OBJECTIVE: Neuroimaging studies are promising components for a new diagnostic framework for bipolar disorder, but a major issue is the potential confound of psychotropic medication upon experimental measures. Withdrawing all individuals from medication and examining only unmedicated individuals may be clinically unfeasible, and examining only unmedicated individuals may render findings less generalizable. METHOD: The authors review structural and functional neuroimaging studies of medicated and unmedicated patients with bipolar disorder to discern the possible confounding effect of medication. RESULTS: Findings from studies identified on MEDLINE that included medicated individuals with bipolar disorder indicated either no significant effect or ameliorative effects of psychotropic medications on abnormal structural and functional neuroimaging measures relevant to pathophysiologic mechanisms of the disorder. Different strategies for assessing medication effects are compared. CONCLUSIONS: Neuroimaging studies of bipolar disorder ideally should recruit both unmedicated and medicated individuals. Individuals who are unable to tolerate medication withdrawal likely have more severe illness and are especially informative for research examining biomarkers of illness and treatment response.
OBJECTIVE: Neuroimaging studies are promising components for a new diagnostic framework for bipolar disorder, but a major issue is the potential confound of psychotropic medication upon experimental measures. Withdrawing all individuals from medication and examining only unmedicated individuals may be clinically unfeasible, and examining only unmedicated individuals may render findings less generalizable. METHOD: The authors review structural and functional neuroimaging studies of medicated and unmedicated patients with bipolar disorder to discern the possible confounding effect of medication. RESULTS: Findings from studies identified on MEDLINE that included medicated individuals with bipolar disorder indicated either no significant effect or ameliorative effects of psychotropic medications on abnormal structural and functional neuroimaging measures relevant to pathophysiologic mechanisms of the disorder. Different strategies for assessing medication effects are compared. CONCLUSIONS: Neuroimaging studies of bipolar disorder ideally should recruit both unmedicated and medicated individuals. Individuals who are unable to tolerate medication withdrawal likely have more severe illness and are especially informative for research examining biomarkers of illness and treatment response.
Authors: Hilary P Blumberg; Nelson H Donegan; Charles A Sanislow; Susan Collins; Cheryl Lacadie; Pawel Skudlarski; Ralitza Gueorguieva; Robert K Fulbright; Thomas H McGlashan; John C Gore; John H Krystal Journal: Psychopharmacology (Berl) Date: 2005-10-26 Impact factor: 4.530
Authors: Hilary P Blumberg; John H Krystal; Ravi Bansal; Andrés Martin; James Dziura; Kathleen Durkin; Laura Martin; Elizabeth Gerard; Dennis S Charney; Bradley S Peterson Journal: Biol Psychiatry Date: 2006-01-18 Impact factor: 13.382
Authors: Caleb M Adler; Melissa P DelBello; Kelly Jarvis; Ari Levine; John Adams; Stephen M Strakowski Journal: Biol Psychiatry Date: 2006-10-06 Impact factor: 13.382
Authors: G J Moore; J M Bebchuk; K Hasanat; G Chen; N Seraji-Bozorgzad; I B Wilds; M W Faulk; S Koch; D A Glitz; L Jolkovsky; H K Manji Journal: Biol Psychiatry Date: 2000-07-01 Impact factor: 13.382
Authors: Lakshmi N Yatham; Peter F Liddle; Raymond W Lam; I-Shin Shiah; Carol Lane; A Jon Stoessl; Vesna Sossi; Thomas J Ruth Journal: Am J Psychiatry Date: 2002-10 Impact factor: 18.112
Authors: Hilary P Blumberg; Hoi-Chung Leung; Pawel Skudlarski; Cheryl M Lacadie; Carolyn A Fredericks; Brent C Harris; Dennis S Charney; John C Gore; John H Krystal; Bradley S Peterson Journal: Arch Gen Psychiatry Date: 2003-06
Authors: Pilyoung Kim; Sarah E Jenkins; Megan E Connolly; Christen M Deveney; Stephen J Fromm; Melissa A Brotman; Eric E Nelson; Daniel S Pine; Ellen Leibenluft Journal: J Psychiatr Res Date: 2011-10-22 Impact factor: 4.791
Authors: Daniel P Dickstein; Cristina Gorrostieta; Hernando Ombao; Lisa D Goldberg; Alison C Brazel; Christopher J Gable; Clare Kelly; Dylan G Gee; Xi-Nian Zuo; F Xavier Castellanos; Michael P Milham Journal: Biol Psychiatry Date: 2010-08-24 Impact factor: 13.382
Authors: M T Keener; J C Fournier; B C Mullin; D Kronhaus; S B Perlman; E LaBarbara; J C Almeida; M L Phillips Journal: Psychol Med Date: 2012-01-25 Impact factor: 7.723
Authors: Daniel P Dickstein; Brendan A Rich; Roxann Roberson-Nay; Lisa Berghorst; Deborah Vinton; Daniel S Pine; Ellen Leibenluft Journal: Bipolar Disord Date: 2007-11 Impact factor: 6.744