Avoiding Cardiometabolic Symptoms in Conventional Bipolar Disorder Treatment

Join Julie Carbray, PhD, PMHNP-BC, clinical professor at the University of Illinois at Chicago, as she delves into the critical challenges of managing cardiometabolic symptoms in patients with bipolar disorder. In this video, Dr Carbray explores the adverse cardiometabolic effects of conventional treatments, including weight gain, impaired glucose, and elevated cholesterol, and their impact on patient outcomes. Dr Carbray emphasizes the importance of monitoring metabolic markers and distinguishing between disease-related and treatment-related wellness aspects. 

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Read the Transcript:

Psych Congress Network: What are the key possible cardiometabolic symptoms and adverse effects associated with conventional treatments? How can these symptoms and adverse effects impact outcomes, and what strategies do you use to get around those?

Julie Carbray, PhD: When treating a patient with bipolar disorder, one of the largest challenges is navigating cardiometabolic adverse effects that happen with many of the drugs that we currently have available to us. Weight gain, impaired glucose, and beginning to see elevated cholesterol or triglycerides. So tracking those metabolic markers along with weight and wellness routines for our patients becomes critical. And unfortunately, many of the medications we've had to date only make those markers worse. We know that bipolar illness in and of itself increases mortality risk because patients with bipolar disorders seem to have a preclusion towards metabolic risk to begin with. And so we have to be cautious knowing that many of the agents that we have may also have weight gain sedation. Our patients are not feeling as active, and have elevated metabolic profile lipids and glucose as potential adverse effects. And so when we're working with patients, we have to understand what aspects of their wellness are related to their bipolar illness and illness effects.

If they're gaining weight, is it related to medication adverse effects or is it because their illness is contributing? When you're depressed, you're not moving. When you're manic, you're burning more calories. So this illness state, combined with our treatments, can really lead to a storm of cardiometabolic risk. And so monitoring, understanding what elements are disease-related and treatment-related and continuing to address those adverse risks across treatment really becomes critical for saving the lives of our patients in the context of their illness. We have several new treatments available that mitigate the risk of cardiometabolic effects for our patients. These new mechanisms of action of these agents really address weight gain, address elevated glucose, and mitigate the adverse risk that we see with our conventional agents used for bipolar disorder. So being able to use newer agents to mitigate the effects of our treatments on compounding the risk of cardiometabolic effects really gives us more tools in our toolbox to be able to help our patients to navigate improved symptom control without having to take that risk of enhanced cardiometabolic morbidity. So it's exciting new technologies that we have available to us are able to address cardiometabolic adverse effects.

Julie Carbray, PhD, PMHNP-BC, PMHCNS-BC, APRN, holds her PhD (93) and master of science (88) degrees from Rush University, Chicago, and her bachelor of science (87) degree from Purdue University in West Lafayette, Indiana. A clinical professor of psychiatry and nursing at the University of Illinois at Chicago, she has been on faculty at UIC since 1993. As a clinician, Dr Carbray has a national reputation of excellence in serving families with mood disorders and was recognized by the UIC community in 2008 by receiving the Karen Gousman Excellence in Nursing Award and the American Psychiatric Nurses Association’s (APNA) Best Practices in Outpatient Mental Health Nursing Award. In 2012, Dr. Carbray was awarded the University of Illinois at Chicago’s Inspire award for her long-standing commitment to UIC values and her inspiration of others in her work and in 2016, Dr. Carbray was awarded the Distinguished Service Award by APNA for her service to the profession of psychiatric nursing.