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Review
. 2020 Mar;43(1):167-186.
doi: 10.1016/j.psc.2019.10.015. Epub 2019 Dec 3.

Pharmacologic Treatment of Mixed States

Affiliations
Review

Pharmacologic Treatment of Mixed States

Maurizio Pompili et al. Psychiatr Clin North Am. 2020 Mar.

Abstract

Despite the relatively high prevalence of mixed symptoms and features among patients with mood disorders, the current literature supporting the specific efficacy of second-generation antipsychotics and mood stabilizers for the treatment of mixed symptoms is limited. Several studies have demonstrated that acute affective episodes with mixed symptoms or features tend to respond unsatisfactory to treatments that are usually more effective for the management of other affective phases. There is clearly a need for clinical trials in order to determine the more adequate pharmacologic option for the treatment of individuals suffering from affective episodes with mixed features.

Keywords: Lithium; Mixed depression; Mixed features; Mood stabilizers; Pharmacologic treatment; Second-generation antipsychotics.

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Conflict of interest statement

Disclosure S.M. Stahl is an Adjunct Professor of Psychiatry at the University of California San Diego; Honorary Visiting Senior Fellow at the University of Cambridge, UK; and Director of Psychopharmacology for California Department of State Hospitals. Over the past 36 months (January 2016–December 2018) Dr S.M. Stahl has served as a consultant to Acadia, Adamas, Alkermes, Allergan, Arbor Pharmaceutcials, AstraZeneca, Avanir, Axovant, Axsome, Biogen, Biomarin, Biopharma, Celgene, Concert, ClearView, DepoMed, Dey, EnVivo, EMD Serono, Ferring, Forest, Forum, Genomind, Innovative Science Solutions, Intra-Cellular Therapies, Janssen, Jazz, Lilly, Lundbeck, Merck, Neos, Novartis, Noveida, Orexigen, Otsuka, PamLabs, Perrigo, Pfizer, Pierre Fabre, Reviva, Servier, Shire, Sprout, Sunovion, Taisho, Takeda, Taliaz, Teva, Tonix, Trius, Vanda, Vertex, and Viforpharma; he has been a board member of RCT Logic and Genomind; he has served on speakers bureaus for Acadia, Astra Zeneca, Dey Pharma, EnVivo, Eli Lilly, Forum, Genentech, Janssen, Lundbeck, Merck, Otsuka, PamLabs, Pfizer Israel, Servier, Sunovion, and Takeda, and he has received research and/orgrantsupport from Acadia, Alkermes, AssureX, AstraZeneca, Arbor Pharmaceuticals, Avanir, Axovant, Biogen, Braeburn Pharmaceuticals, BristolMyer Squibb, Celgene, CeNeRx, Cephalon, Dey, Eli Lilly, EnVivo, Forest, Forum, GenOmind, GlaxoSmithKline, Intra-Cellular Therapies, ISSWSH, Janssen, JayMac, Jazz, Lundbeck, Merck, Mylan, Neurocrine, Neuronetics, Novartis, Otsuka, PamLabs, Pfizer, Reviva, Roche, Sepracor, Servier, Shire, Sprout, Sunovion, TMS NeuroHealth Centers, Takeda, Teva, Tonix, Vanda, Valeant, and Wyeth (updated 1-23-2018). M. Pompili: Advisory Boards: Janssen, Ferrer, Italfarmaco; Lectures: FB Health, Lundbeck, Angelini, Otsuka, Allergan. Other authors: nothing to declare.

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