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IN THIS MONTH'S ISSUE:
April 2015

Antidepressants and the Risk of a Manic Switch in Young Bipolar Patients
Current evidence suggests that antidepressants are associated with a substantially increased risk of precipitating a manic switch in children and adolescents with bipolar disorder.

Start Lithium Early?
Starting lithium early in the course of bipolar disorder appears to improve the probability of an excellent response to lithium.

New-Onset Cardiovascular Disease in Bipolar Disorder Patients
Patients with bipolar I or bipolar II disorder experience cardiovascular disease earlier in their lives and at a higher rate than the general population and than patients with major depressive disorder.

In Brief
Attention-Deficit/Hyperactivity Disorder (ADHD) Is Associated with Increased Mortality; Depressive, Anxiety, and Behavioral Disorders May Be Risk Factors for Bipolar Disorder

Antipsychotics and Mortality in Schizophrenia
Examining a nationwide cohort of patients with schizophrenia, investigators in Finland found that the highest risk of mortality was associated with no antipsychotic treatment, and the next highest risk came from high antipsychotic doses.

Anticholinergic Drugs for Dementia Patients
A majority of nursing home residents with dementia are treated with anticholinergic agents, which may counteract the benefits of acetylcholinesterase inhibitors and directly impair memory and cognition.

A Message from Alan J. Gelenberg, M.D.

When I first started writing BTP in the 1970s, it was to bridge the gap between new knowledge in our field and its application to patient care. Over the decades since, the need for this bridge has become even greater. Neuroscience rockets forward. Psychiatrists and other clinicians have a broader array of treatments for patients with mental disorders than we even dreamed of back then. But we have less time to spend with patients and less time to keep up with developments that affect treatment decisions. Our medications, and those prescribed by colleagues in other specialties, are more varied, complex, and prone to interactions. What were formerly crisp boundaries between major psychopharmacologic categories are now murky.

This makes the modern practice of psychiatry challenging—but also fun and promising. With the expanding armamentarium of treatment options comes enhanced ability to alleviate suffering. The mission of BTP remains constant, even while the field grows. We are still here to bridge the gap, to make science applicable and relevant, and to help you in your day-to-day work relieve distress and improve function in patients' lives.