Highlights from BNN Articles in 2020

(Issue # 1).  Family focused therapy (FFT) effective for bipolar prodrome; At risk youth do poorly on SSRIs;  Lurasidone effective over 2-3 years; Prazosin good for PTSD in children;  Hafeman et al in Colby lithium better than ACs and AAs;  Birmaher says delay in Rx of child bipolar led to more suicide attempts, completed suicides, substance abuse, and school failure; BP-NOS is severe, requires concerted Rx and converts to BP I & II 50% if family Hx is positive; Post says combination Rx of BP child most often necessary.

(Issue # 2).  Accelerated intermittent theta burst TMS (aiTBS) rapidly effective for depression and PTSD; cannabis withdrawal symptoms in half of regular users; tDCS for 30 mintes  for 20 days may help OCD; Environmental effects (stress and drugs) can leave long lasting epigenetic scars and some convey to next generation;  Gabapentin 1200mg/day helpful for reducing heavy alcohol use.

(Issue # 3). Lumateperone (Caplyta) 42mg effective in BP depression;  Hafeman predictors of risk for BP include low level mania, depression, anxiety, mood lability, poor functioning, and early age of onset in BP parent.

Highlights from BNN Articles in 2019, Issues 1-3

(Issue # 1).  Suicide rate in 18,000 lowest with LA injectables, lithium (Li), highest with antidepressants; positive family Hx of Li response yields 68.8% Li response while only 22% responded when on family Hx of Li response; ketamine rapid acting via block glutamate NMDA receptor and increasing AMPA activity; in UP depression high CRP predicts poor response to SSRIs and good response to bupropion, nortriptyline, minocycline, L-methylfolate, and most interestingly good response to lurasidone in children and adults; low acetyl-L-carnitine in Rx refractory depressed adults especially those with childhood trauma Hx.

(Issue #2).  Adding 200mg of coenzyme Q10 remitted BP depression in 72% while only 12% on placebo; folate 4mg safe before 12 weeks of pregnancy; family focused therapy recommended for high risk youth and good rationale but little data for N-acetylcycteine (NAC) and acetyl-L-carnitnine; B12 helped children with autism.

(Issue #3).  Li FDA-approved for age 7-17;  Li reverses white matter alterations in BP;  Don’t stop Li when it is working well as re-response may not occur in 10%; Li reverses cortex thinning in BP;  Inflammation associated with cognitive deficits;  NAC N-acetylcysteine helps BD and reduces habits and drug use and helps PTSD in those with depression and substance abuse; in mice knock out of CLOCK gene mimics Sx in BD.

‍