Mindfulness Therapy Improves Anxiety in Youth with a Bipolar Parent
Children of parents with bipolar disorder are prone to anxiety and emotional dysregulation, but treating these symptoms with antidepressants can provoke symptoms of mania. Thus, non-pharmacological treatements for anxiety and depression are needed. A recent study by Melissa DelBello found that twelve weeks of mindfulness-based cognitive therapy improved symptoms of anxiety and mood dysregulation in 20 youth with a bipolar parent. DelBello used functional magnetic resonance imaging (fMRI) to observe that the therapy increased activation of brain structures related to emotion and sensing. Amygdala activation differed between those with anxiety and those with mood dysregulation, suggesting that the therapy’s effect was on regions that modulate the amygdala, including prefrontal and insular regions, rather than on the amygdala itself.
Quetiapine May Be an Effective Monotherapy for Bipolar I
An article published by Weisler et al. last year in the Journal of Clinical Psychiatry suggests that quetiapine may be effective as a monotherapy maintenance treatment for bipolar I disorder. It has previously been shown to work in combination with lithium or divalproex and is approved by the Federal Drug Administration for this combination treatment.
Adult patients diagnosed with bipolar I disorder who were currently or recently in a mood episode received open-label quetiapine in doses of 300-800mg per day for up to 24 weeks. Patients who became stable either remained on quetiapine or were switched to lithium (at doses of 0.6-1.2 mEq/L) or placebo. This double-blind phase of the study continued for up to 104 weeks.
The study began with 2,438 patients, 1,172 of whom made it to the second phase of the trial. On the main outcome measure of time to recurrence of any mood event, both quetiapine and lithium were significantly better than placebo.
Editor’s Note: In the 50% of patients with a recent mood episode who were able to be stabilized on quetiapine monotherapy, those who remained on long-term quetiapine or those who switched to lithium were both much less likely to have subsequent relapses into either depression or mania than those who switched to placebo. Whether Astra-Zeneca, the company that produces quetiapine, will file to gain Federal Drug Administration approval of quetiapine monotherapy for long-term preventive treatment is not known.
