Bipolar II Carlat Reports | Carlat Publishing

Research Update

From The Carlat Psychiatry Report, Schizophrenia

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Lumateperone | Second Generation Antipsychotics (SGAs)

REVIEW OF: Calabrese JR et al, Am J Psychiatry 2021. Epub ahead of print STUDY TYPE: Randomized, placebo-controlled trial In 2019, lumateperone (Caplyta) became the 13th atypical antipsychotic with FDA approval in schizophrenia. Compared to other atypicals, it is relatively well tolerated, with low rates of akathisia and metabolic side effects. On

Research Update

A Novel Treatment for Methamphetamine Use Disorder

From The Carlat Psychiatry Report, Schizophrenia

Topics: Bipolar Depression | Bipolar Disorder | Bipolar II | Lumateperone | Second Generation Antipsychotics (SGAs)

REVIEW OF: Trivedi MH et al, N Engl J Med 2021;384(2):140–153 STUDY TYPE: Randomized, double-blind, placebo-controlled trial with sequential parallel comparison design Methamphetamine use disorder is an increasing cause of overdose deaths in the US. Pharmacologic options are scarce, but pilot studies suggest that bupropion and naltrexone may be

Expert Q&A

How to Diagnose Bipolar Disorder

From The Carlat Psychiatry Report, Bipolar Disorder

TCPR: When I ask a depressed patient if they’ve ever had manic symptoms, I often run into a problem. They say, “Of course I feel more confident, energetic, and happy ... when I’m not depressed.”Dr. Parker: As it can be hard to tease apart true hypomania from normal happiness, we’ve developed a rating scale to assist, the Sydney Bipolar Screene

Clinical Update

How to Treat ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Bipolar Disorder

Topics: | | | | | | | | | | | | | | | | | | ADHD Alpha Agonists Amphetamines ArModafinil Atomoxetine Attention Deficit Hyperactivity Disorder Bipolar Disorder Bipolar II Comorbidity Guanfacine methylphenidate Modafinil Nuvigil Pharmacology Provigil Psychopharmacology Psychopharmacology Tips stimulant Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized).

Clinical Update

How to Diagnose ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Mood Disorders

Hailey is a 24-year-old woman with bipolar II disorder who has recently come out of a mixed episode. Although her mood symptoms have resolved, she is distracted easily, has difficulty organizing her work, and often forgets important tasks. She read about ADHD online and asks if she can have a stimulant to help her focus. ADHD and hypomania share many

Expert Q&A

Overdiagnosis in Psychiatry

From The Carlat Psychiatry Report, Overdiagnosis

TCPR: Which disorders are the most overdiagnosed in psychiatry? Dr. Paris: At the top of the list are major depression, PTSD, bipolar II, adult ADHD, and—this one is a recent addition because it used to be underdiagnosed—borderline personality disorder. Each of these conditions may be underdiagnosed in some settings as well, but they have also been

Research Update

Maintenance Pharmacotherapy of Bipolar Disorder: How Long Is Long Enough?

From The Carlat Psychiatry Report, Problems with Generics

Review of: Kishi T et al, Psychol Med 2020 Oct 13:1–9; PMID: 33046156 Type of study: Meta-analysis of double-blind, randomized placebo-controlled trials Bipolar disorder is a lifelong illness whose treatment is an ongoing challenge, complicated not least by difficulties in treatment adherence. What do we know and what can we tell our patients about

Clinical Update

How to Use Lamotrigine

From The Carlat Psychiatry Report, Mind-Gut Connection

Lamotrigine is FDA approved as maintenance treatment for bipolar disorder—that is, for delaying episodes of depression, hypomania, or mania. However, it is not approved for active depression or mania—which has given it a reputation as a “light” mood stabilizer. For patients who appreciate tolerability, that’s a good thing, but it isn’t the f

Research Update

Mood Stabilizers: What You Don’t Know Can Hurt Them

From The Carlat Psychiatry Report, Mood and Menopause

Review of: Bai Y et al, J Clin Psychopharmacol 2020;40(2):167–179 STUDY TYPE: Combined meta-analysis and literature review of placebo-controlled trials Medication adherence is an ongoing struggle in bipolar disorder, and it’s compounded by the fact that our patients often don’t advertise their non-adherence. While numbers vary, reviews general

Expert Q&A

Who Should Get Lithium?

From The Carlat Psychiatry Report, When to Use Lithium

TCPR: Lithium has been called the gold-standard treatment in bipolar disorder. Why is it not used more often? Dr. Rybakowski: That is a paradox. On the one hand, lithium is accepted as a first-line treatment for bipolar disorder, but it is also greatly underutilized. And I think there are two main reasons. One is aggressive promotion of branded mood st

Research Update

A New Antipsychotic for Bipolar Depression

From The Carlat Psychiatry Report, Traumatic Brain Injury

Lumateperone (Caplyta) just hit the pharmacy shelves with FDA approval in schizophrenia (see TCPR March 2020), and its manufacturer is pursuing further approval for bipolar depression. So far they’ve completed two phase III trials—one negative and one positive—and the positive one was presented in poster form by Suresh Durgam and colleagues at the