Pharmacotherapy of Bipolar Disorders

Jean-Michel Aubry is a psychiatrist and psychotherapist. He is privat docent at the Medical School of the University of Geneva where he teaches Neurosciences and Psychiatry. As head of a specialised programme for bipolar disorders at the Department of Psychiatry of the Geneva University Hospital, Dr Aubry's research interests include the pharmacologicala and psychosocial treatments of bipolar disorders and more specifically, relapse prevention. Francois Ferrero is psychiatrist, psychotherapist, professor of psychiatry and chair of the Department of Psychiatry of the University of Geneva. His research in the domain of bipolar disorders aims to better specify the epidemiology and the links with genetics and the environment in order to develop and evaluate ever more effective therapeutic and preventive approaches. Nicolas Schaad is the pharmacist in charge of the pharmacy la Cote that serves the hospital network of the Geneva-Lausanne region. Within this structure, he has developed a clinical pharmacy service. He is privat docent in the pharmacy section, and he also teaches in the Department of Fundamental Neurosciences at the University of Geneva. For the past few years, his research interests have been oriented towards a psychopharmacology applied to psychiatric disorders. Mark S. Bauer is Professor in the Department of Psychiatry and Human Behavior at Brown University and on staff in the Mental Health service of the Department of Veterans Affairs Medical Center in Providence, Rhode Island, USA. He has been recognized with awards for his research, clinical expertise and teaching skills. He served for 11 years on the Scientific Advisory Board for the Depression and Bipolar Support Alliance and has been named Exemplary Psychiatrist by the National Alliance for the Mentally Ill.

Foreword. Preface by N. Sartorius. Chapter 1 Epidemiology of bipolar disorders. Contribution of epidemiological studies to the diagnosis. The definition of bipolar disorder (BD). Demographic and social variables. A few important historical epidemiological studies. Other studies carried out in the general population. Key points. References. Chapter 2 Classification of bipolar disorders. Mania. Hypomania. Cyclothymia. Hyperthymia and hyperthymic temperament. Bipolar depression. Depressive mixed states (DMX). Mixed mania. Bipolar I disorder. Bipolar II disorder. Bipolar III disorder (Pharmacological hypomania). Bipolar IV disorder. Rapid cycling. Minor bipolar disorders. Some open questions. Key points. References. Chapter 3 How to define a mood stabilizer. The definitions of a mood stabilizer. Key points. References. Chapter 4 Lithium. History. Mode of action. Clinical studies. Principal indications. Pharmacokinetic and metabolism. Interactions. Medications that can be administered with lithium. Side effects. Practical aspects. Key points. References. Chapter 5 Carbamazepine. History. Mode of action. Clinical studies. Principal indications. Pharmacokinetic and metabolism. Interactions. Side effects. Practical aspects. Key points. References. Chapter 6 Lamotrigine. History. Mode of action. Clinical studies. Principal indications. Pharmacokinetic and metabolism. Interactions. Side effects. Practical aspects. Key points. References. Chapter 7 Topiramate. History. Mode of action. Clinical studies. Pharmacokinetic and metabolism. Interactions. Side effects. Practical aspects. Key points. References. Chapter 8 Valproic acid. History. Mode of action. Clinical studies. Principal indications. Pharmacokinetic and metabolism. Interactions. Side effects. Practical aspects. Key points. References. Chapter 9 The role of atypical or second generation antipsychotics. What is an atypical antipsychotic? For the pharmacologist. For the clinician. Side effects. Effects on memorization processes. Interactions. Antipsychotics and bipolar disorder. Atypical or second generation antipsychotics and the treatment of mania. Atypical or second generation antipsychotics and the treatment of depression. Atypical or second generation antipsychotics and maintenance treatment. Key points. References. Chapter 10 Other medications used for bipolar disorders. Gabapentin. Oxcarbazepine. Calcium channel blockers. Omega-3 fatty acids. Key points. References. Chapter 11 Medications that may potentially induce a depressive state. References. Chapter 12 Medications that may potentially induce a (hypo)manic syndrome. References. Chapter 13 Maintenance treatment: when should be a long term treatment introduced. Initiating treatment during a manic or mixed episode. Initiating treatment during a depressive episode. Initiating treatment during an euthymic period. Choosing a maintenance treatment. Key points. References. Chapter 14 Treatment of the depressive phases of bipolar disorders. Antidepressants. Risk of manic switch. Duration of antidepressant treatment. Antidepressant discontinuation syndromes. Mood stabilizers. Antipsychotics. Depression in the absence of a mood stabilizer. Depressive relapse despite a mood stabilizing treatment. Depressive relapse despite a combined treatment. Resistant depression. Key points. References. Chapter 15 Treatment of Bipolar II disorder. Treatment of bipolar II depression. Treatment of hypomania. Long-term treatment. Key points. References. Chapter 16 Treatment of manic phases. Different sub-types of mania. Treatment of hypomania. Treatment of euphoric mania. Treatment of dysphoric mania. Treatment of mania with psychotic symptoms. Treatment of mania in patients with rapid cycling. Other psychotropic drugs in evaluation for the treatment of mania. Other treatments. Key points. References. Chapter 17 Treatment of rapid cycling. Lithium. Valproate. Carbamazepine and oxcarbazepine. Lamotrigine. Other anticonvulsants. Clozapine and other atypical antipsychotics. Thyroid hormones. Key points. References. Chapter 18 Treatment of mixed states. Lithium. Valproate. Carbamazepine. Other anticonvulsants. Antidepressants. Antipsychotics. Key points. References. Chapter 19 Combination treatments. Combination treatments for mania. Combination treatments for depression. Combination treatments for relapse prevention. Treatment combinations and side effects. Treatment combinations and interactions. Key points. References. Chapter 20 Bipolar disorders, pregnancy and breastfeeding. Pregnancy and the risk of relapse. Risk of relapse during the postpartum period. Psychotropic medication and the risks for the fetus. Key points. Breastfeeding. Key points. References. Chapter 21 Bipolar disorders in children and adolescents. Clinical characteristics and differential diagnosis. Pharmacological treatments. Lithium. Valproate. Carbamazepine. Other treatments. Juvenile bipolar disorder and relapse prevention treatment. Key points. References. Chapter 22 Bipolar disorders in geriatric patients. Epidemiology. Clinical presentation and diagnosis. Secondary mania and comorbidity with certain neurological disorders. Disinhibition syndromes. Bipolar III disorder. Pharmacological treatments. Key points. References. Appendix. 1. Diagnostic criteria ICM 10. 2. Diagnostic criteria DSM IV. 3. FDA approved medications for the treatment of bipolar disorders. 4. Major guidelines for bipolar disorders. 5. Trade names of selected drugs used in bipolar disorders. List of abbreviations. Index.