nach oben

CNS Drugs

Erschienen in:

01.11.2002 | Current Opinion

Treatment Research in Bipolar Disorder

Issues and Recommendations

verfasst von: Dr Ross J. Baldessarini

Erschienen in: CNS Drugs | Ausgabe 11/2002

Einloggen, um Zugang zu erhalten

Abstract

Bipolar (manic-depressive) disorder is one of the most common of the severe mental illnesses. Officially recognised forms comprise type I (with mania), type II (with hypomania), cyclothymia and a rapid-cycling subtype. International lifetime prevalence estimates are 1 to 5% of the general population, and bipolar disorder accounts disproportionately for idiopathic psychoses. Psychiatric and substance-abuse comorbidities are common complications, and mortality rates are increased as a result of high suicidal risks, accidents, complications of substance abuse and increased fatality of stress-sensitive medical illnesses. Complex and labile symptomatic presentations, a tendency for patients to deny illness and reject treatment, and diagnostic heterogeneity severely complicate the design, conduct and interpretation of experimental treatment trials in bipolar disorder.

Progress in the short-term treatment of mania with certain antiepileptic drugs and atypical antipsychotic agents has advanced greatly in recent years; however, long-term treatment trials other than with lithium remain rare, as are studies of type II disorder, bipolar depression and mixed states, and there is limited information on treatment effectiveness against comorbidity, dysfunction and mortality. There is a growing realisation that bipolar disorder represents a major, largely unmet, international public health challenge and that innovative methods for carrying out reliable and generalisable long-term pharmacological treatment trials, alone and in combination with cost-effective psychosocial and rehabilitative interventions, are urgently required.

Goodwin FK, Jamison KR. Manic depressive illness. New York: Oxford University Press, 1990

Baldessarini RJ. A plea for integrity of the bipolar disorder concept. Bipolar Disord 2000; 2: 3–7PubMedCrossRef

Tohen M, Angst J. Epidemiology of bipolar disorder. In: Tsuang MT, Tohen M, editors. Textbook in psychiatric epidemiology. 2nd ed. New York: John Wiley & Sons, 1995

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed., text revision. Washington, DC: American Psychiatric Association, 2000

Akiskal HS, Bourgeois ML, Angst J, et al. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorders. J Affect Disord 2000; 59: S5–30PubMedCrossRef

Baldessarini RJ, Tondo L, Hennen J. Reduced suicide risk during long-term treatment with lithium. Ann N Y Acad Sci 2001; 932: 24–43PubMedCrossRef

Tondo L, Hennen J, Baldessarini RJ. Reduced suicide risk with long-term lithium treatment in major affective illness: a meta-analysis. Acta Psychiatr Scand 2001; 104: 163–72PubMedCrossRef

Tondo L, Baldessarini RJ, Floris G. Long-term effectiveness of lithium maintenance treatment in types I and II bipolar disorders. Br J Psychiatry 2001; 178Suppl. 40: S184–90PubMedCrossRef

Baldessarini RJ, Tarazi FI. Drugs and the treatment of psychiatric disorders: antipsychotic and antimanic agents. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed. New York: McGraw-Hill Press, 2001: 485–520

10.

Baldessarini RJ. Drugs and the treatment of psychiatric disorders: antidepressant and antianxiety agents. In: Hardman JG, Limbird LE, Gilman AG, editors. Goodman and Gilman’s the pharmacological basis of therapeutics. 10th ed. New York: McGraw-Hill Press, 2001: 447–83

11.

Brambilla P, Barale F, Soares JC. Perspectives on the use of anticon vulsants in the treatment of bipolar disorder. Int J Neuro-psychopharmacol 2001; 4: 421–46

12.

Strakowski SM, Del Bello MP, Adler CM. Comparative efficacy and tolerability of drug treatments for bipolar disorder. CNS Drugs 2001; 15:701–18PubMedCrossRef

13.

Ghaemi SN, Lenox MS, Baldessarini RJ. Effectiveness and safety of long-term antidepressant treatment in bipolar disorder. J Clin Psychiatry 2001; 62: 565–9PubMedCrossRef

14.

Nemeroff CB, Evans DL, Gyulai L, et al. Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. Am J Psychiatry 2001; 158: 906–12PubMed

15.

Baldessarini RJ, Tondo L, Hennen J. Effects of rapid cycling on response to lithium maintenance treatment in 360 bipolar I and II disorder patients. J Affect Disord 2000; 61: 13–22PubMedCrossRef

16.

Baldessarini RJ, Tondo L, Hennen J. Latency and episodes before treatment: effects on pretreatment morbidity but not response to maintenance treatment in bipolar I and II disorders. Bipolar Disord 2002. In press

17.

Kukopulos A, Reginaldi D, Laddomada P, et al. Course of the manic-depressive cycle and changes caused by treatments. Pharmakopsychiatr Neuropsychopharmakol 1980; 13: 156–67PubMed

18.

Kupfer DJ, Carpenter LL, Frank E. Possible role of antidepressants in precipitating mania and hypomania in recurrent depression. Am J Psychiatry 1988; 145: 804–8PubMed

19.

Stoll AL, Mayer PV, Kolbrener M, et al. Antidepressant-associated mania: a controlled comparison with spontaneous mania. Am J Psychiatry 1994; 151: 1642–5PubMed

20.

Baldessarini RJ, Tondo L, Hennen J, et al. Is lithium still worth using? An update of selected recent research. Harv Rev Psychiatry 2002; 10: 59–75PubMed

21.

Kruger S, Braunig P, Cooke RG. Comorbidity of obsessive-compulsive disorder in recovered inpatients with bipolar disorder. Bipolar Disord 2000; 2: 71–4PubMedCrossRef

22.

Cassidy F, Ahearn EP, Carroll BJ. Substance abuse in bipolar disorder. Bipolar Disord 2001; 3: 181–8PubMedCrossRef

23.

MacKinnon DF, Zandi PP, Cooper J, et al. Comorbid bipolar disorder and panic disorder in families with a high prevalence of bipolar disorder. Am J Psychiatry 2002; 15: 30–5CrossRef

24.

Ghaemi SN, Pope Jr HG. Lack of insight in psychotic and affective disorders: a review of empirical studies. Harv Rev Psychiatry 1994; 2: 22–33PubMedCrossRef

25.

Osby U, Brandt L, Correia N, et al. Excess mortality in bipolar and unipolar disorder in Sweden. Arch Gen Psychiatry 2001; 58: 844–50PubMedCrossRef

26.

Bowden CL, Brugger A, Swann AC, et al. Efficacy of divalproex vs. lithium and placebo in the treatment of mania. JAMA 1994; 271: 918–24

27.

Tohen M, Sanger TM, McElroy SL, et al. Olanzapine versus placebo in the treatment of acute mania: the Olanzapine HGEH Study Group. Am J Psychiatry 1999; 156: 702–9PubMed

28.

Tohen M, Jacobs TG, Grundy SL, et al. Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study: the Olanzapine HGGW Study Group. Arch Gen Psychiatry 2000; 57: 841–9PubMedCrossRef

29.

Cade JFJ. Lithium salts in the treatment of psychotic excitement. Med J Aust 1949; 2: 349–52PubMed

30.

Prien RF, Kupfer DJ, Mansky PA, et al. Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Arch Gen Psychiatry 1984; 41: 1096–104PubMedCrossRef

31.

Bowden CL, Calabrese JR, McElroy SL, et al. A randomized, placebo-controlled, 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder: the Divalproex Maintenance Study Group. Arch Gen Psychiatry 2000; 57: 481–9PubMedCrossRef

32.

Baldessarini RJ, Tohen M, Tondo L. Maintenance treatment in bipolar disorder. Arch Gen Psychiatry 2000; 57: 490–2PubMedCrossRef

33.

Kupfer DJ, Frank E, Grochocinski VJ, et al. Demographic and clinical characteristics of individuals in a bipolar disorder case registry. J Clin Psychiatry 2002; 63: 120–5PubMedCrossRef

34.

Keller MB, Lavori PW, Klerman G, et al. Low levels and lack of predictors of somatotherapy and psychotherapy received by depressed patients. Arch Gen Psychiatry 1986; 43: 458–66PubMedCrossRef

35.

Harman JS, Mulsant BH, Kelleher KJ, et al. Narrowing the gap in treatment of depression. Int J Psychiatry Med 2001; 31: 239–53PubMedCrossRef

36.

Bowden CL, Swann AC, Calabrese JR, et al. Maintenance clinical trials in bipolar disorder: design implications of the divalproex-lithium-placebo study. Psychopharmacol Bull 1997; 33: 693–9PubMed

37.

Gelenberg AJ, Frank E, Keller MB, et al. Evaluating pharmacologic treatments for bipolar disorder. In: Prien RF, Robison DS, editors. Clinical evaluation of psychotropic drugs: principles and guidelines. New York: Raven Press, 1994: 327–44

38.

Prien RF, Robison DS, editors. Clinical evaluation of psychotropic drugs: principles and guidelines. New York: Raven Press, 1994: 728

39.

Prien RF, Rush AJ. National Institute of Mental Health workshop report on the treatment of bipolar disorder. Biol Psychiatry 1996; 40: 215–20PubMedCrossRef

40.

Calabrese JR, Rapport DJ. Mood stabilizers and the evolution of maintenance study designs in bipolar I disorder. J Clin Psychiatry 1999; 60 Suppl. 5: 5–13

41.

Lavori PW. Placebo control groups in randomized treatment trials: a statistician’s perspective. Biol Psychiatry 2000; 47: 717–23PubMedCrossRef

42.

Post RM, Denicoff KD, Leverich GS. Special issues in trial design and use of placebo in bipolar illness. Biol Psychiatry 2000; 47: 727–32PubMedCrossRef

43.

Rush AJ, Post RM, Nolen WA, et al. Methodological issues in development new acute treatment for patients with bipolar illness. Biol Psychiatry 2000; 46: 615–24CrossRef

44.

Calabrese JR, Rapport DJ, Shelton MD, et al. Evolving methodologies in bipolar disorder maintenance research. Br J Psychiatry 2001; 178Suppl. 41: s157–63PubMedCrossRef

45.

Geddes J, Goodwin G. Bipolar disorder: clinical uncertainty, evidence-based medicine and large-scale randomized trials.Br J Psychiatry 2001; 178Suppl. 4: sl91–4

46.

Post RM, Keck Jr PE, Rush AJ. New designs for studies of the prophylaxis of bipolar disorder. J Clin Psychopharmacol 2002; 22: 1–3PubMedCrossRef

47.

Baldessarini RJ, Tondo L, Viguera AC. Effects of discontinuing lithium maintenance treatment. Bipolar Disord 1999; 1: 17–24PubMedCrossRef

48.

Hennen J. Methods of design and analysis of experimental treatment trials in bipolar disorder. Bipolar Disord. In press

49.

Coppen A, Montgomery SA, Gupta RK, et al. A double-blind comparison of lithium carbonate and maprotiline in the prophylaxis of the affective disorders. Br J Psychiatry 1976; 128: 479–85PubMedCrossRef

50.

Huxley NA, Parikh SV, Baldessarini RJ. Effectiveness of psychosocial treatments in bipolar disorder: state of the evidence. Harv Rev Psychiatry 2000; 8: 126–40PubMed

51.

Klein DF. Improvement of phase III psychotropic drug trials by intensive phase II work. Neuropsychopharmacology 1991; 4: 251–8PubMed

52.

Centorrino F, Hernán MA, Drago-Ferrante G, et al. Noncompliance with psychiatric outpatient visits: associated factors. Psychiatr Serv 2001; 52: 378–80PubMedCrossRef

Titel: Treatment Research in Bipolar Disorder
Issues and Recommendations
verfasst von: Dr Ross J. Baldessarini
Publikationsdatum: 01.11.2002
Verlag: Springer International Publishing
Erschienen in: CNS Drugs / Ausgabe 11/2002
Print ISSN: 1172-7047
Elektronische ISSN: 1179-1934
DOI: https://doi.org/10.2165/00023210-200216110-00001

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Schützt Olivenöl vor dem Tod durch Demenz?

10.05.2024 Morbus Alzheimer Nachrichten

Konsumieren Menschen täglich 7 Gramm Olivenöl, ist ihr Risiko, an einer Demenz zu sterben, um mehr als ein Vierten reduziert – und dies weitgehend unabhängig von ihrer sonstigen Ernährung. Dafür sprechen Auswertungen zweier großer US-Studien.

Bluttest erkennt Parkinson schon zehn Jahre vor der Diagnose

10.05.2024 Parkinson-Krankheit Nachrichten

Ein Bluttest kann abnorm aggregiertes Alpha-Synuclein bei einigen Menschen schon zehn Jahre vor Beginn der motorischen Parkinsonsymptome nachweisen. Mit einem solchen Test lassen sich möglicherweise Prodromalstadien erfassen und die Betroffenen früher behandeln.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Wartezeit nicht kürzer, aber Arbeit flexibler

Psychotherapie Medizin aktuell

Fünf Jahren nach der Neugestaltung der Psychotherapie-Richtlinie wurden jetzt die Effekte der vorgenommenen Änderungen ausgewertet. Das Hauptziel der Novellierung war eine kürzere Wartezeit auf Therapieplätze. Dieses Ziel wurde nicht erreicht, es gab jedoch positive Auswirkungen auf andere Bereiche.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2002

Aripiprazole

Therapeutic Potential of Kava in the Treatment of Anxiety Disorders

Spotlight on Sertraline in the Management of Major Depressive Disorder in Elderly Patients

Teratogenic Potential of the Newer Antiepileptic Drugs

Liquid Risperidone in the Treatment of Psychotic Agitation