Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study

Woo, Young Sup; Yoon, Bo-Hyun; Song, Jye-Heon; Seo, Jeong Seok; Nam, Beomwoo; Lee, Kwang-Hun; Lee, Jong-Hun; Jung, Young-Eun; Kim, Moon-Doo; Lee, Jung Goo; Wang, Sheng‐Min; Kwon, Young Joon; Bahk, Won‐Myong

doi:10.1371/journal.pone.0227217

Cited by 15 publications

(12 citation statements)

References 47 publications

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“…A score of ≥7 indicates a good response, a score from 4 to 6 a moderate response, and a score of ≤3 a poor response. Although it was originally developed to evaluate the lithium response, the Alda scale has also been administered to subjects treated with mood stabilizers (Woo et al., 2020).…”

Section: Methodsmentioning

confidence: 99%

Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder

Cascino

D'Agostino

Monteleone

et al. 2021

Human Psychopharmacology

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Objective The association between childhood maltreatment (CM) and clinical response to mood stabilizers has been scarcely investigated in bipolar disorder (BD). Therefore, we assessed whether CM affects the response to lithium or anticonvulsant treatments in BD patients. Methods A retrospective assessment of clinical response to mood stabilizers was conducted in 97 euthymic patients with BD by means of the Alda scale. History of CM was investigated through the Childhood Trauma Questionnaire. Results Thirty‐seven patients (24 with a history of CM and 13 without CM) were on stable lithium treatment while sixty (35 with a history of CM and 25 without CM) were on stable anticonvulsant treatment. Clinical response to drug treatment did not differ between BD with CM and those without CM in the whole sample as well as in the anticonvulsant‐treated subgroup. In the lithium‐treated subgroup, a significant negative correlation emerged between childhood physical abuse and clinical response and patients with CM showed a significantly reduced Alda score. Conclusions In BD patients, CM did not influence the clinical response to anticonvulsant mood stabilizers whereas it was associated with a poorer response to lithium with childhood physical abuse playing a major role in this effect.

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Section: Methodsmentioning

confidence: 99%

Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder

Cascino

D'Agostino

Monteleone

et al. 2021

Human Psychopharmacology

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“…MDI pattern is reported as a favorable predictor of re-sponse to lithium in several studies [12,63,65]; others do not report any correlation [61]. Psychiatric comorbidities are related to poor response to lithium [12], including alcohol use [57,64,71,72], anxiety symptoms/disorders [73,74] and personality disorders [64], while valproate is related to good response with alcohol use [57], anxiety symptoms/disorders, OCD [58], borderline personality symptoms [12,70].…”

Section: Discussionmentioning

confidence: 99%

Lithium and Valproate in Bipolar Disorder: From International Evidence-based Guidelines to Clinical Predictors

Crapanzano¹,

Casolaro

Amendola

et al. 2022

Clin Psychopharmacol Neurosci

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Since decades, lithium and valproate remain the pharmacological cornerstone to treat bipolar disorder. Different response patterns occur according to the phases of illness. At same time, individual pretreatment variables may concur to determine a specific drug-response. Our narrative review focuses on these two key clinical aspects to summarize the state of art. Information from i) clinical trials and ii) the most relevant international guidelines is collected to assess the clinical and preclinical factors that may guide the use of lithium rather than valproate. Lithium may be effective in treating acute mania, and lithium efficacy is maximized when used to prevent both manic and depressive episodes. Lithium may be a better treatment choice in patients with: positive family history for bipolar disorder, mania-depression-interval pattern, few previous affective episodes/hospitalizations, high risk for suicide, no comorbidities. Valproate may be more effective as antimanic rather than prophylactic agent. Valproate might be a better choice in patients with many previous affective episodes/hospitalizations and psychiatric comorbidities. Finally, neither lithium nor valproate are suggested for the treatment of acute mixed states or bipolar depression. To consider clinical and preclinical factors may thus be useful to select the best treatment strategy.

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“…Briefly, this scale quantifies the degree of improvement during the treatment (Criterion A), which is rated on a 0–10 scale, and weighs clinical factors that are considered to be relevant for determining if the observed improvement is a result of the treatment rather than a spontaneous improvement or an effect of additional medication (Criteria B1-B5), which are rated as 0, 1, or 2 points. The total score on the Alda scale is obtained by subtracting the B score from the A score ( 57 ).…”

Section: Methods and Analysismentioning

confidence: 99%

Functionality and Neurocognition in Patients With Bipolar Disorder After a Physical-Exercise Program (FINEXT-BD Study): Protocol of a Randomized Interventionist Program

et al. 2020

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Introduction: Recent studies have shown that symptoms of psychiatric illness, functionality, and cognitive function improve with exercise. The aim of this study will be to investigate whether the implementation of an individualized exercise program will improve the functional status of patients with bipolar disorder (BD). Methods: This longitudinal, interventional, randomized, controlled, simple-blind clinical trial will include 80 patients aged 18–65 years, all of them with BD diagnosis. Patients will be randomly assigned to a physical exercise intervention + Treatment-As-Usual (TAU) group and a non-intervention + TAU group. Patients will be assessed by an extensive battery of clinical tests, physical parameters (e.g., brain structure changes measured by optical coherence tomography, cardiorespiratory fitness) and biological parameters (inflammation, oxidative stress and neurotrophic factors) at baseline, after a 4-month intervention period, and 6-month follow-up. Discussion: This is an innovative study aimed at gaining a deeper understanding of the physiopathology of BD and determining whether the prognosis and evolution of the disease can be improved through modifiable areas of the patient's lifestyle. Clinical Trial Registration: NCT04400630. NCT clinicaltrials.gov . Date of registration in primary registry 22 May 2020. clinicaltrials.gov .

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Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study

Cited by 15 publications

References 47 publications

Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder

Childhood maltreatment and clinical response to mood stabilizers in patients with bipolar disorder

Lithium and Valproate in Bipolar Disorder: From International Evidence-based Guidelines to Clinical Predictors

Functionality and Neurocognition in Patients With Bipolar Disorder After a Physical-Exercise Program (FINEXT-BD Study): Protocol of a Randomized Interventionist Program

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