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21 Aug 2019
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Roshini Claire Anthony, 20 Aug 2019

The combination of emtricitabine and dolutegravir with either a tenofovir alafenamide fumarate (TAF) or tenofovir disoproxil fumarate (TDF)-based regimen fared similarly to a TDF-emtricitabine-efavirenz regimen in reducing HIV-1 RNA levels, according to results of the phase III ADVANCE* study presented at IAS 2019.

Carbamazepine, valproic acid may pose increased stroke risk in bipolar patients

22 Jul 2019

Mood stabilizers for bipolar disorder are implicated in the risk of stroke, which appears to vary among the different types of drugs, as suggested in a recent study. Carbamazepine carries the highest risk of stroke, followed by valproic acid, whereas lithium and lamotrigine have a null effect.

The study used data from the Taiwan National Health Insurance Research Database and identified 19,433 patients with bipolar disorder. Of these, 609 developed stroke. Researchers applied 14-day windows to evaluate the acute exposure effect of individual mood stabilizers on the risk of ischaemic, haemorrhagic and other types of stroke in the study population.

Mood stabilizers overall were associated with about a 20-percent increase in stroke risk (adjusted risk ratio, 1.26; p=0.041).

On separate analysis, acute exposure to carbamazepine posed the highest risk of stroke (adjusted risk ratio [RR], 1.68; p=0.018), especially the ischaemic type (adjusted RR, 1.81; p=0.037). Acute exposure to valproic acid, on the other hand, was associated with a heightened risk of haemorrhagic stroke (adjusted RR, 1.76; p=0.022).

Acute exposure to neither lithium nor lamotrigine significantly increased the risk of any type of stroke.

The current data may be used as a guide for choosing which mood stabilizers to use in the management of patients with bipolar disorder who require acute therapy for affective symptoms and who already have the risk factors for stroke, according to the researchers.

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Most Read Articles
21 Aug 2019
Daily use of the selective oral Bruton’s tyrosine kinase inhibitor evobrutinib in the treatment of patients with relapsing multiple sclerosis helps reduce the number of gadolinium-enhancing lesions, according to the results of a phase II trial.
20 Aug 2019
The combination of pravastatin and sorafenib does not appear to improve survival in patients with hepatocellular carcinoma (HCC), a recent study has shown.
08 Jul 2017
Entecavir and lamivudine demonstrate comparable effects on the mortality rate of patients with chronic hepatitis B virus (HBV)-related acute exacerbation with or without acute-on-chronic liver failure (ACLF), reports a study. In patients with ACLF, however, entecavir delivers a more favourable long-term outcome and is associated with greater clinical improvements.
Roshini Claire Anthony, 20 Aug 2019

The combination of emtricitabine and dolutegravir with either a tenofovir alafenamide fumarate (TAF) or tenofovir disoproxil fumarate (TDF)-based regimen fared similarly to a TDF-emtricitabine-efavirenz regimen in reducing HIV-1 RNA levels, according to results of the phase III ADVANCE* study presented at IAS 2019.