Many people with bipolar receive atypical antipsychotics with mood stabilizers. As in many areas of medicine, we have relatively little data about longer-term outcomes when people receive this combination. If an atypical antipsychotic is added to a mood stabilizer to control a manic episode, how long should that combination be prescribed? A recent study conducted by the Canadian Mood and …
Antipsychotic Medications in Pregnancy
After decades during which the accepted medical dogma was that pregnant women should avoid all medications, the last 10 years have shown a significant increase in the quality of information available to help guide pregnant women in making decisions about which medications to continue taking during pregnancy. A recent editorial in the JAMA Psychiatry gives a sense of the context and …
Antipsychotics
I just wanted to note the addition of a page on atypical antipsychotics which I added to the existing page on antidepressants and hope to compliment with a page on mood stabilizers. This page, and its companions, are all intended to be adjuncts to treatment, a place for patients with an interest in knowing more about medications and medication changes …
Lurasidone for Depression with Mixed Features
Lurasidone (Latuda) May Treat Depression with Mixed Features A recently published clinical trial suggests that lurasidone, which is an atypical antipsychotic with strong evidence for efficacy in treating bipolar depression, may be associated with response in patients who, according to DSM5, do not meet criteria for bipolar disorder, but do have evidence of mixed features. The study points to the importance …
Weight Gain with Atypical Antipsychotics – A Review of Strategies
Many antipsychotics, especially some atypical or second generation antipsychotics, like olanzapine (Zyprexa) or quetiapine (Seroquel), cause significant weight gain, as well as insulin resistance (diabetes) and elevated lipids. What to do if the medication is helping (much more than alternatives) but the patient is developing these serious adverse effects? Two recent articles review the literature on strategies for managing these …
Genetic Testing Guides Treatment for Bipolar or Depression
We have been using a relatively new assay from a company called Genomind (the Genecept test) in some of our patients with bipolar and/or depression. The test involves a saliva sample which is analyzed for ten gene variants that may be useful in guiding treatment. So far we find that in about half of the patients with treatment resistant depression …
Lithium versus Quetiapine for Bipolar Disorder
In a recent study comparing the efficacy of lithium and the second-generation antipsychotic quetiapine, the drugs had remarkably similar results. Researcher Andrew Nierenberg et al. presented the results at the 2014 meeting of the American Society of Clinical Psychopharmacology. By the end of the 6-month study period, most patients had improved substantially, but only about a quarter of each group became …