Peripheral PDLIM5 expression in bipolar disorder and the effect of olanzapine administration

<p>Abstract</p> <p>Background</p> <p>One of the genes suggested to play an important role in the pathophysiology of bipolar disorder (BPD) is <it>PDLIM5</it>, which encodes LIM domain protein. Our main objective was to examine the effect of olanzapine treatment on <it>PDLIM5</it> mRNA expression in the peripheral blood leukocytes of BPD patients.</p> <p>Methods</p> <p>We measured the expression of <it>PDLIM5</it> mRNA from 16 patients with BPD Type I after 0, 4, and 8 weeks of treatment with olanzapine using quantitative real-time PCR. The Young Mania Rating Scale was used to evaluate the severity of manic symptoms in BPD patients. We also compared <it>PDLIM5</it> mRNA expression in treatment-naïve BPD patients with that in healthy control subjects.</p> <p>Results</p> <p>No significant difference was found in <it>PDLIM5</it> mRNA expression between patients before olanzapine treatment and following 4 and 8 weeks of treatment (<it>p</it>>0.05). Although we observed a significant reduction in the severity of manic symptoms in all BPD patients (<it>p</it><0.05), the effectiveness of the medication did not significantly correlate with the expression of <it>PDLIM5</it> mRNA (<it>p</it>>0.05). Interestingly, <it>PDLIM5</it> mRNA expression differed significantly between treatment-naïve BPD patients and healthy control subjects (<it>p</it>=0.002).</p> <p>Conclusion</p> <p><it>PDLIM5</it> mRNA expression did not appear to be a reflection of the efficacy of olanzapine in reducing the manic symptoms of BPD. The significant difference in expression of <it>PDLIM5</it> mRNA in the peripheral blood leukocytes of treatment-naïve BPD patients versus that of healthy control subjects, however, suggests that it may be a good biological marker for BPD.</p

Polypharmacy Patterns: Unravelling Systematic Associations between Prescribed Medications

OBJECTIVES: The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy, and the clinical interpretation of the associations found in each pattern. METHODS: A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy database in 2008. An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy. The analysis was stratified by age and sex. RESULTS: Seven patterns of polypharmacy were identified, which may be classified depending on the type of disease they are intended to treat: cardiovascular, depression-anxiety, acute respiratory infection (ARI), chronic obstructive pulmonary disease (COPD), rhinitis-asthma, pain, and menopause. Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication (i.e., ARI and COPD patterns). Other patterns were more complex but also clinically consistent: in the cardiovascular pattern, drugs for the treatment of known risk factors—such as hypertension or dyslipidemia—were combined with other medications for the treatment of diabetes or established cardiovascular pathology (e.g., antiplatelet agents). Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern. CONCLUSIONS: The present study demonstrated the existence of non-random associations in drug prescription, resulting in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population. This finding necessitates future longitudinal studies to confirm some of the proposed causal associations. The information discovered would further the development and/or adaptation of clinical patient guidelines to patients with multimorbidity who are taking multiple drugs

Psychiatric and physical outcomes of long-term use of lithium in older adults with bipolar disorder and major depressive disorder: A cross-sectional multicenter study

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