Augmenting pharmacotherapy with neuromodulation techniques for the treatment of bipolar disorder: a focus on the effects of mood stabilizers on cortical excitability
| Autor: | F. Di Carlo, Elena Picutti, M. Di Giannantonio, D. Viceconte, Lorenza Lucidi, Giovanni Martinotti, Rita Santacroce, Chiara Montemitro, Marie-Christine Alessi, Mauro Pettorruso |
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| Rok vydání: | 2019 |
| Předmět: |
Bipolar Disorder
medicine.medical_treatment Transcranial Direct Current Stimulation Treatment of bipolar disorder 03 medical and health sciences 0302 clinical medicine Antimanic Agents medicine Humans Pharmacology (medical) Bipolar disorder Neurostimulation Pharmacology Transcranial direct-current stimulation business.industry General Medicine medicine.disease Combined Modality Therapy Antidepressive Agents Neuromodulation (medicine) Transcranial magnetic stimulation Mood 030220 oncology & carcinogenesis Brain stimulation Cortical Excitability Lithium Compounds business Neuroscience 030217 neurology & neurosurgery Antipsychotic Agents |
| Zdroj: | Expert Opinion on Pharmacotherapy. 20:1575-1588 |
| ISSN: | 1744-7666 1465-6566 |
| DOI: | 10.1080/14656566.2019.1622092 |
| Popis: | Introduction: Mood stabilizers and antipsychotics have been demonstrated to be effective in Bipolar Disorder, with lithium as the gold standard. However, the presence of adverse events and treatment-resistance is still a relevant issue. To this respect, the use of brain stimulation techniques may be considered as an augmentation strategy, with both Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) having shown some level of efficacy in bipolar patients although clinical trials are still not sufficient to draw any conclusion. Areas covered: The authors have conducted a systematic review of the literature, in order to evaluate the role of mood stabilizers on neural activity and cortical excitability. Furthermore, the article reviews neuromodulation techniques and highlights the potential of integrating pharmacological first-line therapies with these techniques to treat BD patients. Expert opinion: The combination of neuromodulation techniques and available pharmacotherapies is a valuable opportunity which is not undermined by specific effects on cortical excitability and could improve BD patient outcome. Neurostimulation techniques may be considered safer than antidepressant treatments in BD, with a lower level of manic switches and may represent a new treatment strategy in BD depressive episodes. |
| Databáze: | OpenAIRE |
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