Showing papers by "Peter C. Whybrow published in 2010"

Subsyndromal Mood Symptoms: A Useful Concept for Maintenance Studies of Bipolar Disorder?

Abstract: Objective: To explore the measurement of subsyndromal mood symptoms in relation to studies of maintenance therapy for bipolar disorder. Methods: Literature review

The association between concurrent psychotropic medications and self-reported adherence with taking a mood stabilizer in bipolar disorder

Abstract: Objective Multiple psychotropic medications are routinely prescribed to treat bipolar disorder, creating complex medication regimens. This study investigated whether the daily number of psychotropic medications or the daily number of pills were associated with self-reported adherence with taking a mood stabilizer. Methods Patients self-reported their mood and medications taken daily for about 6 months. Adherence was defined as taking at least one pill of any mood stabilizer daily. Univariate general linear models (GLMs) were used to estimate if adherence was associated with the number of daily medications and the number of pills, controlling for age. The association between mean daily dosage of mood stabilizer and adherence was also estimated using a GLM. Results Three hundred and twelve patients (mean age 38.4 ± 10.9 years) returned 58,106 days of data and took a mean of 3.1 ± 1.6 psychotropic medications daily (7.0 ± 4.2 pills). No significant association was found between either the daily number of medications or the daily number of pills and adherence. For most mood stabilizers, patients with lower adherence took a significantly smaller mean daily dosage. Conclusions The number of concurrent psychotropic medications may not be associated with adherence in bipolar disorder. Patients with lower adherence may be taking smaller dosages of mood stabilizers. Copyright © 2009 John Wiley & Sons, Ltd.

Regional cerebral glucose metabolism and anxiety symptoms in bipolar depression: effects of levothyroxine

Abstract: We examined the relationships between regional brain activity and anxiety in bipolar depressed patients receiving adjunctive treatment with levothyroxine. Regional brain activity was assessed with positron emission tomography and [18F]fluorodeoxyglucose in 10 euthyroid, depressed bipolar women before and after 7 weeks of adjunctive therapy with levothyroxine. The primary biological measures were relative (to global) regional radioactivity as a surrogate index of glucose metabolism in pre-selected brain regions. Relationships were assessed between regional brain activity and anxiety symptoms while controlling for depression severity. At baseline, Trait Anxiety Inventory measures covaried positively with relative brain activity bilaterally in the dorsal anterior cingulate, superior temporal gyri, parahippocampal gyri, amygdala, hippocampus, ventral striatum, and right insula; state anxiety showed a similar pattern. After treatment anxiety was improved significantly. Change in trait anxiety covaried positively with changes in relative activity in right amygdala and hippocampus. Change in state anxiety covaried positively with changes in relative activity in the hippocampus bilaterally and left thalamus, and negatively with changes in left middle frontal gyrus and right dorsal anterior cingulate. Results indicate that comorbid anxiety symptoms have specific regional cerebral metabolic correlates in bipolar depression and cannot only be explained exclusively by the depressive state of the patients.