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Purpose: This study aimed to explore the associations between homocysteine, rumination, affective temperaments, clinical features, and hopelessness in bipolar disorder-1 (BD-1)., Materials and Methods: In total, 57 euthymic patients with BD-1 and 57 healthy controls were included. The Beck Hopelessness Scale (BHS), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Ruminative Responses Scale Short Form (RRS-SF) were administered. Homocysteine, folate, and vitamin B12 levels were measured., Results: The BHS total ( p  = 0.047), TEMPS-A irritable ( p  = 0.007), and TEMPS-A cyclothymic ( p = 0.001) scores were significantly higher than the control group in the BD-1 group. Hyperhomocysteinemia (HHcy) was found in 33.3% of the patients ( n  = 19). In the HHcy group, age of onset of disease ( p  = 0.020) was significantly lower than the non-HHcy group in patients. Previous suicide attempt number was significantly correlated with scores of reflective pondering, brooding, and global rumination in BD-1 ( p  ˂ 0.05). Except for hyperthymic temperament, all types of affective temperaments were correlated with the scores of RRS-SF brooding ( p  ˂ 0.05) in the BD-1 group. The RRS-SF brooding scores significantly correlated with the BHS total scores ( r  = 0.263, p  < 0.05); the TEMPS-A hyperthymic ( β  = -0.351, p  = 0.001) and TEMPS-A irritable ( β  = 0.536, p  < 0.001) scores significantly predicted the BHS total scores in the BD-1 group., Conclusions: The findings may lead clinical efforts and future clinical trials to explore and intervene in related sources and presentations of BD-1's adverse consequences.

Carbamazepine is an anticonvulsant and is extensively used in patients with bipolar disorder as a mood stabilizer. Although carbamazepine affects dopamine, norepinephrine, and glutamic acid levels in neurons, it mainly shows its effect on sodium and potassium channels. Carbamazepine enhances dopamine release and turnover and leads to differential alterations of monoamine levels in discrete brain regions. The mechanism of the emergence of prolonged erection and priapism is related to α1 adrenergic blockage in corpus cavernosum, however the knowledge about the effects of carbamazepine on adrenergic receptors is very limited. Therefore, further studies are necessary to identify the risk for prolonged erection in patients treated with carbamazepine and to investigate the relationship between prolonged erection and carbamazepine. [ABSTRACT FROM AUTHOR]