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Bipolar Disorder

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Bipolar Disorder

NIH - Medical Encyclopedia Bipolar disorder

"There are two primary types of bipolar disorder. People with bipolar disorder I have had at least one fully manic episode with periods of major depression. (In the past, bipolar disorder I was called manic depression.) People with bipolar disorder II seldom experience full-fledged mania. Instead they experience periods of hypomania (elevated levels of energy and impulsiveness that are not as extreme as the symptoms of mania). These hypomanic periods alternate with episodes of major depression."

Highlighted Article

Clinical features of bipolar depression versus major depressive disorder in large multicenter trials. (Am J Psychiatry. 2006)

"RESULTS: Bipolar depression was associated with family history of bipolar disorder, an earlier age at onset, a greater previous number of depressive episodes … Fears were more common in patients with bipolar disorder, whereas sadness; insomnia; intellectual (cognitive), somatic (muscular), respiratory, genitourinary complaints; and depressed behavior were more common in patients with unipolar depression."

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Notes

The 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section).

Bipolar Disorder

Daily Treatment Report

In this Report:

Cognitive Therapy-CBT-Psychotherapy
Drug Side-Effects and Interactions
Drugs
Exercise
General Information
Guidelines
Internet Sites
Nutrition
Other
Supplements-Vitamins-CAM

Cognitive Therapy-CBT-Psychotherapy

Psychotherapy to Stabilize Daily Routines Is Beneficial in Bipolar Disorder

Cognitive behavioral therapy for rapid-cycling bipolar disorder: a pilot study. (J Psychiatr Pract. 2007)

[Psychotherapeutic interventions in bipolar disorder: a review.] (Neuropsychiatr. 2007)

[Psychotherapy for bipolar disorder : A systematic review of controlled studies.] (Nervenarzt. 2007)

A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence. (Am J Psychiatry. 2007) " CONCLUSIONS: Integrated group therapy, a new treatment developed specifically for patients with bipolar disorder and substance dependence, appears to be a promising approach to reduce substance use in this population."

Intensive Psychotherapy More Effective Than Brief Therapy for Treating Bipolar Depression

Psychosocial Treatments for Bipolar Depression: A 1-Year Randomized Trial From the Systematic Treatment Enhancement Program (Arch Gen Psychiatry 2007)

Drug Side-Effects and Interactions

Treatment with lithium, alone or in combination with olanzapine, relieves oxidative stress but increases atherogenic lipids in bipolar disorder. (Tohoku J Exp Med. 2007)

Bipolar pharmacotherapy and suicidal behavior Part 2. The impact of antidepressants. (J Affect Disord. 2007) "CONCLUSIONS: During treatment with antidepressants (even when coupled with mood stabilizers), patients with bipolar disorder have significantly higher rates of non-lethal suicidal behavior compared to those on mood stabilizers without antidepressants, and thus require careful monitoring."

Lithium-induced nephropathies. (Psychopharmacol Bull. 2007) "Therefore, regular monitoring of creatinine and creatinine clearance are recommended in all subjects taking lithium."

Polypharmacy and suicide attempts in bipolar disorder. (Rev Bras Psiquiatr. 2007) "RESULTS: Approximately half of all patients (48.5%) presented a history of suicide attempt; 84% were using more than one medication, and 19% were using more than three drugs. The most frequent combinations of drugs used by these patients were: lithium + valproate (17%); lithium + antipsychotics (10%); lithium + valproate + antipsychotics (9%); and antidepressants + any drug (6%). The number of suicide attempts was associated with the use of multiple drugs."

Lithium and risk for Alzheimer's disease in elderly patients with bipolar disorder (The British Journal of Psychiatry (2007))

Extrapyramidal adverse events associated with atypical antipsychotic treatment of bipolar disorder. (J Clin Psychopharmacol. 2007) "Second-generation antipsychotics (SGAs) have generally replaced classic neuroleptics in managing bipolar disorder because of their property of inducing extrapyramidal symptoms (EPS) less frequently than conventional agents. However, EPS and tardive dyskinesia both remain a concern especially in bipolar patients who may be at greater risk of developing these unwanted events."

Mother Wonders if Psychosis Drug Helped Kill Son "For many patients, the side effects of Zyprexa are severe. Connecting them to specific deaths can be difficult, because people with mental illness develop diabetes and heart disease more frequently than other adults. But in 2002, a statistical analysis conducted for Eli Lilly found that compared with an older antipsychotic drug, Haldol, patients taking Zyprexa would be significantly more likely to develop heart disease, based on the results of a clinical trial comparing the two drugs."

Drugs

Atypical antipsychotics in bipolar disorder: systematic review of randomised trials. (BMC Psychiatry. 2007) "CONCLUSION: Atypical antipsychotics are effective in treating both phases of bipolar disorder compared with placebo, and as effective as established drug therapies. Atypical antipsychotics produce fewer extrapyramidal symptoms, but weight gain is more common (with olanzapine). There is insufficient data confidently to distinguish between different atypical antipsychotics."

Continuation versus discontinuation of lithium in recurrent bipolar illness: a naturalistic study (Bipolar Disorders 2007) "Conclusions: Despite considerable rates of illness recurrence in both groups, those who continued on lithium sustained markedly lower rates of recurrence over a lengthy follow-up period. Lithium discontinuation in BD after successful maintenance monotherapy is not advisable. If discontinuation is considered, lithium levels previously required to maintain clinical stability, and breakthrough or residual mood symptoms experienced during remission, should inform clinical decision making."

[Anticonvulsants in the treatment of bipolar disorder.] (Neuropsychiatr. 2007)

Prophylactic treatment response in bipolar disorder: Results of a naturalistic observation study. (J Affect Disord. 2007) "CONCLUSIONS: Less than one-third of patients treated with lithium achieved remission; the effectiveness of other treatments in this naturalistic sample was even lower."

Antidepressants don't help bipolar depression "The swings in mood from depression to mania that afflict people with bipolar disorder can be tempered with drugs such as lithium, but adding an antidepressant drug to ease the depression component is not helpful, new research suggests."

Antidepressants May Not Help Fight Bipolar Disorder "Patients with bipolar disorder will gain no treatment benefit by adding an antidepressant to a standard mood stabilizer such as lithium, a new study finds. The results suggest that treating with a mood stabilizer alone is preferable, a recommendation that goes against common practice."

Study Sheds Light on Medication Treatment Options for Bipolar Disorder "For depressed people with bipolar disorder who are taking a mood stabilizer, adding an antidepressant medication is no more effective than a placebo (sugar pill), according to results published online on March 28, 2007 in the New England Journal of Medicine."

Consumer Reports Best Buy Drugs: Treating Schizophrenia and Bipolar Disorder

Historical review of carbamazepine for the treatment of bipolar disorder. (Pharmacotherapy. 2007)

Thirty years of clinical experience with carbamazepine in the treatment of bipolar illness : principles and practice. (CNS Drugs. 2007)

Exercise

General Information

Early intervention in bipolar disorders: opportunities and pitfalls. (Med J Aust. 2007)

Family interventions for bipolar disorder. (Cochrane Database Syst Rev. 2007)

Effects of treatment latency on response to maintenance treatment in manic-depressive disorders. (Bipolar Disord. 2007)

Maintenance Treatment of Bipolar Disorder: An Expert Interview With Trisha Suppes, MD, PhD

Bilateral Hippocampal Volume Increase in Patients with Bipolar Disorder and Short-term Lithium Treatment. (Neuropsychopharmacology. 2007)

Greater Cortical Gray Matter Density in Lithium-Treated Patients with Bipolar Disorder. (Biol Psychiatry. 2007) " CONCLUSIONS: These brain maps are consistent with previous voxel-based morphometry reports of greater GMD in portions of the anterior limbic network in bipolar patients and suggest neurotrophic effects of lithium as a possible etiology of these neuroanatomic differences."

Guidelines

Use of treatment guidelines in clinical decision making in bipolar disorder: a pilot survey of clinicians. (Curr Med Res Opin. 2007) "CONCLUSIONS: These results suggest that, despite considerable efforts to develop and disseminate evidence-based guidelines, they are not widely implemented and substantial opportunities exist to educate clinicians about their value and relevance."