Opinion - (2022) Volume 8, Issue 5
Received: 13-Sep-2022, Manuscript No. cdp-22-76112;
Editor assigned: 16-Sep-2022, Pre QC No. P-76112;
Reviewed: 25-Sep-2022, QC No. Q-76112;
Revised: 28-Sep-2022, Manuscript No. R-76112;
Published:
30-Sep-2022
, DOI: 10.37421/2572-0791.2022.8.32
Citation: Valero, Christian. “Bipolar I Manic Switch: A Clinical and
Molecular Genetic Study.” Clin Depress 8 (2022): 32.
Copyright: © 2022 Valero C. This is an open-access article distributed under the
terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author
and source are credited.
When compared to manic episodes, bipolar depressive episodes are more common, more expensive, more disruptive to functioning, more burdensome for caregivers, and more difficult to treat. Patients with bipolar disorder often need long-term medication treatment. Despite the availability of several modern antipsychotics and the anticonvulsant lamotrigine, treatment of bipolar depression remains ineffective. Antidepressant effectiveness and safety are still debatable topics. Manic switch is a crucial therapeutic concern in the management of bipolar depression. Short-term treatment of a second antidepressant did not result in a significant decrease in the risk of mania or a significant increase in protection against depression compared to providing a mood stabilizer alone. However, continued use is linked to a higher risk of mania or hypomania that develops during treatment. In a trial with small samples, the frequency of mood shift related to acute antidepressant medication was 27%. In bipolar depression, hypomanic/manic shifts happen in 14.0–19.3% of acute treatment trials and 33.0–36.7% of follow-up trials with supplementary antidepressant therapy. A naturalistic investigation on bipolar disorder, however, came to the contrary conclusion that antidepressant medication has no effect on the daily rate of transition from depression to mania. It is encouraging to see how single nucleotide polymorphisms underlying bipolar disorder therapy effectiveness are being uncovered. In bipolar disorder, for instance, a genomewide association research has revealed particular SNPs linked to treatment responsiveness to lithium. In several earlier researches, it was claimed that female patients were more likely than male patients to have antidepressantassociated manic switch; however, no such gender difference was found in the current investigation. This disparity could be due to methodological variations. Manic switch, for instance, is described in the study as a report of mania or hypomania.
It is consistent with earlier studies and evaluations that antidepressants therapy increases the chance of a manic episode in bipolar patients after their depression has subsided. Manic transition from depression was discovered to happen more frequently in bipolar in patients receiving TCA medication than non-TCA treatment in earlier research, including a meta-analysis. Our research showed that manic transition was more frequently linked to TCA medications. Manic switch's phenotypic has caused a lot of controversy. Many studies that examine the treatment-emergent transition to mania only include participants who are taking antidepressants. Patients taking antidepressants should be eliminated if the goal is to study the bipolar disorder's normal transition to mania. In contrast to care switch, this study examined switch to mania within eight weeks of bipolar depression remission. We did not exclude participants receiving antidepressant treatment or examine only that receiving antidepressant treatment due to consideration of the sample size for GWAS. In this study, manic switch may refer to both naturally occurring switch and switch that develops during treatment. One could not completely rule out the likelihood that certain mixed affective episodes were labelled as manic switch following bipolar depression. This could increase the manic switch rate in this study. The study has its drawbacks. First, the sample size was relatively small, which may have contributed, at least in part, to our findings that some SNPs did not show a statistically significant connection once multiple testing was corrected. However, in both the discovery and replication groups, the prevalence of the risk genotype CC was higher in patients with manic switch than in those without. Second, only patients of Han ancestry were included in our study, which has the crucial benefit of eliminating the possibility of population structure confounding but also restricts the generalizability of our findings. Other psychotic and emotional problems in the patients were prohibited. We first identified 1310 BPI patients with a thorough history of their condition and treatment for the analyses of manic switch. In the analysis of manic transition, 1004 of the 1310 individuals with BPI who had at least one severe depressive episode were included. Each participant in the study signed a written informed consent form. A crucial clinical concern in the treatment of bipolar disorder is affective switch [1-5]. The advantages of using antidepressants for bipolar depression are still debatable despite being frequently recognized in clinical practice. Few genetic researches on the subject of manic transition following bipolar depression have been conducted to date, and none have used genome-wide association studies (GWAS). This study attempts to examine how manic switch risk in bipolar I disorder is affected by genetic makeup and antidepressants. Complete information on the antidepressant treatment and outcome for 1004 BPI patients who experienced at least one depressive episode was included. Using the Chinese version of the Schedules for Clinical Assessment in Neuropsychiatry, qualified mental health professionals assessed patients for mania, depression, and BPI using DSM-IV diagnostic criteria. A manic episode that occurs eight weeks or less after the end of an acute depressive episode is known as a manic flip.
In conclusion, the likelihood of a manic flip was dramatically raised by antidepressant therapy for bipolar depressive episodes. Future research on the top SNPs found in the GWAS for manic switch may be warranted.
None.
Google Scholar, Crossref, Indexed at
Clinical Depression received 89 citations as per Google Scholar report
