Most Read Articles
Roshini Claire Anthony, 11 Sep 2019

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.

Elvira Manzano, 3 days ago

The US Preventive Services Task Force (USPSTF), in an update of its 2013 recommendations, called on clinicians to offer risk-reducing medications to women who are at increased risk for breast cancer but at low risk for adverse effects.

Pearl Toh, 4 days ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.
14 Sep 2019
In type 2 diabetes patients taking sulfonylureas, hypoglycaemia duration is longer at night and is inversely correlated with the level of glycated haemoglobin (HbA1c), a new study reports.

Methylphenidate monotherapy ups risk of mania in patients with bipolar disorder

14 Apr 2017

There is no positive association between methylphenidate and treatment-emergent mania among patients with bipolar disorder simultaneously taking a mood-stabilizing medication, reports a new study. This is clinically important given that up to 20 percent of individuals with bipolar disorder have comorbid attention deficit hyperactivity disorder.

Researchers used linked Swedish national registries to identify adults (n=2,307) with bipolar disorder who initiated therapy with methylphenidate between 2006 and 2014. The participants were divided into those with and those without concomitant mood-stabilizing treatment.

Cox regression analyses were used to adjust for individual-specific confounders, including disorder severity, genetic makeup and early environmental factors, conditioning on individual to compare the mania rate (defined as hospitalization for mania or a new dispensation of stabilizing medication) 0 to 3 and 3 to 6 months after medication initiation following nontreated periods.

Methylphenidate monotherapy demonstrated an increased rate of manic episodes in patients within 3 months of medication start (hazard ratio [HR], 6.7; 95 percent CI, 2.0 to 22.4), with similar results for the subsequent 3 months.

In contrast, patients receiving mood stabilizers had lower risk of mania after starting methylphenidate (HR, 0.6; 0.4 to 0.9). There were similar results seen when only hospitalizations for mania were counted.

“Given the markedly increased hazard ratio of mania following methylphenidate initiation in bipolar patients not taking mood stabilizers, careful assessment to rule out bipolar disorder is indicated before initiating monotherapy with psychostimulants,” researchers said.

A national registry study found a similar result, in which antidepressant monotherapy correlated with an elevated mania risk. It added that there was no risk of mania in patients taking an antidepressant while treated with a mood stabilizer. These findings stressed the importance of avoiding antidepressant monotherapy in the treatment of bipolar disorder. [Am J Psychiatry 2014;171:1067-73]

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Most Read Articles
Roshini Claire Anthony, 11 Sep 2019

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.

Elvira Manzano, 3 days ago

The US Preventive Services Task Force (USPSTF), in an update of its 2013 recommendations, called on clinicians to offer risk-reducing medications to women who are at increased risk for breast cancer but at low risk for adverse effects.

Pearl Toh, 4 days ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.
14 Sep 2019
In type 2 diabetes patients taking sulfonylureas, hypoglycaemia duration is longer at night and is inversely correlated with the level of glycated haemoglobin (HbA1c), a new study reports.