Outcome of Bipolar Disorder on Long-Term Treatment with Lithium

1991 ◽  
Vol 159 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Ralph A. O'Connell ◽  
Julia A. Mayo ◽  
Leslie Flatow ◽  
Beverly Cuthbertson ◽  
Barbara E. O'Brien
Keyword(s):  
Bipolar Disorder ◽  
Treatment Outcome ◽  
Lithium Treatment ◽  
Term Treatment ◽  
Poor Outcome ◽  
Psychiatric Admissions ◽  
Long Term Treatment ◽  
Alcohol And Drug Abuse ◽  
Bipolar Patients

The long-term treatment outcome of 248 bipolar patients in an out-patient lithium programme was assessed. Over half of the patients (138 or 56%) had no affective episodes in the year observed. Patients were divided into outcome groups according to GAS scores: the outcome for 40% of patients was good, for 41% fair, and for 19% poor. More frequent psychiatric admissions before starting lithium treatment was the best predictor of poor outcome, followed by a negative affective style in the family and lower social class. Current alcohol and drug abuse was associated with poor outcome. Although familial and psychosocial factors were significantly associated with outcome, the findings suggest there may be inherent differences in the pathophysiology of bipolar disorder reflected in an increased frequency of episodes which account for a large variance in lithium treatment outcome.

Long-term lithium treatment in the prevention of suicidal behavior in bipolar disorder patients

2009 ◽  
Vol 18 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Leonardo Tondo ◽  
Ross J. Baldessarini
Keyword(s):  
Bipolar Disorder ◽  
Suicidal Behavior ◽  
Antidepressant Treatment ◽  
Lithium Treatment ◽  
Term Treatment ◽  
Mood Stabilizers ◽  
Major Depressive ◽  
Long Term Treatment ◽  
Meta Analyses

AbstractWe reviewed available research findings, including meta-analyses on effects of lithium-treatment associated with rates of suicidal behavior in bipolar disorder or unipolar major depressive disorder patients, and for comparisons of lithium to mood-stabilizing anticonvulsants. Data from meta-analyses consistently indicate marked reductions of suicidal behavior and mortality during long-term treatment with lithium salts in bipolar disorder patients, and possibly also in unipolar, recurrent major depressive, perhaps even more effectively than with anticonvulsants proposed as mood-stabilizers. Suicidal risk is frequently associated with dysphoric-agitated symptoms, anger, aggression, and impulsivity-all of which may respond better to treatment with lithium or other mood-stabilizing medicines than to antidepressants. In these conditions, antidepressant treatment may not provide a beneficial effect on risk of suicidal thoughts and perhaps attempts, particularly in juveniles, whereas, lithium, perhaps even more than anticonvulsants, seems to be remarkably effective in the preventing suicidal behavior. The mechanism of action is not well defined and may be associated with either a prevention of mood recurrences or a more specific “antisuicidal” activity.Declaration of Interest: Dr. Tondo has received research support from Janssen and Eli Lilly Corporations and has served as a consultant to Glaxo-SmithKline and Merck Corporations. Dr. Baldessarini has recently been a consultant or investigator-initiated research collaborator with: AstraZeneca, Auritec, Biotrofix, Janssen, JDS-Noven, Lilly, Luitpold, NeuroHealing, Novartis, Pfizer, and SK-BioPharmaceutical Corporations. Neither author is a member of pharmaceutical speakers’ bureaus, nor do they or any family member hold equity positions in biomedical or pharmaceutical corporations.

Does psychoeducatioanal Approach Could Reach the Target Patients with Bipolar Disorder?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Cakir ◽  
R. Bensusan ◽  
Z. Akca ◽  
O. Yazici
Keyword(s):  
Bipolar Disorder ◽  
Participation Rate ◽  
Poor Response ◽  
Term Treatment ◽  
Recruitment Rate ◽  
Mood Stabilizers ◽  
Blood Levels ◽  
Long Term Treatment ◽  
Bipolar Patients

The recurrent nature of bipolar disorder needs an optimum compliance with long term pharmacotherapy, however the poor adherence is common. Adjunctive psychoeducation seems favorable effects on adherence during the long term pharmacotherapy. Even strong benefits were showed, setting a psychoeducation in clinical practice is still novel and recruiting the patients with long history of bipolar disorder may not be feasible. In literature, recruitment rate, motivation and attitudes of patients for participation in psychoeducation is not studied. The present study was conducted to clarify the intends of patients with bipolar disorder to participate in psychoeducation and the factors that contribute.The euthymic patients with diagnosis of bipolar disorder I or II, were invited to the 6 week psychoeducation program in prospective study. The demographic and clinical data were obtained from life charts and updated with a clinical interview. The blood levels of mood stabilizers, adherence, response to prophylactic treatment, relapses and hospitalization rates between the participants and non-participants were compared.84 patients were attended the program, 71 patients were considered as unwilling to attend. The motivation of patients to attend a psychoeducation is limited. The participation rate was only 54.2%. The patients who refused attending to this program have fewer adherences to medication and irregular follow up visits, insufficient blood levels of mood stabilizers, poor response to long term treatment, more likely have mood episodes. Education level between attendees and non-attendees were not different.Optimum methods are required for recruitment of bipolar patients to a psychoeducation program.

Genetics of Lithium Response in Bipolar Disorder

2018 ◽  
Vol 51 (05) ◽  
pp. 206-211 ◽  
Author(s):  
Sergi Papiol ◽  
Thomas Schulze ◽  
Martin Alda
Keyword(s):  
Bipolar Disorder ◽  
Genetic Architecture ◽  
Association Studies ◽  
Lithium Treatment ◽  
Genetic Association Studies ◽  
Term Treatment ◽  
Individual Response ◽  
Long Term Treatment ◽  
Lithium Response

Abstract Introduction Lithium remains the best-established long-term treatment for bipolar disorder because of its efficacy in maintaining periods of remission and reducing the risk of suicide. Not all patients successfully respond to lithium treatment, and the individual response, including the occurrence of side effects, is highly variable and not easy to predict. The genetic basis of lithium response is supported by the fact that the response clusters in families. Likewise, recent high-throughput genomic analyses have shed light on its genetic architecture. Methods This nonsystematic review summarizes the main results obtained in genetic association studies using lithium response as target trait. Results These studies suggest that several genetic loci might modulate the way a patient responds to lithium maintenance treatment. Further studies to fully characterize the genetic architecture of lithium response are warranted. Discussion The identification of genetic factors associated with lithium response will be important for (1) better understanding of lithium’s mode of action and (2) development of a predictive model for optimization of long-term treatment of bipolar disorder.

What is the optimal serum lithium level in the long-term treatment of bipolar disorder? A review

2007 ◽  
Vol 40 (06) ◽  
Author(s):  
E Severus ◽  
N Kleindienst ◽  
F Seemüller ◽  
S Frangou ◽  
HJ Möller ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Lithium Level ◽  
Serum Lithium Level ◽  
Long Term Treatment

scholarly journals Defining the role of SGAs in the long-term treatment of bipolar disorder

2017 ◽  
Vol 19 (1) ◽  
pp. 65-67 ◽  
Author(s):  
Gin S Malhi ◽  
Grace Morris ◽  
Amber Hamilton ◽  
Tim Outhred ◽  
Pritha Das
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Long Term Treatment

Long-Term Treatment of Bipolar Disorder with Valproate

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Caitlin S. Yee ◽  
Gustavo H. Vázquez ◽  
Emily R. Hawken ◽  
Aleksandar Biorac ◽  
Leonardo Tondo ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Term Treatment ◽  
Long Term Treatment
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