Stability of lithium treatment in bipolar disorder - long-term follow-up of 346 patients

Berghöfer, Anne; Alda, Martin; Adli, Mazda; Baethge, Christopher; Bauer, Michael; Bschor, Tom; Grof, Paul; Müller‐Oerlinghausen, B.; Rybakowski, Janusz; Suwalska, Aleksandra; Pfennig, Andrea

doi:10.1186/2194-7511-1-11

Cited by 24 publications

(22 citation statements)

References 60 publications

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“…The number of manic episodes that a patient experiences has been associated with greater resistance to pharmacological treatment [8,9,22]. However, these findings were not replicated when the response to lithium was examined in a large 20-year follow-up study among adults with BD [23]. Concerning psychological interventions, cognitive behavioural therapy (CBT) and psychoeducational therapy have shown more effectiveness in the early stages of the disease compared with the later stages [24][25][26].…”

Section: The Life-time Course Of Bipolar Disordermentioning

confidence: 99%

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Benarous

Consoli

Milhiet

et al. 2015

Eur Child Adolesc Psychiatry

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In recent decades, ongoing research programmes on primary prevention and early identification of bipolar disorder (BD) have been developed. The aim of this article is to review the principal forms of evidence that support preventive interventions for BD in children and adolescents and the main challenges associated with these programmes. We performed a literature review of the main computerised databases (MEDLINE, PUBMED) and a manual search of the literature relevant to prospective and retrospective studies of prodromal symptoms, premorbid stages, risk factors, and early intervention programmes for BD. Genetic and environmental risk factors of BD were identified. Most of the algorithms used to measure the risk of developing BD and the early interventions programmes focused on the familial risk. The prodromal signs varied greatly and were age dependent. During adolescence, depressive episodes associated with genetic or environmental risk factors predicted the onset of hypomanic/manic episodes over subsequent years. In prepubertal children, the lack of specificity of clinical markers and difficulties in mood assessment were seen as impeding preventive interventions at these ages. Despite encouraging results, biomarkers have not thus far been sufficiently validated in youth samples to serve as screening tools for prevention. Additional longitudinal studies in youths at high risk of developing BD should include repeated measures of putative biomarkers. Staging models have been developed as an integrative approach to specify the individual level of risk based on clinical (e.g. prodromal symptoms and familial history of BD) and non-clinical (e.g. biomarkers and neuroimaging) data. However, there is still a lack of empirically validated studies that measure the benefits of using these models to design preventive intervention programmes.

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Section: The Life-time Course Of Bipolar Disordermentioning

confidence: 99%

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Benarous

Consoli

Milhiet

et al. 2015

Eur Child Adolesc Psychiatry

View full text Add to dashboard Cite

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“…High variability is generally observed in patient response to treatment, which has led to several investigations of lithium’s mechanisms of action and the biological underpinnings of this response heterogeneity. Accordingly, the responsiveness to lithium has been particularly investigated in genomic studies and point to the existence of a distinct, more homogenous phenotype within BD patients (Alda et al, 2005; Grof et al, 2002; Scott et al, 2017) that appears to be stable across life (Berghofer et al, 2013). In addition, as seen in other diseases (Brunner-La Rocca et al, 2001; Potze et al, 2014), lithium might induce different effects in patients compared to controls, and understanding these diagnosis-specific effects might shed light into the genetic make-up of patients and its interaction with lithium.…”

Section: Introductionmentioning

confidence: 99%

Distinct lithium-induced gene expression effects in lymphoblastoid cell lines from patients with bipolar disorder

Fries

Colpo

Monroy-Jaramillo

et al. 2017

European Neuropsychopharmacology

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Lithium is the most commonly prescribed medication for the treatment of bipolar disorder (BD), yet the mechanisms underlying its beneficial effects are still unclear. We aimed to compare the effects of lithium treatment in lymphoblastoid cell lines (LCLs) from BD patients and controls. LCLs were generated from sixty-two BD patients (based on DSM-IV) and seventeen healthy controls matched for age, sex, and ethnicity. Patients were recruited from outpatient clinics from February 2012 to October 2014. LCLs were treated with 1 mM lithium for 7 days followed by microarray gene expression assay and validation by real-time quantitative PCR. Baseline differences between groups, as well as differences between vehicle- and lithium-treated cells within each group were analyzed. The biological significance of differentially expressed genes was examined by pathway enrichment analysis. No significant differences in baseline gene expression (adjusted p-value < 0.05) were detected between groups. Lithium treatment of LCLs from controls did not lead to any significant differences. However, lithium altered the expression of 236 genes in LCLs from patients; those genes were enriched for signaling pathways related to apoptosis. Among those genes, the alterations in the expression of PIK3CG, SERP1 and UPP1 were validated by real-time PCR. A significant correlation was also found between circadian functioning and CEBPG and FGF2 expression levels. In summary, our results suggest that lithium treatment induces expression changes in genes associated with the apoptosis pathway in BD LCLs. The more pronounced effects of lithium in patients compared to controls suggest a disease-specific effect of this drug.

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“…This episodic recurrent form of BD is known to be associated with an increased rate of recurrent mood disorders, but not schizophrenia in relatives, and a high response rate to long-term lithium, estimated at 80%. 13,14 A recent large prospective study 15 of patients with classical BD reported that the morbidity index in lithium-treated patients remained stable for up to 20 years. Moreover, lithium response was found to cluster in affected members.…”

Section: Natural History and Heterogeneity Of Bipolar Disordermentioning

confidence: 99%

Toward a Comprehensive Clinical Staging Model for Bipolar Disorder: Integrating the Evidence

Duffy

2014

Can J Psychiatry

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Objectives: To describe key findings relating to the natural history and heterogeneity of bipolar disorder (BD) relevant to the development of a unitary clinical staging model. Currently proposed staging models are briefly discussed, highlighting complementary findings, and a comprehensive staging model of BD is proposed integrating the relevant evidence.Method: A selective review of key published findings addressing the natural history, heterogeneity, and clinical staging models of BD are discussed. Results:The concept of BD has broadened, resulting in an increased spectrum of disorders subsumed under this diagnostic category. Different staging models for BD have been proposed based on the early psychosis literature, studies of patients with established BD, and prospective studies of the offspring of parents with BD. The overarching finding is that there are identifiable sequential clinical phases in the development of BD that differ in important ways between classical episodic and psychotic spectrum subtypes. In addition, in the context of familial risk, early risk syndromes add important predictive value and inform the staging model for BD. Conclusions:A comprehensive clinical staging model of BD can be derived from the available evidence and should consider the natural history of BD and the heterogeneity of subtypes. This model will advance both early intervention efforts and neurobiological research. W W WVers un modèle complet de staification clinique du trouble bipolaire : intégrant l'évidence Objectifs : Décrire les principaux résultats concernant l'histoire naturelle et l'hétérogénéité du trouble bipolaire (TB) qui se rapportent à l'élaboration d'un modèle unitaire de stades cliniques. Les modèles de staification présentement proposés sont brièvement présentés, de même que les résultats complémentaires, et un modèle complet de staification du TB est proposé qui intègre les données probantes pertinentes.Méthode : Est présentée une revue sélective des principaux résultats publiés sur l'histoire naturelle, l'hétérogénéité, et les modèles de staification clinique du TB.Résultats : Le concept du TB s'est élargi, ce qui a donné un spectre accru de troubles classés dans cette catégorie diagnostique. Différents modèles de staification du TB ont été proposés d'après la littérature sur la psychose précoce, les études de patients souffrant d'un TB établi, et les études prospectives des enfants de parents souffrant de TB. Le résultat déterminant est qu'il y a des phases cliniques séquentielles identifiables dans le développement du TB qui diffèrent de manière importante entre les sous-types épisodiques classiques et ceux du spectre psychotique. En outre, dans le contexte du risque familial, les syndromes de risque précoce ajoutent une valeur prédictive importante et éclairent le modèle de stadification du TB.Conclusions : Un modèle complet de stadification clinique du TB peut être déduit des données probantes disponibles et devrait tenir compte de l'histoire naturelle du TB et de l'hétérogénéité des sous-types. Ce ...

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Stability of lithium treatment in bipolar disorder - long-term follow-up of 346 patients

Cited by 24 publications

References 60 publications

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Early interventions for youths at high risk for bipolar disorder: a developmental approach

Distinct lithium-induced gene expression effects in lymphoblastoid cell lines from patients with bipolar disorder

Toward a Comprehensive Clinical Staging Model for Bipolar Disorder: Integrating the Evidence

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