Author
Heinz Grunze
Other affiliations: University of Texas Southwestern Medical Center, University of Freiburg, Newcastle University ...read more
Bio: Heinz Grunze is an academic researcher from Paracelsus Private Medical University of Salzburg. The author has contributed to research in topics: Bipolar disorder & Mania. The author has an hindex of 64, co-authored 330 publications receiving 16430 citations. Previous affiliations of Heinz Grunze include University of Texas Southwestern Medical Center & University of Freiburg.
Topics: Bipolar disorder, Mania, Mood stabilizer, Lamotrigine, Mood
Papers published on a yearly basis
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University of Oxford1, Northumberland, Tyne and Wear NHS Foundation Trust2, Imperial College London3, University of Melbourne4, Cognition and Brain Sciences Unit5, King's College London6, Fulbourn Hospital7, University Hospitals Birmingham NHS Foundation Trust8, University of California, Los Angeles9, University of Cambridge10, South London and Maudsley NHS Foundation Trust11
TL;DR: The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder, and recommend strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment.
Abstract: The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.
989 citations
TL;DR: Consideration is given to the possibility that selective disruption of NMDA-dependent modulation of local circuit inhibition may serve as a model for some aspects of dysfunction associated withNMDA-antagonist exposure and schizophrenia.
Abstract: Whole-cell and extracellular recording techniques were used to examine local circuit inhibition in the CA1 region of the rat hippocampus in vitro. Activation, primarily of the recurrent inhibitory circuit by alvear stimulation, elicited an IPSP in pyramidal neurons that was dependent, in part, on NMDA receptor activation. Application of a tetanizing stimulus to the alveus evoked long-term potentiation (LTP) of the intracellularly recorded recurrent IPSPs. This LTP also was NMDA-dependent and was more sensitive to blockade by the NMDA antagonists 2-amino-5-phosphonovalerate (APV) and N-acetyl-aspartyl-glutamate, than the excitatory LTP produced by Schaffer collateral stimulation. With regard to APV, the sensitivity of inhibitory LTP was an order of magnitude greater. A biophysical simulation of hippocampal CA1 circuitry was used in a model of learned pattern recognition that included LTP in both excitatory and inhibitory recurrent circuits. In this model, selective blockade of inhibitory LTP produced aberrant spread of lateral excitation, resulting in confusion of normally distinguishable patterns of neuronal activity. Consideration is given to the possibility that selective disruption of NMDA-dependent modulation of local circuit inhibition may serve as a model for some aspects of dysfunction associated with NMDA-antagonist exposure and schizophrenia.
477 citations
TL;DR: A consensus was reached on 12 statements on the use of antidepressants in bipolar disorder, and antidepressants should be prescribed only as an adjunct to mood-stabilizing medications.
Abstract: A task force report presents 12 recommendations for antidepressant use in bipolar disorder rated by at least 80% of International Society for Bipolar Disorders experts as essential or important.
475 citations
Harvard University1, University of Texas Health Science Center at San Antonio2, University of Pittsburgh3, University of Barcelona4, Tufts University5, University of British Columbia6, University of Sydney7, Case Western Reserve University8, University of Groningen9, Universidade Federal do Rio Grande do Sul10, Warneford Hospital11, Stanford University12, Newcastle University13, University of New South Wales14, Kyushu University15, University of Melbourne16
TL;DR: Determination and dissemination of a consensus nomenclature serve as the first step toward producing a validated and standardized system to define course and outcome in bipolar disorders in order to identify predictors of outcome and effects of treatment.
Abstract: Objectives: Via an international panel of experts, this paper attempts to document, review, interpret, and propose operational definitions used to describe the course of bipolar disorders for worldwide use, and to disseminate consensus opinion, supported by the existing literature, in order to better predict course and treatment outcomes. Methods: Under the auspices of the International Society for Bipolar Disorders, a task force was convened to examine, report, discuss, and integrate findings from the scientific literature related to observational and clinical trial studies in order to reach consensus and propose terminology describing course and outcome in bipolar disorders. Results: Consensus opinion was reached regarding the definition of nine terms (response, remission, recovery, relapse, recurrence, subsyndromal states, predominant polarity, switch, and functional outcome) commonly used to describe course and outcomes in bipolar disorders. Further studies are needed to validate the proposed definitions. Conclusion: Determination and dissemination of a consensus nomenclature serve as the first step toward producing a validated and standardized system to define course and outcome in bipolar disorders in order to identify predictors of outcome and effects of treatment. The task force acknowledges that there is limited validity to the proposed terms, as for the most part they represent a consensus opinion. These definitions need to be validated in existing databases and in future studies, and the primary goals of the task force are to stimulate research on the validity of proposed concepts and further standardize the technical nomenclature.
402 citations
TL;DR: The purpose is to supply a systematic overview of all scientific evidence pertaining to the long-term treatment of bipolar disorder in adults, and lithium continues to be the substance with the broadest base of evidence across treatment scenarios.
Abstract: Objectives. These guidelines are based on a fi rst edition that was published in 2004, and have been edited and updated with the available scientifi c evidence up to October 2012. Their purpose is to supply a systematic overview of all scientifi c evidence pertaining to the long-term treatment of bipolar disorder in adults. Methods . Material used for these guidelines are based on a systematic literature search using various data bases. Their scientifi c rigor was categorised into six levels of evidence (A – F) and different grades of recommendation to ensure practicability were assigned. Results . Maintenance trial designs are complex and changed fundamentally over time; thus, it is not possible to give an overall recommendation for long-term treatment. Different scenarios have to be examined separately: Prevention of mania, depression, or an episode of any polarity, both in acute responders and in patients treated de novo . Treatment might differ in Bipolar II patients or Rapid cyclers, as well as in special subpopulations. We identifi ed several medications preventive against new manic episodes, whereas the current state of research into the prevention of new depressive episodes is less satisfactory. Lithium continues to be the substance with the broadest base of evidence across treatment scenarios. Conclusions . Although major advances have been made since the fi rst edition of this guideline in 2004, there are still areas of uncertainty, especially the prevention of depressive episodes and optimal long-term treatment of Bipolar II patients.
362 citations
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Book•
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TL;DR: The brain's default state: self-organized oscillations in rest and sleep, and perturbation of the default patterns by experience.
Abstract: Prelude. Cycle 1. Introduction. Cycle 2. Structure defines function. Cycle 3. Diversity of cortical functions is provided by inhibition. Cycle 4. Windows on the brain. Cycle 5. A system of rhythms: from simple to complex dynamics. Cycle 6. Synchronization by oscillation. Cycle 7. The brain's default state: self-organized oscillations in rest and sleep. Cycle 8. Perturbation of the default patterns by experience. Cycle 9. The gamma buzz: gluing by oscillations in the waking brain. Cycle 10. Perceptions and actions are brain state-dependent. Cycle 11. Oscillations in the "other cortex:" navigation in real and memory space. Cycle 12. Coupling of systems by oscillations. Cycle 13. The tough problem. References.
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TL;DR: This document has been approved by the AASLD, the Infectious Diseases Society of America, and the American College of Gastroenterology.
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TL;DR: Caffeine is the most widely consumed behaviorally active substance in the world and almost all caffeine comes from dietary sources (beverages and food).
Abstract: Caffeine is the most widely consumed behaviorally active substance in the world. Almost all caffeine comes from dietary sources (beverages and food), most of it from coffee and tea. Acute and, especially, chronic caffeine intake appear to have only minor negative consequences on health. For this
2,395 citations
TL;DR: The 193 peer reviewed MRI studies reported in the current review span the period from 1988 to August, 2000 and have led to more definitive findings of brain abnormalities in schizophrenia than any other time period in the history of schizophrenia research.
2,298 citations