Clinical correlates of sustained response to individual drugs used in naturalistic treatment of patients with bipolar disorder

Autor: Michael Rowe, Lori L. Altshuler, Mark A. Frye, Susan L. McElroy, Heinz Grunze, Willem A. Nolen, Gabriele S. Leverich, Trisha Suppes, Paul E. Keck, Ralph W. Kupka, Robert M. Post
Přispěvatelé: EMGO - Mental health, Psychiatry, Clinical Cognitive Neuropsychiatry Research Program (CCNP)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Child abuse
Male
Parents
Bipolar Disorder
STEP-BD
Neuropsychological Tests
law.invention
Benzodiazepines
DOUBLE-BLIND
0302 clinical medicine
Randomized controlled trial
I DISORDER
law
Antimanic Agents
lcsh:Psychiatry
Child Abuse
Child
LIFE-CHART METHOD
Triazines
Middle Aged
DEPRESSION
Antidepressive Agents
Substance abuse
Psychiatry and Mental health
Clinical Psychology
Treatment Outcome
Lithium Compounds
Anxiety
Drug Therapy
Combination
Female
medicine.symptom
Psychology
OUTPATIENTS
medicine.drug
Antipsychotic Agents
Adult
medicine.medical_specialty
Substance-Related Disorders
lcsh:RC435-571
EARLY-ONSET
Lamotrigine
CONTROLLED-TRIAL
03 medical and health sciences
ANTIDEPRESSANT TREATMENT
medicine
Humans
LITHIUM
Bipolar disorder
Psychiatry
Mood Disorders
Valproic Acid
medicine.disease
030227 psychiatry
Regimen
Mood disorders
030217 neurology & neurosurgery
Zdroj: Comprehensive Psychiatry, Vol 66, Iss, Pp 146-156 (2016)
Comprehensive Psychiatry, 66, 146-156. W.B. Saunders Ltd
Comprehensive Psychiatry, 66, 146-156. W B SAUNDERS CO-ELSEVIER INC
Post, R M, Leverich, G S, Kupka, R, Keck, P E J, McElroy, S L, Altshuler, L L, Frye, M A, Rowe, M, Grunze, H, Suppes, T & Nolen, W A 2016, ' Clinical correlates of sustained response to individual drugs used in naturalistic treatment of patients with bipolar disorder ', Comprehensive Psychiatry, vol. 66, pp. 146-156 . https://doi.org/10.1016/j.comppsych.2016.01.009
ISSN: 0010-440X
DOI: 10.1016/j.comppsych.2016.01.009
Popis: Objective: To report use and treatment success rates of medications for bipolar disorder as a function of patients' clinical characteristics.Method: Outpatients with bipolar illness diagnosed by SCID were rated by research assistants on the NIMH-LCM and those who had an good response for at least 6 months (much or very much improved on the CGI-BP) were considered responders (treatment "success"). Clinical characteristics associated with treatment response in the literature were examined for how often a drug was in a successful regimen when a given characteristic was either present or absent.Results: Lithium was less successful in those with histories of rapid cycling, substance abuse, or (surprisingly) a positive parental history of mood disorders. Valproate was less successful in those with >= 20 prior episodes. Lamotrigine (LTG) was less successful in those with a parental history of mood disorders or in BP-I compared to BP-II disorder. Antidepressants (ADs) had low success rates, especially in those with a history of anxiety disorders. Benzodiazepines had low success rates in those with child abuse, substance use, or >= 20 episodes. Atypical antipsychotics were less successful in the presence of rapid cycling, >= 20 prior episodes, or a greater number of poor prognosis factors.Conclusion: Success rates reflect medications used in combination with an average of two other drugs during naturalistic treatment and thus should be considered exploratory. However, the low long-term success rates of drugs (even when used in combination with others) that occurred in the presence of many very common clinical characteristics of bipolar illness speak to the need for the development of alternative treatment strategies. (C) 2016 Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
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