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Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy PDF

285 Pages·2009·1.537 MB·English
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Milestones in Drug Therapy MDT Series Editors Prof. Dr. Michael J. Parnham PhD Prof. Dr. J. Bruinvels Director of Preclinical Discovery Sweelincklaan 75 Centre of Excellence in Macrolide Drug Discovery NL-3723 JC Bilthoven GlaxoSmithKline Research Centre Zagreb Ltd. The Netherlands Prilaz baruna Filipovića 29 HR-10000 Zagreb Croatia Bipolar Depression: Molecular Neurobiology, Clinical Diagnosis and Pharmacotherapy Edited by Carlos A. Zarate Jr. and Husseini K. Manji Birkhäuser Basel . Boston . Berlin Editors Carlos A. Zarate Husseini K. Manji Mood Disorders Research Unit Laboratory of Molecular Pathophysiology Laboratory of Molecular Pathophysiology National Institute of Mental Health National Institute of Mental Health Porter Neuroscience Research Center Mark O. Hatfield Clinical Research Center Building 35, Room 1C-917 Unit 7SE, Rm. 7-3445 36 Convent Drive, MSC 3711 10 Center Drive Bethesda, Maryland 20892 Bethesda, Maryland 20892 USA USA Advisory Board J.C. Buckingham (Imperial College School of Medicine, London, UK) R.J. Flower (The William Harvey Research Institute, London, UK) A.G. Herman (Universiteit Antwerpen, Antwerp, Belgium) P. Skolnick (DOV Pharmaceuticals Inc., Hackensack, NJ, USA) Library of Congress Control Number: 2008935771 Bibliographic information published by Die Deutsche Bibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the internet at http://dnb.ddb.de ISBN: 978-3-7643-8566-8 Birkhäuser Verlag AG, Basel – Boston – Berlin The publisher and editor can give no guarantee for the information on drug dosage and administration contained in this publication. The respective user must check its accuracy by consulting other sources of reference in each individual case. The use of registered names, trademarks etc. in this publication, even if not identified as such, does not imply that they are exempt from the relevant protective laws and regulations or free for general use. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, re-use of illustrations, recitation, broadcasting, reproduction on microfilms or in other ways, and storage in data banks. For any kind of use, permission of the copyright owner must be obtained. © 2009 Birkhäuser Verlag AG, P.O. Box 133, CH-4010 Basel, Switzerland Part of Springer Science+Business Media Printed on acid-free paper produced from chlorine-free pulp. TFC ∞ Printed in Germany ISBN 978-3-7643-8566-8 e-ISBN 978-3-7643-8567-5 9 8 7 6 5 4 3 2 1 www. birkhauser.ch V Contents List of contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VII Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IX Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI Section A:Bipolar depression:Clinical phenotype and course of illness Andreas Marneros The historyof bipolar disorders ............................... 3 Gordon B. Parker and Kathryn Fletcher Theclinical diagnosis of bipolar depression ..................... 17 Tamas Treuer and Mauricio Tohen Course and outcome of bipolar disorder – focusing on depressive aspects .................................................. 29 Zoltán Rihmer Suicide and bipolar disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Section B:Bipolar depression:Neurobiology Thomas G.Schulze and Francis J. McMahon The genetic basis of bipolar disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Jun-Feng Wang and L. Trevor Young Understanding the neurobiology of bipolar depression . . . . . . . . . . . . . 77 Wallace C. Duncan,Jr Non-pharmacological treatments and chronobiological aspects of bipolar disorder:implications for novel therapeutics . . . . . . . . . . . . . . 95 Jonathan Savitz and Wayne C. Drevets Neuroimaging studies of bipolar depression:therapeutic implications . 117 VI Contents Section C:Acute and long-term treatment of bipolar disorder Gary S. Sachs,Louisa G. Sylvia and Hannah G. Lund Pharmacological treatment of acute bipolar depression . . . . . . . . . . . . 147 Keming Gao,David E. Kemp and Joseph R. Calabrese Pharmacological treatment of the maintenance phase of bipolar depression:focus on relapse prevention studies and the impact ofdesign on generalizability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Harold A. Sackeim Non-pharmacological somatic treatments for bipolar depression . . . . . 179 Carlos A. Zarate Jr and Husseini K. Manji Potential novel treatments for bipolar depression . . . . . . . . . . . . . . . . . 191 Section D:Treatment of bipolar disorder in special populations John L. Beyer and K. Ranga R. Krishnan Late-onset bipolar disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Robert L. Findling Treatment of childhood-onset bipolar disorder ................... 241 Patricia Roy and Jennifer L. Payne Treatment of bipolar disorder during and after pregnancy . . . . . . . . . . 253 Carlos A. Zarate Jr and Husseini K. Manji Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 VII List of contributors John L. Beyer, Duke University Medical Center, Durham, NC 27710, USA; e-mail:[email protected] Joseph R. Calabrese, Department of Psychiatry, Bipolar Disorder Research Center in Mood Disorders Program, University Hospitals Case Medical Center,Case Western Reserve University School of Medicine,10524 Euclid Avenue,12th Floor,Cleveland,Ohio 44106,USA; e-mail:joseph.calabrese@ uhhospitals.org Wayne C. Drevets,Section on Neuroimaging in Mood and Anxiety Disorders, NIH/NIMH DIRP,15K North Dr.,Bethesda,MD 20892,USA Wallace C. Duncan, Mood and Anxiety Disorders Program, National Institute of Mental Health,Bethesda,Maryland 20892,USA Robert L. Findling, Department of Psychiatry, University Hospitals Case Medical Center, 10524 Euclid Avenue, Cleveland, Ohio 44106, USA; e-mail:[email protected] Kathryn Fletcher, School of Psychiatry, University of New South Wales, Sydney,NSW 2031,Australia; e-mail:[email protected] Keming Gao, Department of Psychiatry, Bipolar Disorder Research Center in Mood Disorders Program, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine,10524 Euclid Avenue,12th Floor,Cleveland,Ohio 44106,USA; e-mail:[email protected] David E. Kemp,Department of Psychiatry,Bipolar Disorder Research Center in Mood Disorders Program, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, 10524 Euclid Avenue, 12th Floor, Cleveland, Ohio 44106, USA; e-mail: kemp.david@ gmail.com K. Ranga R. Krishnan,Duke University Medical Center,Durham,NC 27710, USA Hannah G. Lund, Bipolar Clinic and Research Program, Massachusetts General Hospital,50 Staniford St,Suite 580,Boston,MA 02114,USA Husseini K. Manji, Laboratory of Molecular Pathophysiology, National Institute of Mental Health, Porter Neuroscience Research Center, Building 35, Room 1C-917, 36 Convent Drive, MSC 3711, Bethesda, Maryland 20892,USA; e-mail:[email protected] Andreas Marneros, Klinik und Poliklinik für Psychiatrie, Psychotherapie und Psychosomatik, Martin-Luther-Universität Halle-Wittenberg, 06097 Halle, Germany; e-mail:[email protected] Francis J. McMahon, Unit on the Genetic Basis of Mood and Anxiety Disorders, Mood & Anxiety Disorders Program, National Institute of VIII List of contributors Mental Health, National Institutes of Health, Dept. of Health & Human Services,Bethesda,MD 20892,USA Gordon B. Parker, Black Dog Institute, Prince of Wales Hospital, Sydney, NSW 2031,Australia; e-mail:[email protected] Jennifer L. Payne,Johns Hopkins School of Medicine,550 N. Broadway,Suite 305,Baltimore,MD 21205,USA; e-mail:[email protected] Zoltán Rihmer, Department of Clinical and Theoretical Mental Health, and Department of Psychiatry and Psychotherapy, Semmelweis Medical University, Kútvölgyi Clinical Centre, Kútvölgyi út 4, 1125 Budapest, Hungary; e-mail:[email protected] Patricia Roy,Johns Hopkins School of Medicine,550 N. Broadway,Suite 305, Baltimore,MD 21205,USA; e-mail:[email protected] Gary S. Sachs, Bipolar Clinic and Research Program, Massachusetts General Hospital, 50 Staniford St, Suite 580, Boston, MA 02114, USA; e-mail: [email protected] Harold A. Sackeim, 4 Grant’s Path, Poughquag, NY 12570, USA; e-mail: [email protected] Jonathan Savitz, Section on Neuroimaging in Mood and Anxiety Disorders, NIH/NIMH DIRP, 15K North Dr., Bethesda, MD 20892, USA; e-mail: [email protected] Thomas G. Schulze, Unit on the Genetic Basis of Mood and Anxiety Disorders, Mood & Anxiety Disorders Program, National Institute of Mental Health, National Institutes of Health, Dept. of Health & Human Services,Bethesda,MD 20892,USA; e-mail:[email protected] Louisa G. Sylvia, Bipolar Clinic and Research Program, Massachusetts General Hospital,50 Staniford St,Suite 580,Boston,MA 02114,USA Mauricio Tohen,Lilly Research Laboratories,Indianapolis IN 46285; McLean Hospital, Harvard Medical School, Belmont MA 02184, USA; e-mail: [email protected] Tamas Treuer, Lilly Hungaria Kft., Madacs Imre u. 13–14, 1075 Budapest, Hungary; e-mail:[email protected] Jun-Feng Wang, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1; e-mail: [email protected] L. Trevor Young, Department of Psychiatry, University of British Columbia 2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1; e-mail: [email protected] Carlos A. Zarate, Mood Disorders Research Unit, Laboratory of Molecular Pathophysiology, National Institute of Mental Health, Mark O. Hatfield Clinical Research Center, Unit 7SE, Rm. 7-3445, 10 Center Drive, Bethesda,Maryland 20892,USA; e-mail:[email protected] IX Acknowledgements The editors gratefully acknowledge the contributions of our book project coor- dinator, Ioline Henter. Her editing abilities, organizational assistance, and attention to detail were integral to the preparation of this volume. We also wish to acknowledge the support of Detlef Klüber and his colleagues at Birkhäuser Publishing, who accepted our delays with good-natured patience, and whose professionalism made them a pleasure to work with. Our thanks also go out to the research staff of the 7 Southeast Unit and the Outpatient Clinic at the National Institute of Mental Health (NIMH-NIH). XI Foreword Bipolar disorder is a major public health problem,a reality reflected in its posi- tion as the sixth leading cause of disability worldwide in 15 to 44-year olds – the age range most associated with the onset of the disorder. Two-thirds of this disability can be traced to the depressive phase of the disorder. While it is beyond question that treatments for the depressive phase of bipolar disorder represent the major unmet need for patients with bipolar disorder and their cli- nicians alike,it is striking how out of balance the medication development for this disorder has been. With one exception, every drug developed for bipolar disorder has entered the market as a treatment for acute mania,so that we now havenearly a dozen agents proven to work for this indication. What proven treatments do we have for bipolar depression? There are two with FDA indications for the acute treatment of bipolar depression, but only one of them is a drug,the other being a combination of two drugs marketed in asingle pill. The one monotherapy that has been proven to the satisfaction of regulatory agencies is quetiapine, and yet, in spite of its ability to separate from placebo in its effect on core depressive symptoms,the size of the overall quetiapine effect in bipolar depression comes substantially from its ability to improvesleepand reduce anxiety. What about monotherapies that can prevent or attenuate new episodes of depression when used as maintenance treatments? One agent – lamotrigine – is effectivein reducing the time to intervention for new episodes of depression among patients with bipolar disorder studied following remission from acute mania or acute depression; in addition,the older maintenance data on lithium suggest that that drug has at least a moderate ability to prevent or attenuate depressive episodes. Placebo-controlled “maintenance” studies of olanzapine and aripiprazole monotherapy show that the great bulk of the difference between drug and placebo occurs in the continuation phase of treatment,i.e. in the first few months after a manic episode (primarily by preventing relapse back into the index manic episode). However, the ability of any atypical antipsychotic to prevent or attenuate new episodes of depression has not yet been established. What about the host of “traditional” antidepressants – both the older tri- cyclic and MAO inhibitor classes and the newer “second-generation” SSRIs, SNRIs, bupropion and a few others? None of these “traditional” antidepres- sants has ever been FDA-approved for bipolar depression. Indeed,in all of the numerous large studies conducted in the process of registering these drugs as antidepressants,patients with bipolar disorder were excluded. And recent large randomized studies of patients with bipolar disorder in the depressive phase

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