Rapid‐cycling bipolar disorder: effects of long‐term treatments

Tondo, Leonardo; Hennen, John; Rj, Baldessarini

doi:10.1034/j.1600-0447.2003.00126.x

Cited by 111 publications

(110 citation statements)

References 43 publications

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“…Relapses, switches, or recurrences occurred in 57% of bipolar I patients within two years of intake (Tondo et al, 2003b;Harvey, 2006;Shi et al, 2006). These risks are consistent with reported failurerates of 39%-52%/year during various maintenance treatments in bipolar I patients (Gitlin et al, 1995;Goldberg et al, 1995;Baldessarini etal, 2000;Maj etal, 2001;Tondo et al, 2001;Tsai et al, 2001;Judd et al, 2002).…”

Section: Early Risks Of New Illness Episodes In Bipolar Disorder Patisupporting

confidence: 75%

Longitudinal research on bipolar disorders

Salvatore¹,

Tohen²,

Khalsa³

et al. 2007

Epidemiol Psichiatr Soc

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Abstract. Longitudinal assessment of the course of major psychiatric disorders has been advanced by studies from onset, but only rarely have large numbers of patients with a range of psychotic and major affective disorders been studied simultaneously and systematically from illness-onset. The decade-long McLean-Harvard First Episode Project & International Consortium for Bipolar Disorder Research has systematically followed-up large numbers of patients with DSM-IV bipolar or psychotic disorders from firsthospitalization. Major findings among patients with bipolar I disorder include: [a] full functional recovery from initial episodes was uncommon, and full symptomatic recovery, much slower than early syndromal recovery; [b] risks of relapse, recurrence, and switching were very high in the first two years; [c] most early morbidity was depressive-dysphoric, as reported in mid-course; [d] initial depression or mixed-states predicted more later depressive and overall morbidity, whereas initial mania or psychosis predicted later mania and a better prognosis; [e] based on within-subject modeling, most patients did not show progressive cycling over time, and illness-course was rather chaotic within and among patients; [f] treatment-latency or episode-counts were unassociated with responsiveness to long-term mood-stabilizing treatment; [g] very high rates of suicidal behavior and accidents occurred early; [h] early substance-use comorbidity associated with anxiety; [i] factor-analysis of prodromal symptoms predicted bipolar disorder much better than non-affective psychotic disorders. Project findings indicate that the course of bipolar I disorder is much less favorable than had been believed formerly, despite clinical treatment with modern mood-stabilizing and other treatments.

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Section: Early Risks Of New Illness Episodes In Bipolar Disorder Patisupporting

confidence: 75%

Longitudinal research on bipolar disorders

Salvatore¹,

Tohen²,

Khalsa³

et al. 2007

Epidemiol Psichiatr Soc

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“…None of these treatments (carbamazepine, lithium, lamotrigine, topiramate and valproate) showed a clear advantage over the others (Baldessarini et al, 2000;Tondo et al, 2003). Also the efficacy of atypical antipsychotics as mood stabilazers in maintenance therapy has not been demonstrated, and current data do not support their use as maintenance agents (Zupancic , 2011).…”

Section: Treatment-resistant Bipolar Disordersmentioning

confidence: 90%

Memantine: A New Mood Stabilizer for Treatment-Resistant Bipolar Disorders

Serra¹,

Serra²,

Koukopoulos³

et al. 2012

Bipolar Disorder - A Portrait of a Complex Mood Disorder

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“…In addition, several reports suggested that DVPX may be more efficacious for patients who experience rapid cycling, which is defined officially [4] as at least four separate episodes within a year but, practically speaking, includes the large group of individuals who are particularly volatile or dysphoric, prone to substance abuse, have poor interepisode functioning and are underresponsive to lithium [38][39][40][41][42][43][44][45]. Some reviews, though, indicate that this advantage for DVPX may be overstated [46].…”

Section: Mania Without Psychotic Featuresmentioning

confidence: 99%

Pharmacological treatment of bipolar disorder among children and adolescents

Blader

Kafantaris

2007

Expert Review of Neurotherapeutics

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SummaryThere is growing recognition that bipolar disorder (BD) frequently first presents in adolescence. Preadolescents with volatile behavior and severe mood swings also comprise a large group of patients whose difficulties may lie within the bipolar spectrum. However, the preponderance of scientific effort and clinical trials for this condition have focused on adults. This review summarizes the BD's complexity and diagnosis among young people. It proceeds to review the principles of pharmacotherapy, to assess current treatment options, and to highlight areas where evidence-based guidance is lacking. Recent developments have enlarged the range of potential treatments for BD. Nonetheless, differences in the phenomenology, course, and sequelae of BD among young people compel greater attention to the benefits and liabilities of therapy for those affected by this illness' early onset. PHENOMENOLOGY AND DIAGNOSTIC CONSIDERATIONSBipolar disorder (BPD) describes a pattern of major mood disturbances over an extended period of time that typically crystallizes by early adulthood, although onset may occur at any time [1][2][3]. The current prototype for this illness is well-characterized for adults, and has four cardinal features: (1) episodes of major depression; interspersed, to greater or lesser degree, with (2) episodes of mania; (3) intervals between episodes whose duration, mood state and quality of functioning vary widely between patients; and (4) an overall course of psychiatric illness that is chronic [4][5][6]. "Standard" (Classic) Bipolar Disorder Based on Adult PhenomenologyBipolar I Disorder is the diagnosis, per DSM-IV, for individuals who have experienced distinct episodes of mania or an episode of major depression with a prior history of mania. Symptomatically, depression in bipolar disorder does not differ markedly from that seen in individuals without BPD (so-called "unipolar") depression, although it tends to be more persistent and refractory to treatment as our later discussion of pharmacotherapy will elaborate. The classic mood-related abnormality of a manic episode is elation or euphoria, accompanied by an unusually high energy level and the drive and enthusiasm to undertake plans and projects that are often unrealistic and poorly thought out. This frame of mind exerts a severe disinhibitory effect on behavior, which becomes impulsive, erratic, thrill-seeking, and hence AUTHOR CONTACT INFORMATION

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Rapid‐cycling bipolar disorder: effects of long‐term treatments

Cited by 111 publications

References 43 publications

Longitudinal research on bipolar disorders

Longitudinal research on bipolar disorders

Memantine: A New Mood Stabilizer for Treatment-Resistant Bipolar Disorders

Pharmacological treatment of bipolar disorder among children and adolescents

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