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Re: Bipolar Illness And Psychostimulants :- o !!!!

Posted by Chairman_MAO on November 7, 2004, at 3:06:45

In reply to Bipolar Illness And Psychostimulants :- o !!!!!!!!, posted by aazospiro on November 6, 2004, at 20:32:03

1: Bipolar Disord. 2000 Mar;2(1):56-9.

An open study of methylphenidate in bipolar depression.

El-Mallakh RS.

Department of Psychiatry and Behavioral Sciences, University of Louisville
School of Medicine, KY 40292, USA. rselma01@athena.louisville.edu

BACKGROUND: The treatment of bipolar depression is problematic. Mood stabilizing
agents are often inadequate, while antidepressants may induce mania or mood
destabilization. Methylphenidate has been advocated as an effective
antidepressant agent in unipolar depression, and depression secondary to medical
illness. Amphetamine administration has been shown to reduce manic behavior.
These independent observations suggest that methylphenidate may be a safe and
effective agent in bipolar depression. METHODS: Fourteen depressed subjects with
DSM-IV bipolar illness and a Hamilton-depression (HAM-D) scale score of at least
15 had methylphenidate added to a stable mood stabilizer regiment. Patients were
followed weekly for 4 weeks and then biweekly for an additional 8 weeks.
RESULTS: HAM-D scores dropped from 16.9 +/- 1.79 SD at baseline to 9.4 +/- 9.73
on week 12 (p = 0.12, t = 1.84, df= 6) and 9.8 +/- 7.56 on last observation
carried forward (LOCF) (p = 0.019, t = 2.8, df = 10). Psychiatric symptom
assessment scale (PSAS) scores dropped from 17.9 +/- 5.63 at baseline to 4.8 +/-
7.47 at week 12 (p = 0.016, t = 4.02, df= 4) and 6.3 +/- 6.75 on LOCF (p =
0.007, t = 3.74, df = 7). Three individuals stopped secondary to anxiety,
agitation, and hypomania, respectively. CONCLUSION: In this brief, open study,
methylphenidate was effective and relatively safe in depressed bipolar subjects.
1: J Am Acad Child Adolesc Psychiatry. 1995 Apr;34(4):472-6.

Case study: antimanic effectiveness of dextroamphetamine in a brain-injured
adolescent.

Max JE, Richards L, Hamdan-Allen G.

University of Iowa, Department of Psychiatry, Iowa City 52242-1009, USA.

A relatively enduring and counterintuitive antimanic response to
dextroamphetamine in a brain-injured adolescent who had failed trials involving
divalproex, lithium, haloperidol, and carbamazepine is described. This finding
combined with data from previous reports of antimanic effects of test doses of
stimulants imply that such a pharmacological probe may prove relevant for the
prediction of treatment response of mania to dextroamphetamine and perhaps for
subclassification of bipolar disorder.

Publication Types:
Case Reports

1: J Clin Psychiatry. 1987 Oct;48(10):412-3.

Dextroamphetamine treatment of mania.

Garvey MJ, Hwang S, Teubner-Rhodes D, Zander J, Rhem C.

Department of Psychiatry, Veterans Administration Medical Center, Iowa City, IA
52242.

Five of six acutely manic patients treated with dextroamphetamine experienced a
50% or greater reduction in their mania severity scores. Side effects were noted
in only one patient. The treatment results suggest that dextroamphetamine might
be useful in the treatment of mania.

Publication Types:
Clinical Trial

1: Arzneimittelforschung. 1976;26(6):1185-6.

[Proceedings: D-Amphetamine in manic syndrome (author's transl)]

[Article in German]

Beckmann H, Heinemann H.

Six manic patients were acutely treated with 30 or 50 mg d-amphetamine,
respectively. There was no intensification in any of these patients of gross
manic behavior or single manic symptoms. Conversely, there was sedation and
considerable reduction of manic symptomatology in all of them. This effect
lasted for 1 to 3 h only. The clinical subgroup "elated-grandiose" was
significantly, the subgroup "paranoid-destructive" was not significantly
influenced. "Drive" and "mood" were similarly reduced. There was, however, no
complete recovery from mania.

Publication Types:
Clinical Trial



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