OBJECTIVE To review the literature on the use of lithium in the treatment of bipolar disorder and highlight the evidence base supporting its efficacy and safety. METHOD A selective literature review. RESULTS Lithium is widely believed to be effective against acute mania, acute bipolar depression and in relapse prevention to either mania or depression. In fact, the data supporting efficacy i...

This case report highlights the genetic link associated with bipolar disorder and rising prevalence of such cases in Pakistan due to the lack of knowledge and understanding of the disease. It also shows that a family history of bipolar disorder is associated with more aggressive episodes, early onset, and treatment relapse. Further studies are warranted to fully understand the pathophysiology o...

Neuropsychiatric complications of human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS) may present clinically as acute or chronic organic brain syndrome, or mimic functional psychiatric diseases. Among such psychiatric diseases, mania tends to occur with increased frequency after the onset of AIDS. We report a case in which manic manifestations were noted b...

Aims and method To assess whether a home treatment team acute relapse prevention (ARP) strategy reduces admissions to hospital with mania. A retrospective design was used to analyse records for manic admissions since 2002. The number and length of admissions and detentions pre- and post-ARP were determined and rates of admissions and detentions calculated from this. Results We found reductions ...

BACKGROUND Well-tolerated and effective therapies for bipolar mania are required. AIMS To evaluate the efficacy and tolerability of aripiprazole as acute and maintenance of effect therapy in patients with bipolar I disorder experiencing manic or mixed episodes. METHOD Patients were randomised to double-blind aripiprazole (15 or 30 mg/day; n=167), placebo (n=153) or haloperidol (5-15 mg/day,...

According to a Medical Letter review of the recently approved atypical antipsychotic asenapine (Saphris), "available data on its efficacy are not impressive." Asenapine is formulated in a sublingual tablet and is approved for acute schizophrenia and manic or mixed bipolar episodes. Its receptor affinity profile is similar to other atypicals. Three placebo-controlled trials have been conducted i...

Only ash remains after fire is gone. Metaphorically mania is the fire and depression its ash (Koukopoulos & Ghaemi 2009). What is the reason, when there is just fire without ash? Unipolar mania has been described in the literature. Different terms have been used like recurrent mania, chronic mania and persistent mania. But these are scarce diagnoses in psychiatric routine. This topic has got li...

Obesity has become a major public health problem over the past two decades. Non-surgical management of obesity does not often achieve its long term goals. Surgical treatment is roaring in popularity because of dramatic and durable results. However, outcomes from bariatric surgery have become a significant area of scrutiny because it is also associated with several medical and psychological comp...

Double-blind trials conducted in the early 1980s showed that subcutaneous injections of salmon calcitonin in patients suffering from mania resulted in significant decreases in irritability, euphoria and hyperactivity. Although these results were promising, there were no follow-up studies in this area. A MEDLINE search into the effect of calcitonin on neuronal tissues revealed that calcitonin af...

Elderly individuals who have bipolar (BP) disorder present a particular challenge to clinicians, health care services, and caregivers. They are a complex and heterogeneous group of patients who frequently have comorbidities and poor outcomes, including a high mortality rate. BP elders represent 5% to 19% of patients presenting for acute treatment at geriatric psychiatry services [1,2]. They use...