Ute Lewitzka
Dresden University of Technology
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Featured researches published by Ute Lewitzka.
Acta Psychiatrica Scandinavica | 2004
Tom Bschor; Marcus Ising; Michael Bauer; Ute Lewitzka; M. Skerstupeit; Bruno Müller-Oerlinghausen; Christopher Baethge
Objective: Studies on the time sense of depressed patients have revealed inconsistent results. Manic patients have been almost neglected.
Acta Psychiatrica Scandinavica | 2008
Erik Lauterbach; Werner Felber; Bruno Müller-Oerlinghausen; Bernd Ahrens; Thomas Bronisch; Thorsten Meyer; Birgit Kilb; Ute Lewitzka; Barbara Hawellek; Arnim Quante; Kneginja Richter; Andreas Broocks; Fritz Hohagen
Objective: Evidence based on controlled studies is still limited for treatment strategies that prevent recurrence of suicide attempts. Findings from observational as well as meta‐analytic studies strongly suggest that lithium may have suicide‐protective properties.
Neuropsychobiology | 2010
Michael Bauer; Mazda Adli; Tom Bschor; Maximilian Pilhatsch; Andrea Pfennig; Johanna Sasse; Rita Schmid; Ute Lewitzka
Background: The late onset of therapeutic response and a relatively large proportion of nonresponders to antidepressants remain major concerns in clinical practice. Therefore, there is a critical need for effective medication strategies that augment treatment with antidepressants. Methods: To review the available evidence on the use of lithium as an augmentation strategy to treat depressive episodes. Results: More than 30 open-label studies and 10 placebo-controlled double-blind trials have demonstrated substantial efficacy of lithium augmentation in the acute treatment of depressive episodes. Most of these studies were performed in unipolar depression and included all major classes of antidepressants, however mostly tricyclics. A meta-analysis including 10 randomized placebo-controlled trials has provided evidence that lithium augmentation has a statistically significant effect on the response rate compared to placebo with an odds ratio of 3.11, which corresponds to a number-needed-to-treat of 5. The meta-analysis revealed a mean response rate of 41.2% in the lithium group and 14.4% in the placebo group. One placebo-controlled trial in the continuation treatment phase showed that responders to acute-phase lithium augmentation should be maintained on the lithium-antidepressant combination for at least 12 months to prevent early relapses. Preliminary studies to assess genetic influences on response probability to lithium augmentation have suggested a predictive role of the –50T/C single nucleotide polymorphism of the GSK3β gene. Conclusion: Augmentation of antidepressants with lithium is currently the best-evidenced augmentation therapy in the treatment of depressed patients who do not respond to antidepressants.
Neuropsychobiology | 2010
Bruno Müller-Oerlinghausen; Ute Lewitzka
From a practical point of view, the well-proven antisuicidal and anti-aggressive effects of lithium are of utmost importance for a rational, safe and economical treatment of patients with affective disorders. Regular lithium long-term treatment reduces the otherwise 2- to 3-fold increased mortality of untreated patients with severe affective disorders down to the level of the general population. This is mainly due to the reduced suicide risk. Many international studies have confirmed this fascinating property of lithium which so far has not been demonstrated with comparable evidence for any other psychotropic compound. The antisuicidal effects of lithium might possibly be related to its anti-aggressive effects which have been shown in various species, populations and settings, such as animals, inhabitants of nursing homes for the elderly, mentally handicapped subjects, children and adolescents with hyperactive, hostile and aggressive behavior, and particularly in hyperaggressive inmates of correction units and prisons.
Early Intervention in Psychiatry | 2011
Anne Duffy; Sarah Doucette; Ute Lewitzka; Martin Alda; Tomas Hajek; Paul Grof
Aim: High‐risk studies provide the opportunity to describe the early natural history of bipolar disorder (BD); however, findings have varied substantially. In this review, we compare different methods of ascertainment and assessment, and their impact on study findings.
International Journal of Bipolar Disorders | 2015
Ute Lewitzka; Emanuel Severus; Rita Bauer; Philipp Ritter; Bruno Müller-Oerlinghausen; Michael Bauer
The management and treatment of patients with suicidal behavior is one of the most challenging tasks for health-care professionals. Patients with affective disorders are at high risk for suicidal behavior, therefore, should be a target for prevention. Numerous international studies of lithium use have documented anti-suicidal effects since the 1970s. Despite the unambiguous evidence of lithium’s anti-suicidal effects and recommendations in national and international guidelines for its use in acute and maintenance therapy of affective disorders, the use of lithium is still underrepresented. The following article provides a comprehensive review of studies investigating the anti-suicidal effect of lithium in patients with affective disorders.
Psychiatry Research-neuroimaging | 2008
Michael Bauer; Tina Wilson; Kathrin Neuhaus; Johanna Sasse; Andrea Pfennig; Ute Lewitzka; Paul Grof; Tasha Glenn; Natalie L. Rasgon; Tom Bschor; Peter C. Whybrow
With the widespread recognition of the value of active patient participation in their care, ChronoRecord software was developed to automate daily self-reporting by patients with bipolar disorder. A prior study demonstrated concurrent validity between self-ratings on ChronoRecord and clinician ratings on the Hamilton Depression Rating Scale (HAMD), but validity with the Young Mania Rating Scale (YMRS) could not be shown due to a lack of data when the outpatients were manic (Bauer et al., Bipolar Disorders 6, 67-74, 2004). This study expanded upon the prior validation study to include inpatients with mania. Self-reported mood ratings on ChronoRecord and clinician ratings on the YMRS were obtained on the same day from 27 inpatients (57 ratings); these data were also combined with the ratings from the 80 outpatients (total 107 patients, 340 ratings). Using Pearson correlation, the self-reported ratings on ChronoRecord were significantly correlated with the YMRS. The accuracy of ChronoRecord to discriminate hypomania and mania was high, as described by the area under the receiver operating characteristic curve. Post-hoc analysis of the level of agreement between ChronoRecord and YMRS ratings was excellent or good in all cases using the kappa statistic. These data demonstrate concurrent validity between ChronoRecord and YMRS.
Early Intervention in Psychiatry | 2012
Anne Duffy; Ute Lewitzka; Sarah Doucette; Ana Cristina Andreazza; Paul Grof
Aim: The study aims to provide a selective review of the literature pertaining to the hypothalamic‐pituitary‐adrenal (HPA) axis and immune abnormalities as informative biological indicators of vulnerability in bipolar disorder (BD).
Journal of Affective Disorders | 2014
Michael Bauer; Tasha Glenn; Martin Alda; Ole A. Andreassen; Elias Angelopoulos; Raffaella Ardau; Christopher Baethge; Rita Bauer; Frank Bellivier; R.H. Belmaker; Michael Berk; Thomas Bjella; Letizia Bossini; Yuly Bersudsky; Eric Yat Wo Cheung; Jörn Conell; Maria Del Zompo; Seetal Dodd; Bruno Etain; Andrea Fagiolini; Mark A. Frye; Kostas N. Fountoulakis; Jade Garneau-Fournier; Ana González-Pinto; Hirohiko Harima; Stefanie Hassel; Chantal Henry; Apostolos Iacovides; Erkki Isometsä; Flávio Kapczinski
BACKGROUND The onset of bipolar disorder is influenced by the interaction of genetic and environmental factors. We previously found that a large increase in sunlight in springtime was associated with a lower age of onset. This study extends this analysis with more collection sites at diverse locations, and includes family history and polarity of first episode. METHODS Data from 4037 patients with bipolar I disorder were collected at 36 collection sites in 23 countries at latitudes spanning 3.2 north (N) to 63.4 N and 38.2 south (S) of the equator. The age of onset of the first episode, onset location, family history of mood disorders, and polarity of first episode were obtained retrospectively, from patient records and/or direct interview. Solar insolation data were obtained for the onset locations. RESULTS There was a large, significant inverse relationship between maximum monthly increase in solar insolation and age of onset, controlling for the country median age and the birth cohort. The effect was reduced by half if there was no family history. The maximum monthly increase in solar insolation occurred in springtime. The effect was one-third smaller for initial episodes of mania than depression. The largest maximum monthly increase in solar insolation occurred in northern latitudes such as Oslo, Norway, and warm and dry areas such as Los Angeles, California. LIMITATIONS Recall bias for onset and family history data. CONCLUSIONS A large springtime increase in sunlight may have an important influence on the onset of bipolar disorder, especially in those with a family history of mood disorders.
The Journal of Clinical Psychiatry | 2014
Thomas Stamm; Ute Lewitzka; Cathrin Sauer; Maximilian Pilhatsch; Michael N. Smolka; Ursula Koeberle; Mazda Adli; Roland Ricken; Harald Scherk; Mark A. Frye; Georg Juckel; Hans Joerg Assion; Michael J. Gitlin; Peter C. Whybrow; Michael Bauer
OBJECTIVE Suboptimal availability of circulating thyroid hormones may contribute to the high rate of treatment failures in bipolar disorder. This study tested the efficacy of adjunctive treatment with supraphysiologic doses of levothyroxine in patients with bipolar depression and the hypothesis that women would display a better outcome compared to men. METHOD The aims of this multicenter, 6-week, double-blind, randomized, placebo-controlled fixed-dose (300 μg/d) trial conducted from 2004 to 2009 were to assess efficacy and tolerability of levothyroxine adjunctive to continuing treatment with mood stabilizer and/or antidepressant medication for patients with bipolar I or II disorder, currently depressed (DSM-IV), and to investigate gender differences in treatment response. The primary efficacy variable was mean change in Hamilton Depression Rating Scale (HDRS) score. RESULTS Of 74 patients enrolled in the study, 62 (35 with bipolar I; mean age = 44.9 years) were randomized. Mean change in HDRS score from randomization to week 6 was larger in the levothyroxine group compared to the placebo group, with a 2.7-point difference (decline of -7.8 [38.3%] vs -5.1 [25.5%]; last-observation-carried-forward analysis). The course of HDRS scores over time from randomization to week 6 was significantly different between groups at week 4 (P = .046) but not at the end of the placebo-controlled phase (P = .198). The secondary analysis of women (n = 32) revealed a significant difference between groups in mean change in HDRS score (-16.6% placebo vs -42.4% levothyroxine, P = .018). A mixed-effects model for repeated-measures analysis showed a significant between-group difference in HDRS score (6.8, P = .012) for women. High thyroid-stimulating hormone levels, indicating suboptimal levels of circulating thyroid hormones, were predictive for positive treatment outcome in women treated with levothyroxine in a linear regression model (F3 = 3.47; P = .05). DISCUSSION This trial demonstrated that patients treated with levothyroxine did numerically better than those treated with placebo; however, the study failed to detect a statistically significant difference between the 2 groups in the primary outcome measure due to a high placebo response rate. Previous findings that women show better improvement in depression scores with levothyroxine compared to men were confirmed. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01528839.