Journal
AMERICAN JOURNAL OF PSYCHIATRY
Volume 165, Issue 3, Pages 313-320Publisher
AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ajp.2007.07071066
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Funding
- NIMH NIH HHS [P30 MH030915, R01 MH 076971, R01 MH076971, R01 MH076971-01A2] Funding Source: Medline
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH076971, P30MH030915] Funding Source: NIH RePORTER
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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.
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