Rapid cycling

Other agents are also used for the treatment of manic-depressive disorders based on preliminary clinical results (177). The antiepileptic carbamazepine [298-46-4] has been reported in some clinical studies to be therapeutically beneficial in mild-to-moderate manic depression. Carbamazepine treatment is used especially in bipolar patients intolerant to lithium or nonresponders. A majority of Hthium-resistant, rapidly cycling manic-depressive patients were reported in one study to improve on carbamazepine (178). Carbamazepine blocks noradrenaline reuptake and inhibits noradrenaline exocytosis. The main adverse events are those found commonly with antiepileptics, ie, vigilance problems, nystagmus, ataxia, and anemia, in addition to nausea, diarrhea, or constipation. Carbamazepine can be used in combination with lithium. Several clinical studies report that the calcium channel blocker verapamil [52-53-9] registered for angina pectoris and supraventricular arrhythmias, may also be effective in the treatment of acute mania. Its use as a mood stabilizer may be unrelated to its calcium-blocking properties. Verapamil also decreases the activity of several neurotransmitters. Severe manic depression is often treated with antipsychotics or benzodiazepine anxiolytics. 

Vacuum Brazing Furnace. The cross sections of a vacuum brazing furnace of the beU-jar type are shown in Eigures 15 and 16. Contamination is very low even when rapidly cycled from one work load to the next. The beU jar can serve on one hearth while another hearth is being loaded for the next operation. 

Rapid Adsorption-Desorption Cycles For rapid cycles with particle diffusion controlling, when the cycle time is much smaller than the time constant for intraparticle transport, the LDF approximation becomes inaccurate. The generalized expression... 

An oversized relief valve may also chatter since the valve may quickly relieve enough contained fluid to allow the vessel pressure to momentarily fall back to below set pressure only to rapidly increase again. Rapid cycling reduces capacity and is destructive to the valve seat in addition to subjecting all the moving parts in the valve to excessive wear. E.xcessive back pressure can also cause rapid cycling as discussed above. 

Is a multiple-cavity tooling approach possible to reduce piece costs Yes Yes. Depends on size and configuration, although rapid cycle time may eliminate the need. Not necessarily. Secondary operations may be too costly and material flow too difficult... 

The total costs are likely to reflect the efficacy of treatment. In one industry-sponsored study (Keck et al, 1996b) treatment with lithium or valproate was compared in relation to classical, mixed and rapid-cycling disorder. Treatment with lithium was associated with lower costs than treatment with valproate for classical bipolar disorder, but treatment with valproate was associated with lower costs than treatment with lithium for mixed and rapid-cycling disorders. This is in keeping with the evidence that valproate is more effective than lithium for certain patients with rapid-cycling disorder and probably also for certain patients with mixed affective states. However, these associations are a guide to predicting response to treatment but are not very specific. 

However, in today s world of rapid cycle time and cost-efficient manufacturing, perhaps the best examples are in joint development partnerships between chemically or materials-based companies and the end users. One such example is the joint composite development partner-... 

Bipolar I disorder affects men and women equally bipolar II seems to be more common in women. Rapid cycling and mixed mania occur more often in women. Individuals with bipolar disorder commonly have another psychiatric disease with 78% to 85% reporting another Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnosis during their lifetime. The most common comorbid conditions include anxiety, substance abuse, and eating disorders.2... 

Rapid cycling Yes Greater than 3 major depressive or manic episodes (manic, mixed, or hypomanic) in 12 months... 

Divalproex sodium is comprised of sodium valproate and valproic acid. The delayed-release and extended-release formulations are converted in the small intestine into valproic add, which is the systemically absorbed form. It was developed as an antiepileptic drug, but also has efficacy for mood stabilization and migraine headaches. It is FDA-approved for the treatment of the manic phase of bipolar disorder. It is generally equal in efficacy to lithium and some other drugs for bipolar mania. It has particular utility in bipolar disorder patients with rapid cycling, mixed mood features, and substance abuse comorbidity. Although not FDA-approved for relapse prevention, studies support this use, and it is widely prescribed for maintenance therapy. Divalproex can be used as monotherapy or in combination with lithium or an antipsychotic drug.31... 

Wittwer, C. Hahn, M. Kaul, K. (Eds.). Rapid Cycle Real-Time PCR Methods and Applications. Springer-Verlag Berlin, 2004. 

The high heat transfer rate allows rapid cycle times which result in the plant being more compact and less expensive to produce. 

Hypothyroidism can precipitate a depression and be a risk factor for rapid cycling thyroid supplementation can be used for refractory rapid cycling and augmentation of antidepressants in unipolar depression. 

Women are more likely to have mixed states, depressive episodes, and rapid cycling than men. 

Exercise (regular aerobic and weight training at least three times a week) / The use of electroconvulsive therapy for severe mania or mixed episodes, psychotic depression, or rapid cycling is still considered the best... 

Lithium is the drug of choice for bipolar disorder with euphoric mania, whereas valproate has better efficacy for mixed states, irritable/dysphoric mania, and rapid cycling compared with lithium. 

Combination therapies (e.g., lithium plus valproate or carbamazepine lithium or valproate plus an atypical antipsychotic) may provide better acute response and prevention of relapse and recurrence than monotherapy in some bipolar patients, especially those with mixed states or rapid cycling. 

Lithium was the first established mood stabilizer and is still considered a first-line agent for acute mania and maintenance treatment of both bipolar I and II disorders. It is the only bipolar medication approved for adults and children 12 years and older. Long-term use of lithium reduces suicide risk. Patients with rapid cycling or mixed states may not respond as well to lithium monotherapy as to some anticonvulsants. 

Use standard therapeutic serum concentration ranges if clinically indicated if partial response or breakthrough episode, adjust dose to achieve higher serum concentrations without causing intolerable adverse effects valproate is preferred over lithium for mixed episodes and rapid cycling lithium and/or lamotrigine is preferred over valproate for bipolar depression. 

Nimodipine may be more effective than verapamil for rapid-cycling bipolar disorder because of its anticonvulsant properties, high lipid solubility, and good penetration into the brain. 

Antikindling properties can decrease rapid cycling and mixed states. 

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