Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode

Masatake Kurita1–3 1Koutokukai Wakamiya Hospital, Yoshihara, Yamagata, 2Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, 3Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japa...

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Autor principal:	Kurita M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	3-methoxy-4-hydroxyphenylglycol (MHPG) dopamine homovanillic acid (HVA) brain-derived neurotrophic factor (BDNF) biomarker antidepressants selective serotonin reuptake inhibitor (SSRI) serotonin and noradrenaline reuptake inhibitor (SNRI) tricyclic antidepressant (TCA) mood disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/5bd241ae75064147a98aa1fb594e40e1
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spelling	oai:doaj.org-article:5bd241ae75064147a98aa1fb594e40e12021-12-02T01:40:41ZNoradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode1178-2021https://doaj.org/article/5bd241ae75064147a98aa1fb594e40e12016-09-01T00:00:00Zhttps://www.dovepress.com/noradrenaline-plays-a-critical-role-in-the-switch-to-a-manic-episode-a-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Masatake Kurita1–3 1Koutokukai Wakamiya Hospital, Yoshihara, Yamagata, 2Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, 3Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan Abstract: Although antidepressants may increase the risk of switching to mania in bipolar disorder (BD), clinicians have been using antidepressants to treat patients with bipolar depression. Appropriate treatments for bipolar depression remain controversial. In BD, antidepressants comprise a double-edged sword in terms of their efficacy in treating depression and the increased risk of switching. This review presents an important table outlining the benefit in terms of depression improvement and the risk of switching in the clinical setting. It also proposes strategies based on the characteristics of antidepressants such as their pharmacology, specifically the equilibrium dissociation constant (KD) of the noradrenaline transporter. This table will be useful for clinicians while considering benefit and risk. Antidepressants augmenting noradrenaline may be effective in bipolar depression. However, it is easily presumed that such antidepressants may also have a risk of switching to mania. Therefore, antidepressants augmenting noradrenaline will be the recommended treatment in combination with an antimanic agent, or they may be used for short-term treatment and early discontinuation. The corresponding medical treatment guidelines probably need to be reevaluated and updated based on biological backgrounds. From previous studies, we understand that the stability of noradrenaline levels is important for BD amelioration, based on the pathophysiology of the disorder. It is hoped that researchers will reevaluate BD by conducting studies involving noradrenaline. Keywords: 3-methoxy-4-hydroxyphenylglycol, dopamine, homovanillic acid, brain-derived neurotrophic factor, biomarker, antidepressants, selective serotonin reuptake inhibitor, serotonin and noradrenaline reuptake inhibitor, tricyclic antidepressant, mood disorderKurita MDove Medical Pressarticle3-methoxy-4-hydroxyphenylglycol (MHPG)dopaminehomovanillic acid (HVA)brain-derived neurotrophic factor (BDNF)biomarkerantidepressantsselective serotonin reuptake inhibitor (SSRI)serotonin and noradrenaline reuptake inhibitor (SNRI)tricyclic antidepressant (TCA)mood disorderNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 12, Pp 2373-2380 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	3-methoxy-4-hydroxyphenylglycol (MHPG) dopamine homovanillic acid (HVA) brain-derived neurotrophic factor (BDNF) biomarker antidepressants selective serotonin reuptake inhibitor (SSRI) serotonin and noradrenaline reuptake inhibitor (SNRI) tricyclic antidepressant (TCA) mood disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	3-methoxy-4-hydroxyphenylglycol (MHPG) dopamine homovanillic acid (HVA) brain-derived neurotrophic factor (BDNF) biomarker antidepressants selective serotonin reuptake inhibitor (SSRI) serotonin and noradrenaline reuptake inhibitor (SNRI) tricyclic antidepressant (TCA) mood disorder Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Kurita M Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
description	Masatake Kurita1–3 1Koutokukai Wakamiya Hospital, Yoshihara, Yamagata, 2Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, 3Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan Abstract: Although antidepressants may increase the risk of switching to mania in bipolar disorder (BD), clinicians have been using antidepressants to treat patients with bipolar depression. Appropriate treatments for bipolar depression remain controversial. In BD, antidepressants comprise a double-edged sword in terms of their efficacy in treating depression and the increased risk of switching. This review presents an important table outlining the benefit in terms of depression improvement and the risk of switching in the clinical setting. It also proposes strategies based on the characteristics of antidepressants such as their pharmacology, specifically the equilibrium dissociation constant (KD) of the noradrenaline transporter. This table will be useful for clinicians while considering benefit and risk. Antidepressants augmenting noradrenaline may be effective in bipolar depression. However, it is easily presumed that such antidepressants may also have a risk of switching to mania. Therefore, antidepressants augmenting noradrenaline will be the recommended treatment in combination with an antimanic agent, or they may be used for short-term treatment and early discontinuation. The corresponding medical treatment guidelines probably need to be reevaluated and updated based on biological backgrounds. From previous studies, we understand that the stability of noradrenaline levels is important for BD amelioration, based on the pathophysiology of the disorder. It is hoped that researchers will reevaluate BD by conducting studies involving noradrenaline. Keywords: 3-methoxy-4-hydroxyphenylglycol, dopamine, homovanillic acid, brain-derived neurotrophic factor, biomarker, antidepressants, selective serotonin reuptake inhibitor, serotonin and noradrenaline reuptake inhibitor, tricyclic antidepressant, mood disorder
format	article
author	Kurita M
author_facet	Kurita M
author_sort	Kurita M
title	Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
title_short	Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
title_full	Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
title_fullStr	Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
title_full_unstemmed	Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
title_sort	noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/5bd241ae75064147a98aa1fb594e40e1
work_keys_str_mv	AT kuritam noradrenalineplaysacriticalroleintheswitchtoamanicepisodeandtreatmentofadepressiveepisode
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Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode

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