Dear colleagues,
I am delighted to introduce to you our seventh issue of 2016 featuring up-to-date research on treatment methods in bipolar disorder and schizophrenia as well as transcranial magnetic stimulation in alcoholism and in Tourette syndrome.
Oldani and colleagues review the recent literature on brain stimulation treatments in resistant bipolar disorder (BD) with a specific focus on the hypomanic/manic symptoms. They conclude that brain stimulation treatments look promising in the treatment of the depressive phase of BD while results are uncertain during manic phase. However, results are limited and further studies are needed in order to determine the treatment effect.
Murru and co-workers aimed to systematically review the literature about antipsychotic switching in schizoaffective disorder. Their results indicate preferential switching to aripiprazole and lurasidone and less favourably to risperidone and ziprasidone. Antipsychotic switching would however need a better profiling and the authors suggest that clinicians should bear the receptor binding characteristics of drugs in mind in order to optimize switching.
Baandrup and associates assessed whether prolonged-release melatonin could facilitate the withdrawal of long-term benzodiazepine usage in bipolar and schizophrenic patients. Of 86 patients, 42 received melatonin while 44 received a placebo. The authors did not detect any effect of melatonin on benzodiazepine dosage at 24 weeks. Therefore, they concluded that prolonged-release melatonin does not seem to promote benzodiazepine discontinuation.
Uemura and colleagues aimed to investigate the effects of genetic variants on intracellular calcium dyshomeostasis (ICDH) in bipolar disorder and major depressive disorder patients. An association was detected between a SNP within the CACNA1C gene with bipolar disorder type I (BD-I). Additionally, Ca2+ levels were significantly higher in BD-I patients carrying the A allele in comparison to healthy controls A carriers as well as GG allele carriers. These findings suggest that this genetic variant is associated with BD-I and may increase the risk of ICDH in BD-I.
Lackner and associates sought to investigate the relationship between body fat distribution and domains of cognition in bipolar disorder patients during euthymia. They found that obesity was indeed associated with poorer cognitive performance. Association between verbal learning and memory were found in females, while associations with poor performance on the Trail Making Test and the Stroop interference task in males.
By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG), Naim-Feil et al., assessed cortical inhibition and excitability in the prefrontal cortex (PFC) and motor cortex (MC) in alcohol-dependent patients post-detoxification. Results revealed alterations in cortical excitability in the MC that may indicate hyper-excitability within the MC to be associated with chronic alcohol consumption. Additionally, the authors detected reduced inhibiton in the PFC.
In their brief report, Bloch and associates examined repititive transcranial magnetic stimulation (rTMS) as an add-on treatment for intractable Tourette syndrome. Applying rTMS to the supplementary motor area in patients with combined TS and obsessive compulsive disorder (OCD) resulted in significant improvement in tic severity in addition to patients showing no side effects.
In a letter to the Editor, Grözinger and Conca, discuss the importance of electroconvulsive therapy (ECT) as a treatment option in psychiatric diseases and a commonly passed transnational statement regarding the use of ECT.
Yours sincerely,
Siegfried Kasper, MD
Chief Editor