Értelem és érzelem: A bipoláris affektív zavar, mint a kogníciók és affektusok csatatere - Lamotrigin mint békefenntartó

Translated title of the contribution: Sense and sensibility: Bipolar affective disorder as a battlefield of cognitions and emotions - Lamotrigine therapy as a peacekeeper

J. Kálmán, Kálmán János

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

The cortico-limbic dysregulation theory of bipolar affective disorder (BAD) is supported by ample of recent research evidences. This concept is based on the dysharmonic regulation of prefrontal and anterior limbic structures manifested in a strong interaction of cognitive and affective symptoms. The major aim of the present review is to characterize the BAD specific cognitive profile and to describe the cognitive syndrome of BAD during the natural course of the disorder, based on recent findings in neurobiology, neuropathology, neuroradiology, cognitive psychology and neurogenetics. The authors recommend that BAD-associated cognitive symptoms should always be considered during the recognition, follow up and treatment phases of the disorder. The importance of the cognitive syndrome is also emphasized from the aspects of outcome and existing therapeutic regimens of the disorder. The cognitive syndrome-associated perspective of BAD could therefore provide new approaches regarding the long-term management issues of patients. Evidence from recent clinical trials is also summarized regarding the interactions of existing BAD treatment options with cognitive symptoms of the disorder, since all of the recommended antipsychotics and antiepileptics have a certain degree of cognitive toxicity. Based on the overview of the existing clinical trials, it was concluded that lamotrigine has the smallest cognitive toxicity among the mood stabilizers used for the treatment of BAD type-2. Therefore, as far as the cognitive toxicity profile is concerned, lamotrigine is recommended as the most promising therapeutic approach both for the treatment of bipolar depressive phases and relapse prevention. In addition, neuroprotective properties of the same molecule might also be beneficial regarding the proposed pathomechanism of BAD.

Original languageHungarian
Pages (from-to)357-368
Number of pages12
JournalNeuropsychopharmacologia Hungarica
Volume12
Issue number2
Publication statusPublished - Jun 2010

Fingerprint

Mood Disorders
Bipolar Disorder
Cognition
Emotions
Neurobehavioral Manifestations
Therapeutics
Affective Symptoms
Neurobiology
lamotrigine
Secondary Prevention
Anticonvulsants
Antipsychotic Agents
Meta-Analysis
Clinical Trials
Psychology
Research

ASJC Scopus subject areas

  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Neuropsychology and Physiological Psychology
  • Clinical Neurology

Cite this

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title = "{\'E}rtelem {\'e}s {\'e}rzelem: A bipol{\'a}ris affekt{\'i}v zavar, mint a kogn{\'i}ci{\'o}k {\'e}s affektusok csatatere - Lamotrigin mint b{\'e}kefenntart{\'o}",
abstract = "The cortico-limbic dysregulation theory of bipolar affective disorder (BAD) is supported by ample of recent research evidences. This concept is based on the dysharmonic regulation of prefrontal and anterior limbic structures manifested in a strong interaction of cognitive and affective symptoms. The major aim of the present review is to characterize the BAD specific cognitive profile and to describe the cognitive syndrome of BAD during the natural course of the disorder, based on recent findings in neurobiology, neuropathology, neuroradiology, cognitive psychology and neurogenetics. The authors recommend that BAD-associated cognitive symptoms should always be considered during the recognition, follow up and treatment phases of the disorder. The importance of the cognitive syndrome is also emphasized from the aspects of outcome and existing therapeutic regimens of the disorder. The cognitive syndrome-associated perspective of BAD could therefore provide new approaches regarding the long-term management issues of patients. Evidence from recent clinical trials is also summarized regarding the interactions of existing BAD treatment options with cognitive symptoms of the disorder, since all of the recommended antipsychotics and antiepileptics have a certain degree of cognitive toxicity. Based on the overview of the existing clinical trials, it was concluded that lamotrigine has the smallest cognitive toxicity among the mood stabilizers used for the treatment of BAD type-2. Therefore, as far as the cognitive toxicity profile is concerned, lamotrigine is recommended as the most promising therapeutic approach both for the treatment of bipolar depressive phases and relapse prevention. In addition, neuroprotective properties of the same molecule might also be beneficial regarding the proposed pathomechanism of BAD.",
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