Long-term treatment for bipolar disorders
Abstract
Medical prescriptions for bipolar disorders require taking into account both episodic and long-term treatment. The main objectives will be mood stabilization, avoiding inducing an opposing episode and preventing of relapses. Treatments available include mood stabilizers, antipsychotics, antidepressants, and non- pharmacological therapies. This papers overviews advantages and disadvantages of those treatments. Empirical evidence indicates that lithium is the most widely used mood stabilizer being considered the gold standard for testing new treatments. Antipsychotics are usually used for treating manic episodes with or without that type of symptoms. Atypical antipsychotics are preferred for they present fewer side effects. The use of antidepressants must be cautious for they may induce a manic episode. Finally, behavioral cognitive therapy and psychoeducation prevail as the most effective interventions among non-pharmacological options.
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References
Akiskal, H. S., Cassano, G. B., Musetti, L., Perugi, G., Tundo, A., &, Mignani, V. (1989). Psychopathology, temperament, and past course in primay major depression. 1. Review of evidence for a bipolar spectrum. Psychopathology, 22, 268–277.
Baldessarini, R. J., Bolzani, L., Cruz, N., Jones, P. B., Lai, M., Lepri, B., … Vieta, E. (2010). Onset–age of bipolar disorders at six international sites. Journal of Affective Disorders, 121, 143–146.
Baldessarini, R. J., Tondo, L., Davis, P., Pompili, M., Goodwin, F. K., & Hennen, J. (2006). Decreased risk of suicides and attempts during long–term lithium treatment: a meta–analytic review. Bipolar Disorders, 8, 625–639.
Faedda, G. L., Baldessarini, R. J., Tohen, M., Strakowski, S. M., & Waternaux, C. (1991). Episode sequence in bipolar disorder and response to lithium treatment. The American Journal of Psychiatry, 148, 1237–1239.
Fountoulakis, K. N. & Vieta, E. (2008). Treatment of bipolar disorder: a systematic review of available data and clinical perspectives. The International Journal of Neuropsychopharmacology, 11, 999–1029.
Gitlin, M. J., Cochran, S. D., & Jamison, K. R. (1989). Maintenance lithium treatment: side effects and compliance. Journal of Clinical Psychiatry, 50, 127–131.
Goodwin, F. K. & Jamison, K. R. (2007). Manic–Depressive Illness. New York, NY: Oxford University Press.
Grof, E., Haag, M., Grof, P., & Haag, H. (1987). Lithium response and the sequence of episode polarities: preliminary report on a Hamilton sample. Progress in Neuro–Psychopharmacology & Biological Psychiatry, 11, 199–203.
Grunze, H., Vieta, E., Goodwin, G. M., Bowden, C., Licht, R. W., Moller, H. J., & Kasper, S. (2009). The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the treatment of acute mania. The World Journal of Biological Psychiatry, 10, 85–116.
Haag, H., Heidorn, A., Haag, M., & Greil, W. (1987). Sequence of affective polarity and lithium response: preliminary report on Munich sample. Progress in Neuro–Psychopharmacology & Biological Psychiatry, 11, 205–208.
Kaplan, B. J., Sadock, V. A., & Ruiz, P. (2009). Kaplan & Sadock's comprehensive textbook of psychiatry (9na ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Klerman, G. L. (1981). The spectrum of mania. Comprehensive Psychiatry, 22, 11–20.
Kukopulos, A., Reginaldi, D., Laddomada, P., Floris, G., Serra, G., & Tondo, L. (1980). Course of the manic–depressive cycle and changes caused by treatment. Pharmakopsychiatr Neuropsychopharmakol, 13, 156–167.
Maj, M., Pirozzi, R., & Starace, F. (1989). Previous pattern of course of the illness as a predictor of response to lithium prophylaxis in bipolar patients. Journal of Affective Disorders, 17, 237–241.
Merikangas, K. R., Akiskal, H. S., Angst, J., Greenberg, P. E., Hirschfeld, R. M. A., Petukhova, M., & Kessler, R.C. (2007). Lifetime and 12–Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication. Archives of General Psychiatry, 64, 543–552.
Schatzberg, A., & Nemeroff, C. (2009). Textbook of Psychopharmacology (4ta ed.). Washington, DC: The American Psychiatric Publishing.
Thase, M. E., Macfadden, W., Weisler, R. H., Chang, W., Paulsson, B., Khan, A., BOLDER II Study Group. (2006). Efficacy of quetiapine monotherapy in bipolar I and II depression: a double–blind, placebo–controlled study (the BOLDER II study). Journal of Clinical Psychopharmacology, 26(6), 600–609.
Tondo, L., Hennen, J., & Baldessarini, R. J. (2001). Lower suicide risk with long–term lithium treatment in major affective illness: A meta–analysis. Acta Psychiatrica Scandinavica, 104, 163–172.
Tondo, L., Lepri, B., Cruz, N., & Baldessarini, R. J. (2010). Age at onset in 3014 Sardinian bipolar and major depressive disorder patients. Acta Psychiatrica Scandinavica, 121, 446–452.
Tondo, L., Vázquez, G., & Baldessarini, R. J. (2010). Mania and hypomania associated with antidepressant treatment: comprehensive meta–analytic review. Acta Psychiatrica Scandinavica, 121, 404–414.
Turvey, C. L., Coryell, W. H., Arndt, S., Solomon, D. A., Leon, A. C., Endicott J, … Akiskal, H. (1999). Polarity sequence, depression, and chronicity in bipolar I disorder. The Journal of Nervous and Mental Disease, 187, 181–187.
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