Psychiatr. pro Praxi, 2005; 4: 172-178

TREATMENT OF BIPOLAR DISORDER

prof. MUDr. Eva Češková CSc
Psychiatrická klinika LF MU a FN Brno

A present view at treatment possibilities of bipolar disorder is summarised. Separately the treatment of bipolar depression, mania and maintenance treatment of bipolar disorder is discussed. The article summarises the most important studies. Further some practical approaches are mentioned, which are not necessarily based on evidence based medicine. Also some unanswered questions concerning this topic are brought to attention.

Keywords: Key words: guidelines for treatment, bipolar depression, mania, treatment, antidepressants, antipsychotics, mood stabilizers.

Published: February 1, 2006  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Češková E. TREATMENT OF BIPOLAR DISORDER. Psychiatr. praxi. 2005;9(4):172-178.
Download citation

References

  1. Altshuler LL, Suppes T, Black D, et al. The impact of antidepressant discontinuation after acute remission from bipolar depression on rates of depressive relapse at one-year follow-up. Am J Psychiatry 2003; 160: 1252-1262. Go to original source... Go to PubMed...
  2. American Psychiatric Association Practice Guidelines: Practice guideline for the treatment of patients with bipolar disorder (revision). Am J Psychiatry, 2002; 159: Supplement 4, 2-50.
  3. Amsterdam JD. Efficacy and safety of fluoxetine in the treatment of bipolar II major depressive episode. J Clin Psychopharmacol 1998; 18: 414-417. Go to original source... Go to PubMed...
  4. Baker RW, Zarate JrCM, Brown E, et al. A three-week comparison of olanzapine versus risperidone in the treatment of bipolar mania: improvement in manic and depressive symptoms and treatment adherence. Abstract n 15, APA 2003.
  5. Baker RW, Tohen M, Fawcett J, et al. Acute dysphoric mania: treatment response to olanzapine verus placebo. J Clin Psychophamacology, 2003; 23: 132-137. Go to original source... Go to PubMed...
  6. Baumhackel U, Biziere K, Fischbach R, et al. Efficacy and tolerability of moclobemide compared with imipramine in depressive disorders (DSM III): An Australian double-blind, multicentre study. Br J Psychiatry 1989; Suppl. 155: 8-83. Go to original source...
  7. Benabarre A, Vieta E, Colom F, et al. Treatment of mixed mania with risperidone and mood stabilizers. Can J Psychiatry 2001; 46: 866-867. Go to original source... Go to PubMed...
  8. Berk M, Ichim L, Brook S. Olanzapine compared to lithium in mania: a double-blind randomized controlled trial. Int Clin Psychopharmacol 1999; 14: 339-343. Go to original source... Go to PubMed...
  9. Bowden CL, Brugger AM, Swann AC, et al. (Dekanote Mania Study Group). Efficacy of divalproex vs lithium and placebo in the treatment of mania. JAMA 1994; 271: 918-924. Go to original source...
  10. Bowden CL, Calabrese J R, McElroy SL, et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry 2000; 57: 481-489. Go to original source... Go to PubMed...
  11. Bowden CL, Calabrese JR, Sachs G, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry 2003; 60: 392-400. Go to original source... Go to PubMed...
  12. Bowden CL. Making optimal use of combination pharmacotherapy in bipolar disorder. J Clin Psychiatry 2004; 65, Suppl 15: 21-24.
  13. Bowden CL, Grunze H, Kuklen J, et al. A randomized double-blind placebo-controlled efficacy and safety study of quetiapine or lithium as monotherapy for mania in bipolar disorder. J Clin Psychiatry 2005; 66: 111-121. Go to original source... Go to PubMed...
  14. Burgess S, Geddes J, Hawtohn K, et al. Lithium for Maintenance treatment of mood disorders (Cochrane Review). Cochrane Database Syst Rev 2001; CD003013. Go to original source...
  15. Calabrese JR, Rapport DJ, Kimmel SE, et al. Rapid cycling bipolar disorder and its treatment with valproate. Can J Psychiatry 1993; 38: 57-61.
  16. Calabrese JR, Kimmel SA, Woyshville M, et al. Clozapine for fragment-refractory mania. Am J Psychiatry 1996; 153: 759-764. Go to original source... Go to PubMed...
  17. Calabrese JR, Bowden CL, Sachs GS, et al. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry 1999; 60: 79-88. Go to original source... Go to PubMed...
  18. Calabrese JR, Raport DJ, Kimmel SE, et al. Controlled trials in bipolar I depression: focus on switch rates and efficacy. Eur Neuropsychopharmacol 1999; suppl. 4, 109-112. Go to original source... Go to PubMed...
  19. Calabrese JR, Suppes T, Bowden CL, et al. A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Lamictal 614 Study Group. J Clin Psychiatry 2000; 61: 841-850. Go to original source... Go to PubMed...
  20. Calabrese JR, Bowden CL, Sachs GS, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. J Clin Psychiatry 2003; 64: 1024. Go to original source... Go to PubMed...
  21. Češková E, Švestka J, Náhunek K. Alternativy léčby akutních fází endogenních depresí - antiepileptika a novější benzodiazepiny a jejich srovnání. Čs. Psychiatrie 1992; 88: 273-282.
  22. Coconces C, Delgado P, Shelton MD, et al. Risperidone augmentation in rapid - cycling bipolar disorder. Bipolar Disorders 2003; 5: suppl. 1, 40. Go to PubMed...
  23. Cohn JB, Collins G, Ashbrook E, Wernicke JF. A comparison of fluoxetine imipramine and placebo in patients with bipolar depressive disorder. Int Clin Psychopharmacol 1989; 4: 313-322. Go to original source... Go to PubMed...
  24. D' Souza R, Keks N, Scurrah M. Olanzapine in the treatment of rapid-cycling bipolar disorders: an open prospective study. Bipolar Disord 2003; 5, suppl 1: 42-43.
  25. Denicoff KD, Smith-Jackson EE, Disney ER, et al. Comparative prophylactic efficacy of lithium, carbamazepine, and the combination n bipolar disorder. J Clin Psychiatry 1997; 58: 470-478. Go to original source... Go to PubMed...
  26. Emilien C, Maloteaux JM, Seghers A, Charles C. Lithium compared to valproic acid and carbamazepine in the treatment of mania: a statistical meta-analysis. Eur Neuropsychopharmacol 1996; 6: 245-252. Go to original source... Go to PubMed...
  27. Esparon J, Kolloori J, Naylor GJ, et al. Comparison of the prophylactic action of flupenthixol with placebo in lithium treated manic-depressive patients. Br J Psychiatry 1986; 148: 723-725. Go to original source... Go to PubMed...
  28. Freeman TW, Clothier JL, Pazzzaglia PL, et al. A double blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992; 149: 108-111. Go to original source... Go to PubMed...
  29. Frye MA, Altshuler LL, Bitran JA. Clozapine in rapid cycling bipolar disorder. J Clin Psychopharmacol 1996; 16: 87-90. Go to original source... Go to PubMed...
  30. Frye MA, Ketter TA, Kimbrell TA, et al. A placebo-controlled study of lamotrigine and gabapentin monotherapy in refractory moood disorders. J Clin Psychopharmacol 2000; 20: 607-614. Go to original source... Go to PubMed...
  31. Garfinkel PE, Stancer HC, Persad E. A comparison of haloperidol, lithium carbonate and their combination in the treatment of mania. J Affect Disorder 1980; 2: 279-288. Go to original source... Go to PubMed...
  32. Goodwin FK, Jamison KR. Manic-depressive Illness. New York: Oxford University Press, 1990: 1095 p.
  33. Goodwin GM. Evidence-based guidelines for treating bipolar disorder. Recommendations from the British Association for Psychopharmacology. J Psychopharmacology 2003; 17: 149-173. Go to original source... Go to PubMed...
  34. Grossmann F, Potter WZ, Brown EA, Maislin G. A double-blind study comparing idazoxan and bupropion in bipolar depressed patients. J Affect Disord 1999; 56: 237-243. Go to original source... Go to PubMed...
  35. Grunze H, Kasper S, Goodwin G, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorder. Part III.: Maintenance treatment. World J Biol Psychiatry 2004; 5: 120-135. Go to original source... Go to PubMed...
  36. Grunze H, Kasper S, Goodwin G, et al.: World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorder. Part II.: treatment of mania. World J Biol Psychiatry 2003; 4: 5-13. Go to original source... Go to PubMed...
  37. Grunze H, Kasper S, Goodwin G, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of bipolar disorder. Part I.: treatment of bipolar depression. World J Biol Psychiatry 2002; 3: 115-124. Go to original source... Go to PubMed...
  38. Hartong EG, Moleman P, Hoogduin CA, et al. Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients. J Clin Psychiatry 2003; 64: 144-151. Go to original source... Go to PubMed...
  39. Herman E, Grof P, Hovorka P. Bipolární porucha. In: Seifertová D, Praško J, Hoschl C. (Eds.): Postupy v léčbě psychických poruch. AMEPRA, Medical Tribune Group, Praha, 2004: 94-126. Go to original source...
  40. Himmelhoch JM, Fuchs CZ, Symons BJ. A double-blind study of tranylcypromine treatment of major anergic depression. J Nerv Ment Dis, 1982; 170: 628-634. Go to original source... Go to PubMed...
  41. Hirschfeld RM, Kasper S. A review of the evidence for carbamazepine and oxcarbazepine in the treatment of bipolar disorder. Int J Neuropsychopharmacology 2004; 7: 507-522. Go to original source... Go to PubMed...
  42. Johnson G, Gershon S, Burdock EI, et al. Comparative effects of lithium and chlorpromazine in the treatment of acute manic states. Br J Psychiatry 1971; 119: 267-276. Go to original source... Go to PubMed...
  43. Kasper S, Attarbaschi T. Treatment options for bipolar mania. Clinical Approaches in Bipolar Disorders 2004; 3: 24-32.
  44. Klein E, Bental E, Lerer B, Belmaker RH. Carbamazepine and haloperidol vs placebo and haloperidol in excited psychoses. A controlled study. Arch Gen Psychiatry 1984; 41: 165-170. Go to original source... Go to PubMed...
  45. Kleindienst N, Greil W. Differential efficacy of lithium and carbamazepine in the prophylaxis of bipolar disorder: results of the MAP study. Neuropsychobiology 2000; 42: S2-S10. Go to original source... Go to PubMed...
  46. Kupka RW, Luckenbaugh DA, Post RM, et al. Rapid and non-rapid cycling bipolar disorder: a meta-analysis of clinical studies. J Clin Psychiatry 2003; 64: 1483-1494. Go to original source... Go to PubMed...
  47. Lambert PA. Acute and prophylactic therapies of patients with affective disorders using valpromide (dipropylacetamide). In: Emrich HE, Okuma T, Muller AA (eds.): Anticonvulsants in affective disorders. Elsevier Science Publishers, Amsterdam, 1984, 33-44.
  48. Lerer B, Moore N, Meyendorff E, et al. Carbamazepine versus lithium in mania. A double-blind study. J Clin Psychiatry 1987; 48: 89-93.
  49. Licht RW. Drug treatment of mania. A critical review. Acta Psychiatr Scand 1998; 97: 387-397. Go to original source... Go to PubMed...
  50. MacFadden W, Calabrese J, McCoy R, et al. Double-blind, placebo-controlled study of quetiapine in bipolar I depression. European Neuropsychopharmacology 2004; 14, suppl. 3: S299. Go to original source...
  51. Macritchie K, Geddes JR, Scott J, et al. Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder (Cochrane Review). Cochrane Database Syst Rev CD 003196.
  52. McCormack PL, Wiseman LR. Olanzapine. A review of its use in the management of bipolar I disorder. Drugs 2004; 64: 2709-2726. Go to original source... Go to PubMed...
  53. McElroy SL, Keck PE, Stanton SP, et al. A randomized comparison of divalproex oral loading verus haloperidol in the initial treatment of acute psychotic mania. J Clin Psychiatry 1996; 57: 142-146.
  54. Moller H J, Kissling W, Riehl T, et al. Double-blind evaluation of the antimanic properties of carbamazepine as a comedication to haloperidol. Progres in Neuro-Psychopharmacology and Biological Psychiatry 1989; 13: 127-136. Go to original source... Go to PubMed...
  55. Moller HJ, Bottlender R, Grunze H, et al. Are antidepressants less effective in the acute treatment of bipolar I compared to unipolar depression. J Affect Disord 2001; 67: 141-146. Go to original source... Go to PubMed...
  56. Muller-Oerlinghausen B, Retzow A, Henn FA, et al. Valproate as an adjunct to neuroleptic medication for the fragment of acute episode of mania: a prospective, randomized, double-blind, placebo-controlled, multicenter study. J Clin Psychopharmacol 2000; 20: 195-203. Go to original source... Go to PubMed...
  57. Muller-Oerlinghausen B, Berghofer A, Bauer M. Bipolar disorder. Lancet 2002; 359: 241-247. Go to original source... Go to PubMed...
  58. Nemeroff CB, Evans DL, Gyulai L, et al. Double-blind, placebo-controlled comparison of imipramine and paroxetine in the treatment of bipolar depression. Am J Psychiatry 2001; 158: 906-912. Go to original source... Go to PubMed...
  59. OkumaT, Yamashita I, Takahashi R, et al. Comparison of the antimanic efficacy of carbamazepine and lithium carbonate by double-blind controlled study. Pharmacopsychiatry 1990; 23: 143-150. Go to original source... Go to PubMed...
  60. Okuma T. Effects of carbamazepine and lithium on affective disorders. Neuropsychobiology 1993; 27: 138-145. Go to original source... Go to PubMed...
  61. Pazzaglia PJ, Post RM, Ketter TA, et al. Nimodipine monotherapy and carbamazepine augmentation in patients with refractory recurrent affective illness. J Clin Psychopharmacol 1998; 18: 404-414. Go to original source... Go to PubMed...
  62. Platman SR. A comparison of lithium carbonate and chlorpromazine in mania. Am J Psychiatry 1970; 127: 351-353. Go to original source... Go to PubMed...
  63. Post RM, Uhde TW, Roy-Byrne PP, Joffer RT. Correlates of antimanic response to carbamazepine. Psychiatry Research 1987; 21: 71-83. Go to original source... Go to PubMed...
  64. Prien RF, Klett CJ, Caffey EM. Lithium carbonate and imipramine in prevention of affective episodes. A comparison in recurrent affective illness. Arch Gen Psychiatry 1973; 209: 420-425. Go to original source... Go to PubMed...
  65. Prien RF, Caffey EM jr, Klett C. Comparison of lithium carbonate and chlorpromazine in the treatment of mania: report of the Veteran Administration and National Institute of Mental Health Collaborative Study Group. Arch Gen Psychiatry 1972; 26: 146-153. Go to original source... Go to PubMed...
  66. Sachs GS, Lafer B, Stoll AL, et al. A double-blind trial of bupropion versus desipramine for bipolar depression. J Clin Psychiatry 1994; 55: 391-393.
  67. Segal J, Berk M, Brook A. Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial. Clin Neuropharmacol 1998; 21: 176-180. Go to PubMed...
  68. Shopsin B, Gershon S, Thompson H, Collins P. Psychoactive drugs in mania. A controlled comparison of lithium carbonate, chlorpromazine, and haloperidol Arch Gen Psychiatry 1975; 32: 34-42. Go to original source... Go to PubMed...
  69. Silverstone T. Moclobemide vs imipramine in bipolar depression: A multicentre double-blind clinical trial. Acta Psychiatr Scand 2001; 104: 104-109. Go to original source... Go to PubMed...
  70. Small JG, Klapper M H, Marhenke JD, et al. Lithium combined with carbamazepine or haloperidol in the treatment of mania. Psychopharmacology Bull 1995; 31: 265-372.
  71. Solomon DA, Ryan CE, Keitner GI, et al. A pilot study of lithium carbonate plus divalproex sodium for the continuation and maintenance treatment of patients with bipolar I disorder. J Clin Psychiatry 1997; 58: 95-99. Go to original source... Go to PubMed...
  72. Spring G, Schweid D, Gray C. et al. A double-blind comparison of lithium and chlorpromazine in the treatment of acute manic states. Br J Psychiatry 1971; 119: 267-276. Go to original source... Go to PubMed...
  73. Supppes T, Webb A, Paul B, et al. Clinical outcome in a randomized 1-year trial of clozapine versus treatment as usual for patients with treatment-resistant illness and a history of mania. Am J Psychiatry 1999; 156: 1164-1169. Go to original source... Go to PubMed...
  74. Swann AC, Bowden CL, Morris D, et al. Depression during mania: treatment response to lithium or divalproex. Arch Gen Psychiatry 1997; 54: 37-42. Go to original source... Go to PubMed...
  75. Takahashi R, Sakuma A, Itho K, et al. Comparison of efficacy of lithium carbonate and chlorpromazine in mania: report of collaborative study group on treatment of mania in Japan. Arch Gen Psychiatry 1975; 32: 1310-1318. Go to original source... Go to PubMed...
  76. Thase ME, Mallinger AG, McKnight D, Himmelhoch JM. Treatment of imipramineresistant recurrent depression, IV: a double-blind crossover study of tranylcypromine for anergic bipolar depression. Am J Psychiatry 1992; 149: 195-198. Go to original source... Go to PubMed...
  77. Tohen M, Baker RW, Altshuler L, et al. Olanzapine versus divalproex in the treatment of acute mania. Am J Psychiatry 2002; 159: 1011-1017. Go to original source... Go to PubMed...
  78. Tohen M, Goldberg JF, Gonzales-Pinto Arrillaga AM, et al. A 12-week, double-blind comparison of olanzapine vs haloperidol in the treatment of acute mania. Arch Gen Psychiatry 2003; 60: 1218-1226. Go to original source... Go to PubMed...
  79. Tohen M, Ketter TA, Zaraze CA, et al. Olanzapine versus divalproex sodium for the treatment of acute mania and maintenance of remission: a 47-week study. Am J Psychiatry 2003; 160: 1263-1271. Go to original source... Go to PubMed...
  80. Tohen M, Vieta E, Calabrese J, et al. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar depresssion. Arch Gen Psychiatry 2003; 60: 1079-1088. Go to original source... Go to PubMed...
  81. Vasudev K, Goswami U, Kohli K. Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder. Psychopharmacology 2000; 150: 15-23. Go to original source... Go to PubMed...
  82. Vieta E, Martinez-Arán A, Colom F, et al. Treatment of bipolar depression: paroxetine vs venlafaxine. Int J Neuropsychopharmacol 2000; 3, suppl 1: 336-337.
  83. Vieta E, Gasto C, Colom F, et al. Role of risperidone in bipolar II: an open 6-month study. J Affect Disord 2001; 67: 213-219. Go to original source... Go to PubMed...
  84. Vieta E, Parramon G, Padrell E, et al. Quetiapine in the treatment of rapid cycling bipolar disorder. Bipol Disord 2002; 4: 335-340. Go to original source... Go to PubMed...
  85. Winsberg ME, DeGolia SG, Strong CM, et al. Divalproex therapy in medication naive and mood stabilizer naive bipolar II depression. J Affect Disord 67, 2001; 67: 207-212. Go to original source... Go to PubMed...
  86. Yong LT, Joffe RT, Robb JC, et al. Double-blind comparison of addition of a second moood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression. Am J Psychiatry 2000; 157: 124-126. Go to original source... Go to PubMed...
  87. Zajecka JM, Weisler R, Sachs G, et al. A comparison of the efficacy, safety and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. J Clin Psychiatry 2002; 63: 1148-55. Go to original source... Go to PubMed...
  88. Zornberg GL, Pope HG Jr. Treatment of depression in bipolar disorder: new directions for research. J Clin Psychopharmacol 1993; 13: 397-408. Go to original source... Go to PubMed...




Psychiatry for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.