BACKGROUND Field studies of illicit anabolic-androgenic steroid users suggest that some develop manic or aggressive reactions to these drugs-a potential public health problem. However, controlled laboratory evaluations of these effects remain limited. METHODS In a randomized, placebo-controlled, crossover trial, we administered testosterone cypionate for 6 weeks in doses rising to 600 mg/wk a...

BACKGROUND With the recent attention to evidence-based medicine in psychiatry, a number of treatment guidelines for bipolar disorders have been published. This survey investigated prescribing patterns and predictors for guideline disconcordance in the acute treatment of a manic and mixed episode across mainland China. METHODS The pharmacological treatments of 2828 patients with a recent hypom...

OBJECTIVE Various subjective and objective criteria are used to assess outcome in bipolar disorder. In this study, we explored to what extent they reflect distinct categories and whether underlying dimensions can be identified. PATIENTS AND METHODS One-hundred and twenty-one subjects with at least three episodes of bipolar I disorder (DSM-IV) were assessed on average 4.8 years after hospitali...

BACKGROUND Antidepressant drug therapy can precipitate mania in vulnerable individuals, but little is known about the effects of age on this phenomenon. OBJECTIVE To pharmacoepidemiologically evaluate the risk of conversion to mania by antidepressant class and patient age. DESIGN, SETTING, AND PATIENTS Using an administrative national database of more than 7 million privately insured indivi...

Background: In the treatment of bipolar disorder in youths, often more than one medication should be prescribed. In the current study, we compared the efficacy and tolerability of the combination of lithium and quetiapine with lithium and risperidone in the treatment of manic or mixed episodes in children and adolescents. Methods: Thirty patients (aged 10-18 years) who were hospitalized for ...

This report presents six cardinal results obtained with methods of oscillatory brain dynamics in euthymic and manic bipolar patients in comparison to healthy controls. Measurements include changes in oscillatory response activities in the theta, alpha, beta, and gamma frequency ranges. The analysis shows that spontaneous and response activities in the alpha range are highly reduced in euthymic ...

BACKGROUND Athanasios Koukopoulos provided a radical model for understanding depressive and manic conditions. OBJECTIVE To review, explain, and analyze Koukopoulos' concept of the primacy of mania, with special attention to the role of antidepressants. METHOD A conceptual review of Koukopoulos' writings and lectures on this topic is given. RESULTS Koukopoulos held that depressive states a...

BACKGROUND Autonomic nervous system (ANS) dysfunction and reduced heart rate variability (HRV) have been reported in a wide variety of psychiatric disorders, but have not been well characterized in bipolar mania. We recorded cardiac activity and assessed HRV in acutely hospitalized manic bipolar (BD) and schizophrenia (SCZ) patients compared to age- and gender-matched healthy comparison (HC) su...

Studies that compare the treatment response of patients diagnosed as primary affective disorder or schizoaffective disorder are reviewed. Although relatively few controlled or uncontrolled studies of the chemotherapy of schizoaffective disorders have been conducted, available evidence suggests that: (1) lithium carbonate is effective in the initial treatment of both schizoaffective mania and ma...

After ten years of successful maintenance treatment with lithium and olanzapine, a 40-year-old woman with bipolar disorder expressed concerns about continuing the use of medicines, as she was planning a pregnancy. In the past, she had suffered from five severe manic episodes with hospital admissions. After consultations with the treating psychiatrist, gynaecologist, and family doctor, olanzapin...