Dr Jan Fullerton and Professor Peter Schofield are investigating the genetic contributors to bipolar disorder using Australian families with multiple individuals who have been diagnosed with the disorder.
Print Because cognitive impairment seems to be present from the first manic episode, interventions are needed in the early stages to avoid affective recurrences and to reverse neurocognitive deficits.
During the last few decades, there has been growing interest in identifying and treating cognitive impairment in bipolar disorder, especially as it persists in remission periods.
Their analysis was published in the International Journal of Neuropsychopharmacology. Treatments and Prevention Strategies Pharmacotherapy Many different drugs have been examined for potential benefits to neurocognitive impairment in bipolar disorder, including cholinesterase inhibitors, glutamate receptor antagonists, glucocorticoid receptor antagonists, dopaminergic agonists, intranasal insulin, some antioxidants, erythropoietin, and more.
Continue Reading Below "Unfortunately, there is no well-established pharmacological treatment for cognitive impairment, since studies have yielded mixed results with no convincing effects," the researchers noted.
Mifepristone, a corticosteroid receptor antagonist: There is preliminary evidence of improved spatial working memory in depressed patients with bipolar disorder. This drug might have a beneficial effect on processing speed and working memory, but the effect was only observed in euthymic patients with bipolar I disorder in a post hoc analysis of an 8-week, double-blind, placebo-controlled trial.
This treatment showed an effect in executive function in euthymic patients, but showed no effect on primary cognition outcomes or other secondary outcomes. Euthymic and subsyndromal patients with bipolar disorder showed a better performance in auditory-verbal working memory. Although no effect was seen in verbal memory, improvements were seen in sustained attention, working memory, executive function, and recognition of facial expression in euthymic patients.
Some studies have reported a potential benefit in verbal memory, even in patients receiving electroconvulsive therapy. Results from large clinical trials found no benefit in cognitive functioning. However, very few studies have focused exclusively on patients with bipolar disorder, and many were conducted with mixed affective disorder participants and were not rigorously controlled.
Some nonpharmacological approaches include: Several studies have found functional remediation to be effective at improving psychosocial outcome, including interpersonal and occupational functioning. One study found this to be effective in patients with bipolar II disorder and in cognitively impaired patients, and other studies found the intervention to have been effective at 1 year.
This kind of intervention delivery makes easier the accessibility to patients engaged in working life as well as to younger users who are familiar with new technologies," the researchers noted.
Strategies to enhance social cognition: Results from 1 study showed that "[it] was found to be effective at improving Some studies have seen success in mindfulness-based interventions at reducing anxiety and depression, or as an adjunct to medication.
Although some studies have shown these treatments to improve working memory, psychomotor speed, and visuospatial memory, other results have contradicted these findings.
For example, because cognitive impairment seems to be present from the first manic episode, interventions are needed in the early stages to avoid affective recurrences and to reverse neurocognitive deficits. Another step to treating cognitive impairment in bipolar disorder is to identify and treat subclinical symptoms and comorbidities, including substance use disorder, anxiety, attention deficit hyperactivity disorder, and obesity.
Conclusion "Neurocognitive impairment needs to be considered a therapeutic clinical target in order to improve both psychosocial functioning and quality of life of patients with [bipolar disorder]," the researchers wrote. Further research is needed to draw any firm conclusions.
Dr Martinez-Aran has served as speaker or advisor for the following companies:Sep 18, · An analysis of all 11, bipolar disorder cases and 51, controls confirmed genome-wide significant evidence of association for CACNA1C and identified a new intronic variant in ODZ4.
We identified a pathway comprised of subunits of calcium channels enriched . Bipolar disorder (BD) is considered one of the most disabling mental conditions, with high rates of morbidity, disability, and premature death from suicide. Although BD is often misdiagnosed as major depressive disorder, some attention has recently been drawn to the possibility that BD could be overdiagnosed in some settings.
Bipolar Disorder Pipeline Analysis. The “Bipolar Disorder (Manic Depression) – Pipeline Insights ″ report covers an in-depth analysis of bipolar disorder drug molecules currently undergoing clinical studies.
It provides a deep understanding of potential bipolar disorder drug molecules across all . Genetic research into bipolar disorder traditionally uses strict categorical criteria to define a clinical diagnosis.
However, it is common for relatives of individuals with bipolar to exhibit some evidence of mood disturbance, but not sufficient to meet the strict clinical criteria for a positive diagnosis. Bipolar disorder is thought to be a neurobiological disorder in a specific part of the brain and is due to a malfunction of certain brain chemicals, including serotonin, dopamine and noradrenaline.
A life event may trigger a mood episode in a person with a genetic disposition for bipolar disorder. Even without clear genetic factors, altered health habits, alcohol or drug abuse, or hormonal problems can trigger an episode. Among those at risk for the illness, bipolar disorder is appearing at increasingly early ages.