RESUMO
ADHD and bipolar disorder (BP) commonly coexist, and both share key symptoms, depending on affective state and emotional dysregulation. The overlap poses diagnostic challenges and may lead to underdiagnoses. Comorbid cases exhibit worsened symptom burden, increased psychiatric morbidity, admissions, and suicide attempts. Treating BP before ADHD is recommended. Stimulant use combined with mood stabilisers may be effective and relatively safe; however, this review finds that well-designed randomised controlled studies in the area is warranted.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno Bipolar , Estimulantes do Sistema Nervoso Central , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/diagnóstico , Adulto , Estimulantes do Sistema Nervoso Central/uso terapêutico , Estimulantes do Sistema Nervoso Central/efeitos adversosRESUMO
This review aims at RCT's of psychedelics used in the treatment of depression and PTSD. Psilocybin has shown an antidepressant effect in cancer patients that was sustained at 6- and 12-months follow-up. The effect of psilocybin was comparable to escitalopram in one study. Ketamine has shown effect for the treatment of resistant depression. Phase 2 and 3 trials have shown the effect of MDMA on PTSD. No serious adverse events were reported in controlled settings, but larger studies are needed to establish safety and long-term effects.
Assuntos
Alucinógenos , Ketamina , Transtornos Mentais , Humanos , Psilocibina , Ketamina/efeitos adversos , EscitalopramRESUMO
Antipsychotics are associated with significant weight gain and other metabolic side effects. There are, however, substantial differences in their propensity for causing metabolic side effects as summarised in this review. These differences are important to consider when deciding which antipsychotic to use. Given the risk of metabolic side effects, patients should be closely monitored regarding anthropometric measures and metabolic parameters. Moreover, both non-pharmacological and pharmacological interventions should be considered for treatment of antipsychotic-induced weight gain.
Assuntos
Antipsicóticos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Antipsicóticos/efeitos adversos , Humanos , Doença Iatrogênica , Aumento de PesoRESUMO
Around 1% of the population will experience at least one episode of mania. Mania has negative social consequences, may lead to cognitive impairment and may even be lethal. Therefore, prompt and efficient medical action needs to be taken, not only addressing the acute symptoms but also the high risk of recurrence. Many well-documented antimanic drugs are at hand, and the database has been carefully outlined in recent guidelines, also addressing factors of importance in choosing among the options. The real challenge is dealing with non-response, where the database is extremely poor.
