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Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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MRI-guided dmPFC-rTMS as a Treatment for Treatment-resistant Major Depressive Disorder
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Treatment recommendations for DSM-5-defined mixed features.

Joshua D Rosenblat1, Roger S McIntyre1

  • 1Mood Disorder Psychopharmacology Unit,University Health Network,Department of Psychiatry,University of Toronto,Toronto,Ontario,Canada.

CNS Spectrums
|September 16, 2016
PubMed
Summary
This summary is machine-generated.

Treatment guidelines for mixed features in mood disorders are limited. Second-generation antipsychotics show promise for bipolar disorder, while antidepressants are first-line for major depressive disorder but require monitoring.

Keywords:
AntipsychoticsDSM-5bipolar disorderguidelineslurasidonemajor depressive disordermixed episodemixed featuresmixed statesmood stabilizers

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Area of Science:

  • Psychiatry
  • Mood Disorders
  • Pharmacology

Background:

  • The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) offers a broader definition of mixed features in mood disorders.
  • Limited research exists on treatments specifically for DSM-5-defined mixed features, hindering evidence-based guidelines.

Purpose of the Study:

  • To provide interim treatment recommendations for mood disorders with mixed features.
  • To highlight the current limitations in evidence and guide future research.

Main Methods:

  • Review of existing literature on treatments for mixed features.
  • Expert opinion synthesis to inform recommendations.

Main Results:

  • Second-generation antipsychotics (SGAs) show promise for bipolar disorder with mixed features.
  • Antidepressants remain first-line for major depressive disorder with mixed features, but require careful monitoring due to safety concerns.
  • Lurasidone is the only SGA monotherapy proven effective for major depressive disorder with mixed features.

Conclusions:

  • Interim treatment recommendations are proposed due to insufficient data.
  • Further research is crucial to establish efficacy, safety, and tolerability of treatments for mixed features.