and ccf-mtDNA requires further investigation.
- |||||||||| lithium carbonate ER / Generic mfg.
Journal: Can atypical dysgeusia in depression be related to a deafferentation syndrome? (Pubmed Central) - May 15, 2021
The patient received vitamin B12 supplementation and was treated with clomipramine, lithium, mirtazapine, modafinil, and olanzapine...This could have been increased by depression. Dysgeusia in elederly patients with depression should be extensively investigated in order to elucidate somatic contributing factors but it may not resolve until improvement of the depressive symptoms.
- |||||||||| lithium carbonate ER / Generic mfg.
Journal: Why is lithium effective in alleviating bipolar disorder? (Pubmed Central) - May 15, 2021
In addition, lithium also inhibits K channel activation, leading to the elongation of refractory period, resulting in the inhibition of neuronal excitability. Therefore, in depressive mood, lithium can increase neuronal activity via the inhibition of neuronal GSK3beta activity, and in manic mood, lithium can inhibit neuronal excitability via inhibiting K channel activation, therefore the amplitude of the mood swing is decreased, i.e. alleviating the depressive state and the manic state, resulting in the normalization of the mood swing.
- |||||||||| Journal: Graves' disease inducing a massive cardiac tamponade. (Pubmed Central) - May 15, 2021
An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.
- |||||||||| lithium carbonate ER / Generic mfg.
Review, Journal: Extracorporeal renal replacement therapies in lithium intoxication (Pubmed Central) - May 11, 2021
Preliminary data with prolonged intermittent renal replacement (PIRRT) therapies - hybrid forms of renal replacement therapy (RRT) such as sustained low efficiency dialysis (SLED) - seem to justify their role as potential alternative to conventional IHD. Indeed, SLED allows rapid and effective lithium removal with resolution of symptoms, also minimizing rebound phenomenon.
- |||||||||| lithium carbonate ER / Generic mfg.
Clinical, Journal: The Relationship Between Food Craving, Appetite-Related Hormones and Clinical Parameters in Bipolar Disorder. (Pubmed Central) - May 4, 2021
Individuals with BD taking olanzapine and quetiapine reported higher frequencies of craving for sweet food, while patients currently taking lithium reported less total FC compared to those without lithium therapy...Contrary to previous data, this does not seem to be a female phenomenon only and might encompass more than the specific craving for carbohydrates. Although due to the cross sectional design, causality cannot be determined, the association between depressive symptomatology and fast food craving warrants further research.
- |||||||||| Abilify MyCite (aripiprazole tablets embedded with sensor) / Otsuka
[VIRTUAL] Inpatient Psychiatric Hospitalization Rates in Adults With Schizophrenia: A Phase 3b Open-Label Study of a Digital Medicine System () - May 2, 2021 - Abstract #APA2021APA_1401;
Ensuring medication adherence is a major challenge in patients with schizophrenia.1 The digital medicine system (DMS), comprised of aripiprazole tablets embedded with an ingestible event-marker sensor, wearable sensor patches, and a smartphone application, is indicated for the treatment of adults with schizophrenia or bipolar disorder I (with or without lithium or valproate), and as adjunct treatment for adults with major depressive disorder.2 Patients can track their treatment ingestion data via a smartphone application, while investigators, clinicians, and caregivers can track these data using separate Web-based dashboards...We conclude that, compared with oral SOC therapy, the DMS may reduce inpatient psychiatric hospitalization rates among adults with schizophrenia. By giving providers objective ingestion data to inform timely and appropriate treatment decisions, the DMS may reduce healthcare utilization among patients with schizophrenia.
- |||||||||| lithium carbonate ER / Generic mfg., risperidone / Generic mfg.
[VIRTUAL] Late-Onset Bipolar Disorder Linked to Kratom Use: A Case Report () - May 2, 2021 - Abstract #APA2021APA_1283;
He was diagnosed with Bipolar disorder and d/c on Lithium 300mg BID and Risperdal 1mg BID with follow up...Considering the patient presented with psychiatric symptoms in February, a sound hypothesis is that his episodes are not linked to the pandemic. Patient’s manic symptoms included a lack of sleep, flight of ideas and increase in goal directed activity most likely due to his past Kratom use.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Augmenting Mood Stabilizers With Low-Dose Lithium in Patients With Renal Impairment () - May 2, 2021 - Abstract #APA2021APA_818;
His lithium was discontinued and he was tried on maximal doses of divalproex and olanzapine with minimal effect...With careful monitoring of kidney function, this may be a pathway for re-stabilization, improved quality of life, and fewer hospitalizations for this subset of patients. Further research regarding use of low dose lithium may uncover a safer way to treat bipolar disorder when long-term therapy is required.
- |||||||||| lithium carbonate ER / Generic mfg., risperidone / Generic mfg.
[VIRTUAL] Adding Antipsychotics With Lithium Reduces Hospitalization Stay in Bipolar Manic Episodes () - May 2, 2021 - Abstract #APA2021APA_809;
But we should also consider that combination with haloperidol, olanzapine, risperidone, and quetiapine with a mood stabilizer for managing acute manic episodes is less well- tolerated than monotherapy [3]. Therefore, using the COMBO as an initial treatment for hospitalized patients with BP, manic episodes should be considered as an effective model for faster response based on tolerability and requirement of faster response to manage to acute mania.
- |||||||||| Silenor (doxepin) / Currax
[VIRTUAL] Worsening Depression, Anxiety and Insomnia Due to Overcorrection of Thyroid Medication in a Patient With History of Bipolar Disorder: A Case Report () - May 2, 2021 - Abstract #APA2021APA_801;
The patient’s home psychiatric medication included lithium 900mg qHS, clonazepam 0.5 daily prn daily, topiramate 50mg daily, and recent reduction of quetiapine from 100mg to 50mg due to reported weight gain...At this time, the patient was initiated on Levothyroxine 100mcg, which was later decreased to 88mcg due to increased anxiety, palpitations, and jitteriness...On the unit, the patient underwent the following psychiatric medication adjustment: discontinuation of quetiapine and topiramate, increase in lithium to 300mg qdaily and 900qHS for mood stabilization, initiation of sertraline 50mg daily for mood and doxepin 25mg bedtime for sleep. After 4 days, the exhibited symptomatology on admission resolved and the patient was cleared for discharge and reinstatement back to IOP.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Lithium for Ultra-Rapid Cycling Bipolar Disorder and Comorbid Eating Disorder: A Case Report () - May 2, 2021 - Abstract #APA2021APA_739;
She was treated with a combination of Lithium and medication for both mania and depression prevention. In light of this case report, it is concluded that ultra-rapid cycling can be acknowledged as a severe presentation of bipolar disorder, significantly affecting the case’s quotidian life and long-term prognosis and demanding complicated and particular treatment approaches.
- |||||||||| Rexulti (brexpiprazole) / Lundbeck, Otsuka
[VIRTUAL] Decompensation of Mental Illness After Covid-19 Infection: A Case Series () - May 2, 2021 - Abstract #APA2021APA_712;
His symptoms were successfully maintained on ziprasidone 60mg daily since 2007...He was trialed on several additional psychotropic medications, including lithium, olanzapine, lurasidone, aripiprazole, and brexpiprazole...He returned to the hospital two months later, where he exhibited auditory hallucinations, was noted to be responding to internal and unseen stimuli, and exhibited paranoid ideations regarding COVID-19. He was unable to care for himself and warranted involuntary placement to the inpatient psychiatric unit, where he stayed for nine days and eventually stabilized on long-acting paliperidone preparation.
- |||||||||| [VIRTUAL] Tsunami of Symptoms: A Case of Cycloid Psychosis () - May 2, 2021 - Abstract #APA2021APA_664;
Presentation: 31-yo single, employed male, who lives with mother, has good network of friends with psychiatric history of major depressive disorder (MDD), 2 psychiatric hospitalizations for suicidal ideation (SI) and a suicide attempt (SA) brought to the ED after intentional overdose on 15 pills of Lithium, Lexapro, and Norvasc as a second high lethality suicide attempt...During hospitalization, he was stabilized with Lexapro 10 mg and Abilify 10 mg PO... CS is a relatively less reported form of psychosis and, and providers need to be aware and more research needs to be done.
- |||||||||| risperidone / Generic mfg., lorazepam / Generic mfg.
[VIRTUAL] Treatment of Acute Mania in a Patient With Hemochromatosis () - May 2, 2021 - Abstract #APA2021APA_659;
Lithium and lorazepam were utilized for the same purpose. This solution of relatively bypassing hepatic metabolism by using select agents may be considered in future instances of psychosis with decreased or worsening hepatic function.
- |||||||||| sertraline / Generic mfg.
[VIRTUAL] Psychiatric Management of Associated Symptoms in CLN3 Disease, Juvenile Onset: A Case Study () - May 2, 2021 - Abstract #APA2021APA_640;
Patient initially was on a main medication regimen of quetiapine 400 mg PO BID and sertraline 50 mg PO daily with limited benefits...Ultimately, sertraline was optimized at 100 mg PO daily and patient’s symptoms were markedly improved on lithium 600mg PO QAM and 300mg PO QHS while on lamotrigine 100mg PO BID and zonisamide per neurology...However, it appears that in this patient, lithium was useful as an adjunct to sertraline to address symptoms of mood, agitation, aggression, and impulsivity. In addition to medication management of symptoms of CLN-3, it is important to keep in mind quality of life for these patients and their caregivers and implement a supportive interdisciplinary team and support groups.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Syndrome of Irreversible Lithium-Effectuated Neurotoxicity—Mostly SILENT Since 2005: A Case Study () - May 2, 2021 - Abstract #APA2021APA_558;
Our case presents a diagnostically challenging scenario for Consultation- Liaison psychiatrists and we recommend to think broadly of the differential diagnosis in patients presenting with neurocognitive problems after lithium toxicity. SILENT is a rare presentation of a relatively common medication toxicity; recent technologic advances suggest cerebellar demyelination as the cause and promote physical therapy as the standard of care for this condition.
- |||||||||| risperidone / Generic mfg.
[VIRTUAL] A Rare Case of Psychosis in Balo’s Concentric Sclerosis () - May 2, 2021 - Abstract #APA2021APA_487;
Symptoms at each episode abated within 10-21 days following rituximab re-administration, and the patient was ultimately maintained with risperidone, lithium, and rituximab...Further studies are needed to describe the association between BCS and psychosis, which may have treatment implications. In our case, it is possible that more frequent immunosuppression may have treated the mood disorder.
- |||||||||| risperidone / Generic mfg., lorazepam / Generic mfg., sertraline / Generic mfg.
[VIRTUAL] Overcoming Complications in Management of a Difficult to Treat Adolescent With Schizoaffective Disorder () - May 2, 2021 - Abstract #APA2021APA_437;
She responded to Lorazepam challenge and symptoms resolved on standing Lorazepam 1mg twice daily, which was eventually tapered to discontinuation...J was discharged on day 42 of hospitalization. This poster will discuss the myriad of complications that may arise when attempting to identify an effective antipsychotic to treat adolescent schizoaffective disorder, including extrapyramidal symptoms, catatonia, medication- induced delirium, and potentially toxic serum medication levels.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Lithium Induced Hypercalcemia and Parathyroid Disorders. a Case of Long Term Lithium Treatment, a Parathyroid Adenoma and Hypercalcemia () - May 2, 2021 - Abstract #APA2021APA_420;
This case reviews a patient on long term lithium carbonate treatment for bipolar disorder who developed a parathyroid adenoma suggesting the benefit of periodic monitoring of calcium and parathyroid hormone (PTH)...Medical history was relevant for lithium induced hypothyroidism managed with levothyroxine...Hyperparathyroidism is associated with hypertension, cancer, renal failure, and fractures. Considering the elevated risk of lithium associated hypercalcemia and hyperparathyroidism and parathyroid dysfunction, periodic monitoring of calcium and PTH levels should be incorporated into care to target the potential functional impairment from hypercalcemia and sequelae of parathyroid dysfunction.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Psychotropic Medication Use in a Geriatric Patient With Prolongled QTc () - May 2, 2021 - Abstract #APA2021APA_341;
This can cause interruptions in treatment that can be detrimental to the patient. Underlying causes of QTc prolongation including pre existing cardiac conditions, electrolyte abnormalities, substance use should be considered and ruled out before adjusting psychiatric medications (3).
- |||||||||| [VIRTUAL] Have We Forgotten About Lithium Induced EPS? () - May 2, 2021 - Abstract #APA2021APA_319;
Due to her psychosis and history of non-adherence, she was started on risperidone for bipolar I disorder, current episode manic with psychotic features, and transitioned to paliperidone long acting injectable (Invega Sustenna)...To target to her sustained manic symptoms, lithium carbonate extended-release was initiated...The patient’s parkinsonian symptoms persisted despite multiple doses of diphenhydramine, benztropine, lorazepam, and amantadine...Mood stabilizers and neuroleptics are often used in combination to treat acutely decompensated patients with affective disorders. Therefore, it is also important to appreciate that lithium alone can induce EPS, and when added to an antipsychotic, can precipitate EPS.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Gender Dysphoria With Concurrent Borderline Personality Disorder: A Case Report () - May 2, 2021 - Abstract #APA2021APA_315;
Given the increased incidence of gender dysphoria diagnosis, it is increasingly important for those in mental health fields to look at this sexual minority and its mental health burden. The purpose of this case report is to explore the interaction and overlap of gender dysphoria and BPD, and to further the discussion on the role of gender minority on outcomes in patients with BPD.
- |||||||||| lithium carbonate ER / Generic mfg., haloperidol / Generic mfg.
[VIRTUAL] A Case of First-Episode Mania With Postpartum Onset and Gender Dysphoria in a Transgender Patient Receiving Testosterone Therapy () - May 2, 2021 - Abstract #APA2021APA_269;
While manic symptoms improved on lithium and haloperidol, the patient continued to exhibit distress regarding the return of his menstrual cycle and the cessation of gender- affirming testosterone injections...Transgender men face specific challenges when navigating pregnancy, including an increased risk for worsening gender dysphoria and depression. This case suggests that while abrupt administration of high doses of testosterone may put transgender men at risk for mania or psychosis in the postpartum period, cautious reintroduction of intramuscular testosterone with concurrent use of mood stabilizing medication is potentially safe in transgender men who have experienced a recent mood or psychotic disorder.
- |||||||||| lithium carbonate ER / Generic mfg.
[VIRTUAL] Pharmacologic Renal Protective Strategies in Lithium Use: A Case for Prophylaxis? () - May 2, 2021 - Abstract #APA2021APA_202;
However, given the dearth of current options to prevent or manage lithium-induced renal complications and the high cost to patients of discontinuing lithium, early initiation of renal protective agents may be warranted on a case-by- case basis – namely if (1) an agent is indicated for an existing co-morbidity in a patient on lithium or (2) an agent is relatively benign and not otherwise contraindicated. Specific agents meeting these criteria will be discussed in further detail.
- |||||||||| lithium carbonate ER / Generic mfg.
Journal: Bipolar Disorder and Parkinson's Disease: A I-Ioflupane Dopamine Transporter SPECT Study. (Pubmed Central) - May 1, 2021
Up to 20% of BD patients with parkinsonism might have an underlying dopaminergic deficit, which would not be due to cumulative exposure to offending drugs and is ostensibly higher than expected in the general population. This supports the evidence that BD represents a risk factor for subsequent development of neurodegenerative parkinsonism, the nature of which needs to be elucidated.
- |||||||||| lithium carbonate ER / Generic mfg.
Review, Journal: Lithium beyond psychiatric indications: the reincarnation of a new old drug. (Pubmed Central) - Apr 29, 2021
A detailed understanding of the lithium-induced mechanisms, however, is important for prospective clinical trials which may pave the way for a successful bench-to-bedside translation in the future. In this review, we will give an overview of lithium-induced neuroprotective mechanisms under various pathological conditions, with special emphasis on ischemic stroke.
- |||||||||| lithium carbonate ER / Generic mfg.
Retrospective data, Journal: White Matter Microstructure in Individuals With and At Risk for Bipolar Disorder: Evidence for an Endophenotype From a Voxel-Based Meta-analysis. (Pubmed Central) - Apr 28, 2021
These results are consistent with the hypothesis that lithium may improve impulse control deficits in clinical populations by minimising the effects of proinflammatory signalling on neuronal activity, particularly within the orbitofrontal cortex. Findings suggest that abnormalities in the body and splenium of the corpus callosum may be an endophenotype for BD, and they associate BD with WM tracts relevant for working memory performance, attention, and reward processing.
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