Patterns of response to aripiprazole, lithium, haloperidol, and placebo across factor scores of mania
| Autor: | Alan C. Swann, James M. Eudicone, Trisha Suppes, Berit X. Carlson, Wally Landsberg, Michael J. Ostacher, Ross A. Baker |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Bipolar I disorder Bipolar disorder medicine.medical_treatment Aripiprazole Young Mania Rating Scale Placebo behavioral disciplines and activities Antipsychotic Internal medicine mental disorders medicine Haloperidol Treatment outcome Psychiatry Biological Psychiatry Research medicine.disease Mania Psychiatry and Mental health Factor analysis medicine.symptom Psychology medicine.drug |
| Zdroj: | International Journal of Bipolar Disorders |
| ISSN: | 2194-7511 |
| Popis: | Background A previous factor analysis of Young Mania Rating Scale and Montgomery-Åsberg Depression Rating Scale items identified composite factors of depression, mania, sleep disturbance, judgment/impulsivity, and irritability/hostility as major components of psychiatric symptoms in acute mania or mixed episodes in a series of trials of antipsychotics. However, it is unknown whether these factors predict treatment outcome. Methods Data from six double-blind, randomized, controlled clinical trials with aripiprazole in acute manic or mixed episodes in adults with bipolar I disorder were pooled for this analysis and the previously identified factors were examined for their value in predicting treatment outcome. Treatment efficacy was assessed for aripiprazole (n = 1,001), haloperidol (n = 324), lithium (n = 155), and placebo (n = 694) at baseline, days 4, 7, and 10, and then weekly to study end. Mean change in factor scores from baseline to week 3 was assessed by receiver operating characteristics curves for percentage factor change at day 4 and week 1. Results Subjects receiving aripiprazole, haloperidol, and lithium significantly improved mania factor scores versus placebo. Factors most predictive of endpoint efficacy for aripiprazole were judgment/impulsivity at day 4 and mania at week 1. Optimal factor score improvement for outcome prediction was approximately 40% to 50%. Early efficacy predicted treatment outcome across all factors; however, response at week 1 was a better predictor than response at day 4. Conclusions This analysis confirms clinical benefits in early treatment/assessment for subjects with bipolar mania and suggests that certain symptom factors in mixed or manic episodes may be most predictive of treatment response. |
| Databáze: | OpenAIRE |
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