Our results suggest a high rate of lifetime concurrent anxiety disorders in bipolar disorder .
The diagnostic issues at the interface are particularly difficult because of the substantial symptom overlap .
BACKGROUND Bipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions .
Among all the potential comorbidities , co-existing anxiety disorders st and out due to their high prevalence .
AIMS To determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta- analysis .
Lurasidone as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study.
OBJECTIVE Few studies have been reported that support the efficacy of adjunctive therapy for patients with bipolar I depression who have had an insufficient response to monotherapy with mood-stabilizing agents . The authors investigated the efficacy of lurasidone , a novel antipsychotic agent , as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression . METHOD Patients were r and omly assigned to receive 6 weeks of double-blind adjunctive treatment with lurasidone  ( N=183 )  or placebo  ( N=165 ) , added to therapeutic levels of either lithium or valproate . Primary and key secondary endpoints were change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale ( MADRS ) and depression severity score on the Clinical Global Impressions scale for use in bipolar illness ( CGI-BP ) , respectively . RESULTS Lurasidone treatment significantly reduced mean MADRS total score at week 6 compared with the placebo group ( -17.1 versus -13.5 ; effect size=0.34 ) . Similarly , lurasidone treatment result ed in significantly greater endpoint reduction in CGI-BP depression severity scores compared with placebo ( -1.96 versus -1.51 ; effect size=0.36 ) as well as significantly greater improvement in anxiety symptoms and in patient-reported measures of quality of life and functional impairment . Discontinuation rates due to adverse events were 6.0 % and 7.9 % in the lurasidone and placebo groups , respectively . Adverse events most frequently reported for lurasidone were nausea , somnolence , tremor , akathisia , and insomnia . Minimal changes in weight , lipids , and measures of glycemic control were observed during treatment with lurasidone . CONCLUSIONS In patients with bipolar I depression , treatment with lurasidone adjunctive to lithium or valproate significantly improved depressive symptoms and was generally well tolerated
Our results suggest a high rate of lifetime concurrent anxiety disorders in bipolar disorder .
The diagnostic issues at the interface are particularly difficult because of the substantial symptom overlap .
BACKGROUND Bipolar affective disorder has a high rate of comorbidity with a multitude of psychiatric disorders and medical conditions .
Among all the potential comorbidities , co-existing anxiety disorders st and out due to their high prevalence .
AIMS To determine the lifetime prevalence of comorbid anxiety disorders in bipolar affective disorder under the care of psychiatric services through systematic review and meta- analysis .