The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first-line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first-line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second-line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not-recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long-acting injection, and adjunctive ziprasidone continue to be first-line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third-line options.

/pdf/canadian-network-for-mood-and-anxiety-treatments-canmat-and-2qkz8pbmtg.pdf

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.

Diagnostic and Statistical Manual of Mental Disorders, 4th ed

Schizophrenia, “just the facts” 4. Clinical features and conceptualization

The Canadian Network for Mood and Anxiety Treatments (CANMAT) published guidelines for the management of bipolar disorder in 2005, with a 2007 update. This second update, in conjunction with the International Society for Bipolar Disorders (ISBD), reviews new evidence and is designed to be used in conjunction with the previous publications. The recommendations for the management of acute mania remain mostly unchanged. Lithium, valproate, and several atypical antipsychotics continue to be first-line treatments for acute mania. Tamoxifen is now suggested as a third-line augmentation option. The combination of olanzapine and carbamazepine is not recommended. For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. New data support the use of adjunctive modafinil as a second-line option, but also indicate that aripiprazole should not be used as monotherapy for bipolar depression. Lithium, lamotrigine, valproate, and olanzapine continue to be first-line options for maintenance treatment of bipolar disorder. New data support the use of quetiapine monotherapy and adjunctive therapy for the prevention of manic and depressive events, aripiprazole monotherapy for the prevention of manic events, and risperidone long-acting injection monotherapy and adjunctive therapy, and adjunctive ziprasidone for the prevention of mood events. Bipolar II disorder is frequently overlooked in treatment guidelines, but has an important clinical impact on patients' lives. This update provides an expanded look at bipolar II disorder.

/pdf/canadian-network-for-mood-and-anxiety-treatments-canmat-and-2s1irfxih8.pdf

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009.

https://gwern.net/docs/modafinil/2008-minzenberg.pdf

Modafinil: A Review of Neurochemical Actions and Effects on Cognition

We report the case of a young boy with nonverbal autism and intellectual disability, with a rare de novo 1q21.3 microdeletion. The patient had early and extreme self-injurious behaviours that led to blindness, complicated by severe developmental regression. A significant reduction in the self-injurious behaviours and the recovery of developmental dynamics were attained in a multidisciplinary neurodevelopmental inpatient unit. Improvement was obtained after managing all causes of somatic pains, using opiate blockers and stabilizing the patient’s mood. We offered both sensorimotor developmental approach with therapeutic body wrap and specific psychoeducation adapted to his blindness condition for improving his communication abilities.

/pdf/management-of-severe-developmental-regression-in-an-autistic-4zxlalccq8.pdf

Management of Severe Developmental Regression in an Autistic Child with a 1q21.3 Microdeletion and Self-Injurious Blindness

Resume La desinhibition sexuelle constitue un element semiologique frequent de l'episode maniaque chez l'adolescent. Celle-ci peut (1) favoriser des comportements a risque et mettre l'adolescent en danger, le viol venant ainsi reveler un etat maniaque a l'adolescence ; (2) etre a l'origine, par la frequence d'une dimension psychotique associee, d'idees delirantes a thematique sexuelle et/ou etre source de fausses allegations d'abus sexuel. A partir de la description de quatre observations recentes, nous discuterons les principales implications cliniques, therapeutiques et medicolegales de telles situations.

Manie et désinhibition sexuelle chez l'adolescente : intrications médicolégales et thérapeutiques

Medical and developmental risk factors of catatonia in children and adolescents: A prospective case control study

Catatonia in Children and Adolescents

Resume Le trouble de dysregulation emotionnelle et comportementale severe est un nouveau diagnostic relativement peu connu. Il est integre dans la classification du DSM 5 sous le terme de disruptive mood dysregulation disorder pour DMDD. Cette entite a ete isolee a partir des travaux anglo-saxons sur les troubles bipolaires de l’enfant pre-pubere. Ces enfants souffrent de symptomes thymiques d’allure hypomaniaque ou dysphorique accompagnes de reactions de coleres explosives ayant un retentissement important sur leur environnement familial et scolaire. Ce trouble apparait precocement et evolue de facon chronique et non episodique. On retrouve un mauvais controle emotionnel, ainsi qu’une incapacite a acceder a l’euthymie et a un attachement secure chez ces enfants. L’objet de cet article est de rappeler les controverses qui ont conduit a l’elaboration de cette entite en particulier les travaux sur les troubles bipolaires pediatriques. Nous avons examine les arguments scientifiques qui plaident en faveur de son individualisation. Nous avons aussi etudie les liens avec d’autres troubles psychiatriques comorbides, dont le trouble deficitaire de l’attention avec hyperactivite. Notre discussion est illustree par deux vignettes cliniques.

Angèle Consoli

Papers

Management of Severe Developmental Regression in an Autistic Child with a 1q21.3 Microdeletion and Self-Injurious Blindness

Manie et désinhibition sexuelle chez l'adolescente : intrications médicolégales et thérapeutiques

Medical and developmental risk factors of catatonia in children and adolescents: A prospective case control study

Catatonia in Children and Adolescents

Dysrégulation émotionnelle et comportementale sévère : une nouvelle entité pour des enfants irritables ?