The Journal of clinical psychiatry
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Untreated early-onset bipolar disorder is associated with higher rates of rapid cycling, more comorbidity, and more severe mania and depression than adult-onset bipolar disorder. Correctly diagnosing bipolar disorder early in its course can prevent exposing a young patient to treatments that may exacerbate or advance the progression of the disorder. Appropriate pharmacologic and psychosocial interventions are necessary in the acute treatment of pediatric bipolar disorder.
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Comparative Study
Current prescription patterns and safety profile of irreversible monoamine oxidase inhibitors: a population-based cohort study of older adults.
To determine the prescription pattern and safety profile for irreversible monoamine oxidase inhibitors (MAOIs) in older adults over the past decade. ⋯ The low prescription rate of MAOIs is not consistent with the continued recommendation of MAOIs by expert opinion leaders and consensus guidelines for use in atypical depression and treatment-refractory depression. While their use appeared safe, heightened awareness of the potential risk of concomitant use of serotonergic agents is necessary. Relative underuse of the MAOIs for a significant subgroup of depressed patients with atypical and treatment-refractory depression remains a concern.
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Review Meta Analysis
Effects of lithium on cognitive performance: a meta-analysis.
Cognitive impairment is underrecognized among patients with bipolar disorder and may represent not only effects of the illness but also adverse effects of its treatments. Among these, lithium is the best-studied mood stabilizer. As its cognitive effects are mixed and not well-known, we assessed reported effects of lithium on cognitive performance. ⋯ Lithium treatment appears to have only few and minor negative effects on cognition.
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Comparative Study
Association between attention-deficit/hyperactivity disorder and sleep impairment in adulthood: evidence from a large controlled study.
To examine whether sleep impairment is associated with attention-deficit/hyperactivity disorder (ADHD) in adults. ⋯ Sleep disturbances that are not attributable to comorbid mental health conditions or ADHD pharmacotherapy are associated with ADHD in adulthood. Clinicians and researchers should consider the potential contribution of sleep disruption to the clinical presentation of adults with ADHD.
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Randomized Controlled Trial Multicenter Study
A multicenter, randomized, double-blind, placebo-controlled, 16-week study of adjunctive aripiprazole for schizophrenia or schizoaffective disorder inadequately treated with quetiapine or risperidone monotherapy.
Combining antipsychotics is common practice in the treatment of schizophrenia. This study investigated aripiprazole adjunctive to risperidone or quetiapine for treating schizophrenia and schizoaffective disorder. ⋯ The addition of aripiprazole to risperidone or quetiapine was not associated with improvement in psychiatric symptoms but was generally safe and well tolerated. Further research is warranted to explore whether antipsychotic combination therapy offers benefits to particular patient populations-for example, in cases of hyperprolactinemia.