Maintenance treatment for bipolar disorder
DOI:
https://doi.org/10.25118/2763-9037.2011.v1.878Keywords:
BD, bipolar disorder, bipolar mood disorder, medication, treatment, mood stabilizers, antidepressants, depressionAbstract
Why maintenance treatment. Due to the high risk of recurrence and relapse (time to relapse is three months in 50% of individuals) in patients with bipolar affective disorder (BD), maintenance therapy is of utmost importance. Recurrence rates range from 60-80% after discontinuation of lithium or antipsychotic therapy and 20-50% during the course of treatment (1) Yatham et al., 2005). As a result, the goals of long-term treatment include not only preventing suicidal behavior and recurrence of manic and depressive episodes, but also improving subsyndromal symptoms, treatment adherence, and quality of life and social reintegration of patients (Yatham et al., 2009). Psychiatric comorbidities such as substance abuse and psychotic symptoms are risk factors for recurrence (Kemp et al., 2009).
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Bogarapu S, Bishop JR, Krueger CD, Pavuluri MN. 2008. Complementary medicines in pediatric bipolar disorder. Minerva Pediatr, Feb;60(1):103-14.
Bond DJ, Noronha MM, Kauer-Sant’Anna M, Lam RW, Yatham LN (2008). Antidepressant-associated mood elevations in bipolar II disorder compared with bipolar I disorder and major depressive disorder: a systematic review and meta-analysis. J Clin Psychiatry. Oct;69(10):1589-601. DOI: https://doi.org/10.4088/JCP.v69n1009
Bowden CL (2009). Anticonvulsants in bipolar disorders: current research and practice and future directions. Bipolar Disord. Jun;11 Suppl 2:20-33.Busby KK, Sajatovic M (2010). Review: Patient, treatment, and systems-level factors in bipolar disorder nonadherence: A summary of the literature. CNS Neurosci Ther. Oct;16(5):308-15. DOI: https://doi.org/10.1111/j.1755-5949.2010.00191.x
Costa, RT; Cheniaux, E; Rosaes, PA; Carvalho, MR; Freire, RC; Versiani, M; Rangé BP; Nardi, AE. 2011. The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study. Rev Bras Psiquiatr. Mar 18. pii: S1516 DOI: https://doi.org/10.1590/S1516-44462011005000008
Deeks ED (2010). Risperidone long-acting injection: in bipolar I disorder. Drugs. May 28;70(8):1001-12. DOI: https://doi.org/10.2165/11204480-000000000-00000
Delgado-Escueta A, Janz D, 1992. Consensus guidelines: preconception counseling, management, and care of pregnant women with epilepsy. Neurology; 42:149–160
Duffy A, Milin R, Grof P. (2009). Maintenance treatment of adolescent bipolar disorder: open study of the effectiveness and tolerability of quetiapine. BMC Psychiatry. Feb 6;9:4. DOI: https://doi.org/10.1186/1471-244X-9-4
Ernst LC, Goldberg JF, 2002. The reproductive safety profile of mood silizers, atypical antipsychotics, and broad-spectrum psychotropics. J Clin Psychiatry, 63(suppl 4):42-55.
Findling RL, McNamara NK, Youngstrom EA, Stansbrey R, Gracious BL, Reed MD, Calabrese JR. (2005) Double--blind 18-month trial of lithium versus divalproex maintenance treatment in pediatric bipolar disorder. J Am Acad Child Adolesc Psychiatry. May;44(5):409-17. DOI: https://doi.org/10.1097/01.chi.0000155981.83865.ea
Ghaemi SN, Ostacher MM, El-Mallakh RS, Borrelli D, Baldassano CF, Kelley ME, Filkowski MM, Hennen J, Sachs GS, Goodwin FK, Baldessarini RJ (2010). Antidepressant discontinuation in bipolar depression: a Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) randomized clinical trial of long-term effectiveness and safety. J Clin Psychiatry. Apr;71(4):372-80. DOI: https://doi.org/10.4088/JCP.08m04909gre
Goodwin, F & Jamison, KR. Manic-depressive Illness. Bipolar disorder and recurrent depression. Oxford, 2ed., 2007.
Juruena MF, Ottoni GL, Machado-Vieira R, Carneiro RM, ,Weingarthner N Marquardt AR, Fleig SS, Broilo L, Busnello EA (2009). Bipolar I and II disorder residual symptoms: oxcarbazepine and carbamazepine as add-on treatment to lithium in a double-blind, randomized trial. Prog Neuropsychopharmacol Biol Psychiatry. Feb 1;33(1):94-9. Oct 31. DOI: https://doi.org/10.1016/j.pnpbp.2008.10.012
Kemp DE, Gao K, Ganocy SJ, Elhaj O, Bilali SR, Conroy C, Findling RL, Calabrese JR (2009). A 6-month, double-blind, maintenance trial of lithium monotherapy versus the combination of lithium and divalproex for rapid-cycling bipolar disorder and Co-occurring substance abuse or dependence. J Clin Psychiatry. Jan;70(1):113-21. Epub 2008 Dec 30. DOI: https://doi.org/10.4088/JCP.07m04022
Ketter, TA. Handbook of diagnosis and treatment of bipolar disorder. American Psychiatric Publishing, Inc, 2010.
Kirchheiner J, Berghofer A, Bolk-Weischedel D (2000). Healthy outcome under olanzapine treatment in a pregnant woman. Pharmacopsychiatry, 33:78-80. DOI: https://doi.org/10.1055/s-2000-7974
Lindhout D, Omtzigt J, (1994). Teratogenic effects of antiepileptic drugs: implications for the management of epilepsy in women of childbearing age. Epilepsia, 35:S19–S28. DOI: https://doi.org/10.1111/j.1528-1157.1994.tb05952.x
López P, Mosquera F, de León J, Gutiérrez M, Ezcurra J, Ramírez F, González-Pinto A. (2001). Suicide attempts in bipolar patients. J Clin Psychiatry; 62: 963–966. Obstet Gynecol, 185:845–849. DOI: https://doi.org/10.4088/JCP.v62n1208
MacMillan CM, Korndörfer SR, Rao S, Fleisher CA, Mezzacappa E, Gonzalez-Heydrich J. (2006). A comparison of divalproex and oxcarbazepine in aggressive youth with bipolar disorder. J Psychiatr Pract. Jul;12(4):214-22. DOI: https://doi.org/10.1097/00131746-200607000-00003
Madaan V, Chang KD. (2007). Pharmacotherapeutic strategies for pediatric bipolar disorder. Expert Opin Pharmacother; Aug;8(12):1801-19. DOI: https://doi.org/10.1517/14656566.8.12.1801
Merikangas KR, Ames M, Cui L, Stang PE, Ustun TB, Von Korff M, Kessler RC. (2007) The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch Gen Psychiatry. Oct;64(10):1180-8. DOI: https://doi.org/10.1001/archpsyc.64.10.1180
McIntyre RS (2010). Pharmacology and efficacy of asenapine for manic and mixed states in adults with bipolar disorder. Expert Rev Neurother. May;10(5):645-9. DOI: https://doi.org/10.1586/ern.10.49
McKenna K, Koren G, Tetelbaum M, Wilton L, Shakir S, Diav- Citrin O, Levinson A, Zipursky RB, Einarson A, (2005). Pregnancy out come of women using atypical antipsychotic drugs: a prospective comparative study.J Clin Psychiatry; 66:444–449. DOI: https://doi.org/10.4088/JCP.v66n0406
Miller LJ, 1994. Use of electroconvulsive therapy during pregnancy. Hosp Community Psychiatry; 45:444–450. DOI: https://doi.org/10.1176/ps.45.5.444
Moreno, D. H.; Moreno, R. A. 2005. Mixed States and Rapid Cycling in Bipolar Disorder. Rev. Psiq. Clín. 32, supl 1; 56-62. DOI: https://doi.org/10.1590/S0101-60832005000700009
Miklowitz DJ, Chang KD, Taylor DO, George EL, Singh MK, Schneck CD, Dickinson LM, Howe ME, Garber J. (2011). Early psychosocial intervention for youth at risk for bipolar I or II disorder: a one-year treatment development trial. Bipolar Disord. Feb;13(1):67-75. DOI: https://doi.org/10.1111/j.1399-5618.2011.00890.x
Newport DJ, Stowe ZN, Viguera AC, Calamaras MR, Juric S, Knight B, Pennell PB, Baldessarini RJ. (2008). Lamotrigine in bipolar disorder: efficacy during pregnancy. Bipolar Disord; 10: 432–436. DOI: https://doi.org/10.1111/j.1399-5618.2007.00565.x
Parker GB (2010) Comorbidities in bipolar disorder: models and management. Med J Aust. Aug 16;193(4 Suppl):S18-20. DOI: https://doi.org/10.5694/j.1326-5377.2010.tb03892.x
Popovic D, Reinares M, Amann B, Salamero M, Vieta E (2011). Number needed to treat analyses of drugs used for maintenance treatment of bipolar disorder. Psychopharmacology (Berl). Feb;213(4):657-67. DOI: https://doi.org/10.1007/s00213-010-2056-8
Pavuluri MN, Henry DB, Carbray JA, Naylor MW, Janicak PG. (2005). Divalproex sodium for pediatric mixed mania: a 6-month prospective trial. Bipolar Disord. Jun;7(3):266-73. DOI: https://doi.org/10.1111/j.1399-5618.2005.00204.x
Pavuluri MN, Henry DB, Carbray JA, Sampson G, Naylor MW, Janicak PG. (2004). Open-label prospective trial of risperidone in combination with lithium or divalproex sodium in pediatric mania. J Affect Disord, Oct;82 Suppl 1:S103-11. DOI: https://doi.org/10.1016/j.jad.2004.05.017
Rosa FW, (1991). Spina bifida in infants of women treated with carbamazepine during pregnancy. N Engl J Med; 324:674–677. DOI: https://doi.org/10.1056/NEJM199103073241006
Sachs GS, Thase ME (2000). Bipolar disorder therapeutics: maintenance treatment. Biol Psychiatry. 15;48(6):573-81. DOI: https://doi.org/10.1016/S0006-3223(00)00991-4
Salpekar JA, Conry JA, Doss W, Cushner-Weinstein S, Pearl PL, Weinstein SL, Gaillard WD. (2006). Clinical experience with anticonvulsant medication in pediatric epilepsy and comorbid bipolar spectrum disorder. Epilepsy Behav. Sep;9(2):327-34. Epub 2006 Jul 24. DOI: https://doi.org/10.1016/j.yebeh.2006.06.004
Shapiro NA. (2005). Bipolar disorders in childrenand adolescents. J Pediatr Health Care. 2005 May--Jun;19(3):131-41. DOI: https://doi.org/10.1016/j.pedhc.2005.01.012
Schou M, Goldfield MD, Weinstein MR, Villeneuve A, (1973): Lithium and pregnancy, I: report from the Register of Lithium Babies.Br Med J, 2:135–136. DOI: https://doi.org/10.1136/bmj.2.5859.135
Suppes T, Vieta E, Liu S, Brecher M, Paulsson B; Trial 127 Investigators (2009). Maintenance treatment for patients with bipolar I disorder: results from a north american study of quetiapine in combination with lithium or divalproex (trial 127). Am J Psychiatry. Apr;166(4):476-88. DOI: https://doi.org/10.1176/appi.ajp.2008.08020189
Terp IM , Mortensen PB (1998). Post-partum psychoses. Clinical diagnoses and relative risk of admission after parturition. The British Journal of Psychiatry 172: 521-526 DOI: https://doi.org/10.1192/bjp.172.6.521
Thomas T, Stansifer L, Findling RL. (2011). Psychopharmacology of pediatric bipolar disorders in children and adolescents. Pediatr Clin North Am. Feb;58(1):173-87 DOI: https://doi.org/10.1016/j.pcl.2010.10.001
Vieta E, Nuamah IF, Lim P, Yuen EC, Palumbo JM, Hough DW, Berwaerts J (2010). A randomized, placebo-and active-controlled study of paliperidone extended release for the treatment of acute manic and mixed episodes of bipolar I disorder. Bipolar Disord. May;12(3):230-43. DOI: https://doi.org/10.1111/j.1399-5618.2010.00815.x
Viguera AC, Nonacs R, Cohen LS, Tondo L, Murray A, Baldessarini RJ, (2000). Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry, 157:179–184 67. DOI: https://doi.org/10.1176/appi.ajp.157.2.179
Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, Zurick A, Cohen LS, (2007). Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood silizer discontinuation. Am J Psychiatry 2007; 164: 1817–1824. DOI: https://doi.org/10.1176/appi.ajp.2007.06101639
Wozniak J, Mick E, Waxmonsky J, Kotarski M, Hantsoo L, Biederman J.Comparison of open-label, 8-week trials of olanzapine monotherapy and topiramate augmentation of olanzapine for the treatment of pediatric bipolar disorder.J Child Adolesc Psychopharmacol. 2009 Oct;19(5):539-45 DOI: https://doi.org/10.1089/cap.2009.0042
Yatham LN, Kennedy SH, O’Donovan C, Parikh S, MacQueen G, McIntyre R, Sharma V, Silverstone P, Alda M, Baruch P, Beaulieu S, Daigneault A, Milev R, YoungLT, Ravindran A, Schaffer A, Connolly M, Gorman CP; Canadian Network for Mood and Anxiety Treatments
(2005). Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord; 7 (Suppl.3): 5–69. DOI: https://doi.org/10.1111/j.1399-5618.2005.00219.x
Yatham LN, Kennedy SH, O’Donovan C, Parikh SV, MacQueen G, McIntyre RS, Sharma V, Beaulieu S; Guidelines Group, CANMAT. (2007). Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar
disorder: update. Bipolar Disord 2006; 8: 721–739. DOI: https://doi.org/10.1111/j.1399-5618.2006.00432.x
Yatham LN, Kennedy SH, Schaffer A, Parikh SV, Beaulieu S, O’Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Young AH, Alda M, Milev R, Vieta E, Calabrese JR, Berk M, Ha K, Kapczinski F (2009). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update. Bipolar Disord. May;11(3):225-55. DOI: https://doi.org/10.1111/j.1399-5618.2009.00672.x
Yatham LN (2011). A clinical review of aripiprazole in bipolar depression and maintenance therapy of bipolar disorder. J Affect Disord. Jan;128 Suppl 1:S21-8. DOI: https://doi.org/10.1016/S0165-0327(11)70005-2
Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, Manber R, Viguera A, Suppes T, Altshuler L. (2004). Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry. Apr;161(4):608-20. DOI: https://doi.org/10.1176/appi.ajp.161.4.608
Zeni CP, Tramontina S, Ketzer CR, Pheula GF, Rohde LA. (2009). Methylphenidate combined with aripiprazole in children and adolescents with bipolar disorder and attention-deficit/hyperactivity disorder: a randomized crossover trial. J Child Adolesc Psychopharmacol. Oct;19(5):553-61. DOI: https://doi.org/10.1089/cap.2009.0037
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