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Matching the Bipolar Patient and the Mood Stabilizer

Matching the Bipolar Patient and the Mood Stabilizer Bipolar disorder poses many treatment challenges, including “matching” a particular patient with the optimal treatment regimen. Although there are a number of extant guidelines to assist the clinician in selecting treatment, these recommendations are largely based on general variables and fail to take into account the subtleties and complications that confront a clinician in practice. An analysis of predictors of medication response in bipolar disorder provides a basis for matching patients with optimal medication regimens. Response to treatment may depend on the polarity of an episode or on clinical features such as mixed or psychotic symptomatology and rate of cycling. Comorbid psychiatric disorders such as substance abuse, anxiety disorders, or attention-deficit/hyperactivity disorder should also be considered in designing a treatment regimen. Similarly, medical conditions, especially metabolic abnormalities or kidney insufficiency, must be taken into account. Selection of medication may also involve an analysis of demographic factors, including family and personal history of response to a particular agent. When selecting the most appropriate mood stabilizer for a patient—particularly when polypharmacy is required—the clinician should keep potential side effects and drug interactions in mind. Randomized, controlled studies in bipolar populations are needed to further characterize optimal matching of patient and medication. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Clinical Psychiatry Springer Journals

Matching the Bipolar Patient and the Mood Stabilizer

Gelenberg, Alan; Pies, Ronald
Annals of Clinical Psychiatry , Volume 15 (4) – Oct 11, 2004
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Publisher
Springer Journals
Copyright
Copyright © 2003 by American Academy of Clinical Psychiatrists
Subject
Medicine & Public Health; Neurology; Psychiatry; Psychopharmacology
ISSN
1040-1237
eISSN
1573-3238
DOI
10.1023/B:ACLI.0000008174.46414.a4
Publisher site
See Article on Publisher Site

Abstract

Bipolar disorder poses many treatment challenges, including “matching” a particular patient with the optimal treatment regimen. Although there are a number of extant guidelines to assist the clinician in selecting treatment, these recommendations are largely based on general variables and fail to take into account the subtleties and complications that confront a clinician in practice. An analysis of predictors of medication response in bipolar disorder provides a basis for matching patients with optimal medication regimens. Response to treatment may depend on the polarity of an episode or on clinical features such as mixed or psychotic symptomatology and rate of cycling. Comorbid psychiatric disorders such as substance abuse, anxiety disorders, or attention-deficit/hyperactivity disorder should also be considered in designing a treatment regimen. Similarly, medical conditions, especially metabolic abnormalities or kidney insufficiency, must be taken into account. Selection of medication may also involve an analysis of demographic factors, including family and personal history of response to a particular agent. When selecting the most appropriate mood stabilizer for a patient—particularly when polypharmacy is required—the clinician should keep potential side effects and drug interactions in mind. Randomized, controlled studies in bipolar populations are needed to further characterize optimal matching of patient and medication.

Journal

Annals of Clinical Psychiatry – Springer Journals

Published: Oct 11, 2004

References

  • Have we undersold lithium for bipolar disorder?
    Pies, R
  • The Difficultto-Treat Psychiatric Patient
    Goodwin, FK; Ghaemi, SN
  • The prevalent clinical spectrum of bipolar disorders: Beyond DSM-IV
    Akiskal, HS
  • Bipolar Disorders: Clinical Course and Outcome
    Goldberg, JF; Keck, PE
  • The National Depressive and Manic-Depressive Association (DMDA) survey of bipolar members
    Lish, JD; Dime-Meenan, S; Whybrow, PC; Price, RA; Hirschfeld, RM
  • Diagnosing bipolar disorder and the effect of antidepressants: A naturalistic study
    Ghaemi, SN; Boiman, EE; Goodwin, FK
  • The reproductive safety profile of mood stabilizers, atypical antipsychotics, and broad-spectrum psychotropics
    Ernst, CL; Goldberg, JF
  • Texas Medication Algorithm Project: Development and feasibility testing of a treatment algorithm for patients with bipolar disorder
    Suppes, T; Swann, AC; Dennehy, EB; Habermacher, ED; Mason, M; Crismon, ML; Toprac, MG; Rush, AJ; Shon, SP; Altshuler, KZ
  • Manic-Depressive Illness
    Goodwin, FK; Jamison, KR
  • Bipolar Disorders: Clinical Course and Outcome
    Boland, RJ; Keller, MB
  • A double-blind comparison of valproate and lithium in the treatment of acute mania
    Freeman, TW; Clothier, JL; Pazzaglia, P; Lesem, MD; Swann, AC
  • A pharmacoeconomic model of divalproex vs. lithium in the acute and prophylactic treatment of bipolar I disorder
    Keck, PE; Nabulsi, AA; Taylor, JL; Henke, CJ; Chmiel, JJ; Stanton, SP; Bennett, JA
  • Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders
    Tondo, L; Baldessarini, RJ; Floris, G
  • Carbamazepine and Oxcarbazepine in Psychiatry
    Emrich, HM
  • Mania: Clinical and Research Perspectives
    Ketter, TA; Post, RM; Denicoff, K
  • Stabilization of mood from below versus above baseline in bipolar disorder: A new nomenclature
    Ketter, TA; Calabrese, JR
  • Valproate in the treatment of bipolar disorder: Literature review and clinical guidelines
    McElroy, SL; Keck, PE; Pope, HG; Hudson, JI
  • Predictors of valproate response in bipolar rapid cycling
    Calabrese, JR; Woyshville, MJ; Kimmel, SE; Rapport, DJ
  • Divalproex therapy in medication-naive and mood-stabilizer-naive bipolar II depression
    Winsberg, ME; DeGolia, SG; Strong, CM; Ketter, TA
  • Mania: Clinical and Research Perspectives
    West, SA; Keck, PE; McElroy, SL
  • Pharmacotherapy for Mood, Anxiety, and Cognitive Disorders
    Strakowski, SM; McElroy, SL; Keck, PE
  • Long-term naturalistic treatment of depressive symptoms in bipolar illness with divalproex vs. lithium in the setting of minimal antidepressant use
    Ghaemi, SN; Goodwin, FK
  • Bipolar Disorders: Clinical Course and Outcome
    Post, RM; Denicoff, KD; Frye, MA; Leverich, GS; Cora-Locatelli, G; Kimbrell, TA
  • The emerging differential roles of GABAergic and antiglutamatergic agents in bipolar disorders
    Ketter, TA; Wang, PW
  • A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory mood disorders
    Frye, MA; Ketter, TA; Kimbrell, TA; Dunn, RT; Speer, AM; Osuch, EA; Luckenbaugh, DA; Cora-Locatelli, G; Leverich, GS; Post, RM
  • Gabapentin in bipolar disorder: A placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group
    Pande, AC; Crockatt, JG; Janney, CA; Werth, JL; Tsaroucha, G
  • Diagnostic and Statistical Manual of Mental Disorders-Text Revision
  • Diagnostic and Statistical Manual of Mental Disorders, 4th edn.
  • Duration and stability of the rapid-cycling course: A long-term personal follow-up of 109 patients
    Koukopoulos, A; Sani, G; Koukopoulos, AE; Minnai, GP; Girardi, P; Pani, L; Albert, MJ; Reginaldi, D
  • The manic syndrome: Factors which may predict a patient's response to lithium, carbamazepine and valproate
    Dilsaver, SC; Swann, AC; Shoaib, AM; Bowers, TC
  • Effects of carbamazepine and lithium on affective disorders
    Okuma, T
  • Predictors of response to mood stabilizers
    Calabrese, JR; Fatemi, SH; Kujawa, M; Woyshville, MJ
  • Predictors of response to divalproex and lithium
    Bowden, CL
  • A two-illness model of bipolar disorder—By RT Joffe, LT Young, and GM MacQueen: A Commentary
    Dunner, DL
  • Effects of rapid cycling on response to lithium maintenance treatment in 360 bipolar I and II disorder patients
    Baldessarini, RJ; Tondo, L; Floris, G; Hennen, J
  • Bipolar Disorders: Clinical Course and Outcome
    Dunner, DL
  • A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Lamictal 614 Study Group
    Calabrese, JR; Suppes, T; Bowden, CL; Sachs, GS; Swann, AC; McElroy, SL; Kusumakar, V; Ascher, JA; Earl, NL; Greene, PL; Monaghan, ET
  • Rapid-cycling bipolar disorder: Effects of long-term treatments
    Tondo, L; Hennen, J; Baldessarini, RJ
  • Previous mood state predicts response and switch rates in patients with bipolar depression
    MacQueen, GM; Trevor, YL; Marriott, M; Robb, J; Begin, H; Joffe, RT
  • Mania: Differential effects of previous depressive and manic episodes on response to treatment
    Swann, AC; Bowden, CL; Calabrese, JR; Dilsaver, SC; Morris, DD
  • Long-term outcome of lithium prophylaxis in patients initially classified as complete responders
    Maj, M; Pirozzi, R; Kemali, D
  • Comparison of standard and low serum levels of lithium for maintenance treatment of bipolar disorder
    Gelenberg, AJ; Kane, JM; Keller, MB; Lavori, P; Rosenbaum, JF; Cole, K; Lavelle, J
  • Course and outcome in bipolar affective disorder: A longitudinal follow-up study
    Goldberg, JF; Harrow, M; Grossman, LS
  • The significance of psychotic features in manic episodes: A report from the NIMH collaborative study
    Coryell, W; Leon, AC; Turvey, C; Akiskal, HS; Mueller, T; Endicott, J
  • Short-term and long-term treatment for bipolar patients: Beyond the guidelines
    Mendlewicz, J; Souery, D; Rivelli, SK
  • Atypical antipsychotics and mood stabilization in bipolar disorder
    Brambilla, P; Barale, F; Soares, JC
  • Risperidone safety and efficacy in the treatment of bipolar and schizoaffective disorders: Results from a 6-month, multicenter, open study
    Vieta, E; Goikolea, JM; Corbella, B; Benabarre, A; Reinares, M; Martinez, G; Fernandez, A; Colom, F; Martinez-Aran, A; Torrent, C
  • Olanzapine versus placebo in the treatment of acute mania. Olanzapine HGEH Study Group
    Tohen, M; Sanger, TM; McElroy, SL; Tollefson, GD; Chen-gappa, KN; Daniel, DG; Petty, F; Centorrino, F; Wang, R; Grundy, SL; Greaney, MG; Jacobs, TG; David, SR; Toma, V
  • Efficacy of olanzapine in acute bipolar mania: A double-blind, placebo-controlled study. The Olanzipine HGGW Study Group
    Tohen, M; Jacobs, TG; Grundy, SL; McElroy, SL; Banov, MC; Janicak, PG; Sanger, T; Risser, R; Zhang, F; Toma, V; Francis, J; Tollefson, GD; Breier, A
  • Clinical predictors of acute response with olanzapine in psychotic mood disorders
    Zarate, CA; Narendran, R; Tohen, M; Greaney, JJ; Berman, A; Pike, S; Madrid, A
  • Problems in diagnosing bipolar disorder in catatonic patients
    Fein, S; McGrath, MG
  • Lethal catatonia responding to high-dose olanzapine therapy
    Cassidy, EM; O'Brien, M; Osman, MF; Finucane, J; O'Keane, V
  • The Difficult-to-Treat Psychiatric Patient
    Devanand, DP; Lisanby, SH; Sackeim, HA
  • Lorazepam for psychogenic catatonia
    Salam, SA; Pillai, AK; Beresford, TP
  • Women and mood disorders. Menarche to menopause
    Pariser, SF
  • Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance
    Viguera, AC; Nonacs, R; Cohen, LS; Tondo, L; Murray, A; Baldessarini, RJ
  • Concise Guide to Women's Mental Health
    Burt, VK; Hendrick, VC
  • Seasonal mood disorders. Patterns of seasonal recurrence in mania and depression
    Faedda, GL; Tondo, L; Teicher, MH; Baldessarini, RJ; Gelbard, HA; Floris, GF
  • Seasonality of manic depressive illness in Canada
    Whitney, DK; Sharma, V; Kueneman, K
  • Seasonal variations of lithium plasma levels
    Cusin, C; Serretti, A; Mandelli, L; Lucca, A; Smeraldi, E
  • Suicidal tendencies as a complication of light therapy for seasonal affective disorder: A report of three cases
    Praschak-Rieder, N; Neumeister, A; Hesselmann, B; Willeit, M; Barnas, C; Kasper, S
  • Suicidal behavior and prophylactic lithium treatment of major mood disorders: A review of reviews
    Schou, M
  • Can lithium help to prevent suicide?
    Gelenberg, AJ
  • Clinical outcome in a randomized 1-year trial of cloza-pine versus treatment as usual for patients with treatment-resistant illness and a history of mania
    Suppes, T; Webb, A; Paul, B; Carmody, T; Kraemer, H; Rush, AJ
  • Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT)
    Meltzer, HY; Alphs, L; Green, AI; Altamura, AC; Anand, R; Bertoldi, A; Bourgeois, M; Chouinard, G; Islam, MZ; Kane, J; Krishnan, R; Lindenmayer, JP; Potkin, S
  • Divalproex sodium treatment in late adolescent and young adult acute mania
    Papatheodorou, G; Kutcher, SP
  • Factors associated with response to lithium prophylaxis in DSM III major depression and bipolar disorder
    Maj, M; Arena, F; Lovero, N; Pirozzi, R; Kemali, D
  • Family history and symptom levels during treatment for bipolar I affective disorder
    Coryell, W; Akiskal, H; Leon, AC; Turvey, C; Solomon, D; Endicott, J
  • Prediction of lithium response in affective disorders
    Ananth, J; Pecknold, JC
  • Is response to prophylactic lithium a familial trait?
    Grof, P; Duffy, A; Cavazzoni, P; Grof, E; Garnham, J; Mac-Dougall, M; O'Donovan, C; Alda, M
  • Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group
    Bowden, CL; Brugger, AM; Swann, AC; Calabrese, JR; Janicak, PG; Petty, F; Dilsaver, SC; Davis, JM; Rush, AJ; Small, JG
  • Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study
    Regier, DA; Farmer, ME; Rae, DS; Locke, BZ; Keith, SJ; Judd, LL; Goodwin, FK
  • Predictors of immediate response in the treatment of mania: The importance of comorbidity
    Black, DW; Winokur, G; Hulbert, J; Nasrallah, A
  • Bipolar Disorders: Clinical Course and Outcome
    Himmelhoch, JM
  • A history of substance abuse complicates remission from acute mania in bipolar disorder
    Goldberg, JF; Garno, JL; Leon, AC; Kocsis, JH; Portera, L
  • Medication compliance among patients with bipolar disorder and substance use disorder
    Weiss, RD; Greenfield, SF; Najavits, LM; Soto, JA; Wyner, D; Tohen, M; Griffin, ML
  • Divalproex sodium in substance abusers with mood disorder
    Albanese, MJ; Clodfelter, RC; Khantzian, EJ
  • Posttraumatic stress disorder and cocaine dependence. Order of onset
    Brady, KT; Dansky, BS; Sonne, SC; Saladin, ME
  • Use of lamotrigine in a patient with bipolar disorder and psychiatric comorbidity
    Ballasiotes, AA; Skaer, TL
  • Panic disorder: Treatment with valproate
    Woodman, CL; Noyes, R
  • Treatment of social phobia with gabapentin: A placebo-controlled study
    Pande, AC; Davidson, JR; Jefferson, JW; Janney, CA; Katzel-nick, DJ; Weisler, RH; Greist, JH; Sutherland, SM
  • Diagnostic and therapeutic dilemmas in the management of pediatric-onset bipolar disorder
    Wozniak, J; Biederman, J; Richards, JA
  • Polypharmacy in Psychiatry
    Zamvil, L; Cannon, J
  • The interface between thyroid hormones and psychiatry
    Hennessey, JV; Jackson, IMD
  • The diagnosis and treatment of subclinical hypothyroid states in depressed patients
    Pies, RW
  • Drugs and thyroid function
    Surks, MI; Sievert, R
  • Forty years of lithium treatment
    Schou, M
  • Altered ovarian function and cardiovascular risk factors in valproate-treated women
    Isojarvi, JI; Tauboll, E; Pakarinen, AJ; van Parys, J; Rattya, J; Harbo, HF; Dale, PO; Fauser, BC; Gjerstad, L; Koivunen, R; Knip, M; Tapanainen, JS
  • Hormonal effects of valproic acid?
    Garland, EJ; Behr, R
  • Medication status and polycystic ovary syndrome in women with bipolar disorder: A preliminary report
    Rasgon, NL; Altshuler, LL; Gudeman, D; Burt, VK; Tanavoli, S; Hendrick, V; Korenman, S
  • Transduction of psychosocial stress into the neuro-biology of recurrent affective disorder
    Post, RM
  • Valproate in psychiatric disorders: Literature review and clinical guidelines
    McElroy, SL; Keck, PE; Pope, HG; Hudson, JI
  • Head injury, bipolar disorder, and response to valproate
    Pope, HG; McElroy, SL; Satlin, A; Hudson, JI; Keck, PE; Kalish, R
  • Clinical correlates of valproate augmentation in refractory bipolar disorder
    McCoy, L; Votolato, NA; Schwarzkopf, SB; Nasrallah, HA
  • Secondary mania: Diagnosis and treatment
    Evans, DL; Byerly, MJ; Greer, RA
  • Polypharmacy in Psychiatry
    Ghaemi, SN; Ko, JY
  • Manual of Psychiatric Therapeutics
    Venkataraman, V; Shader, RI; von Moltke, LL; Greenblatt, DJ
  • New antiepileptic drugs: Review on drug interactions
    Hachad, H; Ragueneau-Majlessi, I; Levy, RH
  • Sodium valproate acutely inhibits lamotrigine metabolism
    Yuen, AW; Land, G; Weatherley, BC; Peck, AW
  • Rash in multicenter trials of lamotrigine in mood disorders: Clinical relevance and management
    Calabrese, JR; Sullivan, JR; Bowden, CL; Suppes, T; Goldberg, JF; Sachs, GS; Shelton, MD; Goodwin, FK; Frye, MA; Kusumakar, V
  • Clinical relevance of drug interactions with lithium
    Finley, PR; Warner, MD; Peabody, CA
  • Serum lithium levels and the outcome of maintenance therapy of bipolar disorder
    Hopkins, HS; Gelenberg, AJ
  • A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group
    Calabrese, JR; Bowden, CL; Sachs, GS; Ascher, JA; Monaghan, E; Rudd, GD
  • Topiramate as add-on treatment for patients with bipolar mania
    Chengappa, KN; Rathore, D; Levine, J; Atzert, R; Solai, L; Parepally, H; Levin, H; Moffa, N; Delaney, J; Brar, JS
  • The evolving role of topiramate among other mood stabilizers in the management of bipolar disorder
    Chengappa, KN; Gershon, S; Levine, J
  • Predictors of treatment response in bipolar disorders: Evidence from clinical and brain imaging studies
    Ketter, TA; Wang, PW