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Response to maintenance treatment in bipolar disorder

Publication |
2011

Abstract

The main aim of long-term management for bipolar disorder (BD) is the prevention of new mood episodes and maintaining symptomatic and functional remission. Although several pharmacological and psychosocial interventions have shown effectiveness in maintenance treatment of BP, long-term recovery is achieved only in some patients.

Little is known how these treatments are effective in routine clinical practice. 121 patients (76 women) with BD confirmed by SADS-L interview, with mean age of 44.6 and mean duration of illness of 13.1 years who were at least one year on maintenance monotherapy with mood stabilizers (lithium, carabamazepine, valproate, lamotrigine and olanzapine) were assessed using the Treatment Response Scale (TRS). Total score >= 7 in TRS ("full responders") reached 22 (18 %) patients.

For particular mood stabilizers, we found response rate from 5 to 28 %. Responders did not differ from non-responders in the length of illness, age of onset, the polarity of first episode, number of episodes, the occurrence of psychotic symptoms and suicide attempts, positive family history, and the presence of comorbid disorders.

Although mood stabilizer monotherapies remain recommended and desirable strategies for maintenance treatment of BD, our results show that a satisfactory response is achieved only in a minority of patients