The management of cognitive impairment in bipolar disorder: current status and perspectives.
Bipolar disorder (BD) is associated with important cognitive deficits that persist during the periods of remission. Although these deficits seem to play an important role in the functional impairment experienced by bipolar patients, evidence regarding their clinical management is scant. We revised the databases PubMed, MEDLINE, and clinicaltrials.gov, searching for studies focusing on the pharmacological and nonpharmacological treatment of cognitive deficits among bipolar patients. In addition, a manual search of bibliographical cross-references was performed. Currently, there is no Food and Drug Administration-approved pharmacological agent for the management of cognitive deficits in BD. A number of agents have been tested in the treatment of cognitive deficits in BD, with mixed results. Nonpharmacological interventions, such as cognitive remediation and noninvasive brain stimulation techniques, seem promising, but their role has not yet been properly explored among bipolar patients. Additional studies, aiming at evaluating the efficacy of interventions combining cognitive rehabilitation and biological treatments, are highly desirable.
UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, The University of Texas Health Science Center at Houston, Houston, TX.
Marsal
M
Sanches
Isabelle E
IE
Bauer
Juan F
JF
Galvez
Giovana B
GB
Zunta-Soares
Jair C
JC
Soares
D000927:Anticonvulsants / Q000494:pharmacology; D000975:Antioxidants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000494:pharmacology; D052160:Benzothiazoles / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000188:drug therapy*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008094:Lithium / Q000494:pharmacology; D008559:Memantine / Q000627:therapeutic use; D015735:Mifepristone / Q000627:therapeutic use; D000077487:Pramipexole
D000927:Anticonvulsants; D000975:Antioxidants; D014150:Antipsychotic Agents; D052160:Benzothiazoles; D002800:Cholinesterase Inhibitors; D007328:Insulin; D015735:Mifepristone; D000077487:Pramipexole; D008094:Lithium; D008559:Memantine