Aripiprazole in the Treatment of Refractory Mood Disorders: A Case Series
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Major depressive disorder and bipolar disorders are among the commonest neuropsychiatric conditions, affecting persons ofboth sexes which belong to all age groups. Comorbidity is the rule rather than the exception; anxiety spectrum disorders, somatoformdisorders, eating disorders and substance use disorders frequently co-exist with mood disorders. Catatonia is a seriouscomplication of the latter and every patient with a severe affective exacerbation should be assessed for the presence of catatonicsigns and symptoms. In a significant minority of patients, symptoms show treatment resistance; many patients experience severehopelessness and suicidal ideation, causing high rates of morbidity and mortality in afflicted individuals. Pharmacological managementis challenging and currently available psychotropic agents often fall short of inducing remission. Second generationantipsychotics have been shown in a number of studies as having an antidepressant and mood stabilizing effect. Aripiprazoleis a novel antipsychotic which is being increasingly used in difficult to treat mood disorders patients. Several controlled anduncontrolled studies have shown the efficacy and safety of this medication in subjects of all ages. Here a case series of threepatients is presented who suffered from refractory mood disorders but responded to aripiprazole with complete remission ofaffective symptoms.
Abstract
Major depressive disorder and bipolar disorders are among the commonest neuropsychiatric conditions, affecting persons ofboth sexes which belong to all age groups. Comorbidity is the rule rather than the exception; anxiety spectrum disorders, somatoformdisorders, eating disorders and substance use disorders frequently co-exist with mood disorders. Catatonia is a seriouscomplication of the latter and every patient with a severe affective exacerbation should be assessed for the presence of catatonicsigns and symptoms. In a significant minority of patients, symptoms show treatment resistance; many patients experience severehopelessness and suicidal ideation, causing high rates of morbidity and mortality in afflicted individuals. Pharmacological managementis challenging and currently available psychotropic agents often fall short of inducing remission. Second generationantipsychotics have been shown in a number of studies as having an antidepressant and mood stabilizing effect. Aripiprazoleis a novel antipsychotic which is being increasingly used in difficult to treat mood disorders patients. Several controlled anduncontrolled studies have shown the efficacy and safety of this medication in subjects of all ages. Here a case series of threepatients is presented who suffered from refractory mood disorders but responded to aripiprazole with complete remission ofaffective symptoms.
참고문헌 (17)
- Luca M, "Epidemiology and treatment of mood disorders in a day hospital setting from 1996 to 2007: an Italian study", Neuropsychiatr Dis Treat, 9, pp.169~176 (2013)
- Amital D, "Physical co-morbidity among treatment resistant vs. treatment responsive patients with major depressive disorder", Eur Neuropsychopharmacol, 23, pp.895~901 (2013)
- Sienaert P, "Evidencebased treatment strategies for treatment-resistant bipolar depression: a systematic review", Bipolar Disord, 15, pp.61~69 (2013)
- Vieta E, "Pharmacological management of bipolar depression: acute treatment, maintenance, and prophylaxis", CNS Drugs, 27, pp.515~529 (2013)
- de Bartolomeis A, "Combination of aripiprazole with mood stabilizers for the treatment of bipolar disorder:from acute mania to long-term maintenance", Expert Opin Pharmacother, 13, pp.2027~2036 (2012)
- Nelson JC, "Effects of aripiprazole adjunctive to standard antidepressant treatment on the core symptoms of depression: a post-hoc, pooled analysis of two large, placebo-controlled studies", J Affect Disord, 120, pp.133~140 (2010)
- Dording C, "The effects of aripiprazole on the subscales of the Kellner Symptom Questionnaire in treatment resistant depression", Int Clin Psychopharmacol, 28, pp.238~244 (2013)
- Joshi G, "Comorbidity in pediatric bipolar disorder", Child Adolesc Psychiatr Clin N Am, 18, pp.291~319 (2009)
- Belaizi M, "Acute catatonia: Questions, diagnosis and prognostics, and the place of atypical antipsychotics", Encephale, 39, pp.224~231 (2013)
- Geddes JR, "Treatment of bipolar disorder", Lancet, 381, pp.1672~1682 (2013)
- Vergne DE, "Aripiprazole: a drug with a novel mechanism of action and possible efficacy for alcohol dependence", CNS Neurol Disord Drug Targets, 9, pp.50~54 (2010)
- Ziadi Trives M, "Effect of the addition of aripiprazole on hyperprolactinemia associated with risperidone long-acting injection", J Clin Psychopharmacol, 33, pp.538~541 (2013)
- Caccia S., "Safety and pharmacokinetics of atypical antipsychotics in children and adolescents", Paediatr Drugs, 15, pp.217~233 (2013)
- Katzman MA., "Aripiprazole: a clinical review of its use for the treatment of anxiety disorders and anxiety as a comorbidity in mental illness", J Affect Disord, 128(Suppl 1), pp.S11~S20 (2011)
- Kinghorn WA, "Aripiprazole: pharmacology, efficacy, safety and tolerability", Expert Rev Neurother, 5, pp.297~307 (2005)
- Fountoulakis KN., "Refractoriness in bipolar disorder: definitions and evidence-based treatment", CNS Neurosci Ther, 18, pp.227~237 (2012)
- Blier P, Blondeau C., "Neurobiological bases and clinical aspects of the use of aripiprazole in treatment-resistant major depressive disorder", J Affect Disord, 128(Suppl 1), pp.S3~S10 (2011)