Citation

Vieta E. Prim. Psychiatry 2007; 14(3): 70-76.

Copyright

(Copyright © 2007, MBL Communications)

DOI

unavailable

PMID

unavailable

Abstract

Bipolar disorder has an episodic and chronic nature that requires long-term treatment in all patients. There is an unmet need for well-tolerated and clinically effective maintenance therapy with enhanced patient adherence. Few well-tolerated treatment options are available that are effective in all phases of bipolar disorder and prevent episode recurrence. Lithium has established efficacy in the prevention of further manic episodes and may also be effective in the prevention of depression and suicide. Safety is a concern due to a narrow therapeutic window. For valproate and carbamazepine, data appear much less compelling. Lamotrigine has been shown to be effective for long-term prevention of depressive episodes, but is not effective in acute episodes. Controlled studies suggest that some atypical antipsychotics may also have mood-stabilizing properties and may become standard for long-term therapy. The role of psychoeducation in improving adherence to medication in long-term treatment and patient outcomes is also emphasized.

Language: en

Keywords

human; suicide; bipolar disorder; insomnia; depression; lithium; clinical trial; treatment outcome; clozapine; psychoeducation; review; sedation; headache; quetiapine; anxiety disorder; chronic disease; haloperidol; drug safety; long term care; patient compliance; carbamazepine; drug efficacy; extrapyramidal symptom; olanzapine; risperidone; tardive dyskinesia; valproate semisodium; weight gain; agranulocytosis; hyperprolactinemia; valproic acid; mania; rash; lamotrigine; side effect; hypomania; atypical antipsychotic agent; maintenance therapy; amisulpride; metabolic disorder; ziprasidone; schizoaffective psychosis; nervousness; monotherapy; dizziness; aripiprazole; mood stabilizer; metabolic syndrome X