Evolving trends in the long-term treatment of bipolar disorder.

Full Abstract

The episodic and chronic nature of bipolar disorder usually requires long-term treatment in all patients, yet there is an unmet need for well-tolerated and clinically effective maintenance therapy with enhanced patient adherence. Few well-tolerated treatment options are currently available that are both effective in all phases of bipolar disorder and prevent recurrence of episodes. Lithium has well-established efficacy in the prevention of further manic episodes and may also be effective in the prevention of depression and suicide, but safety is a concern due to narrow therapeutic window. For valproate and carbamazepine, data appear much less compelling. Lamotrigine has shown to be effective for long-term prevention of depressive episodes. Controlled studies suggest that atypical antipsychotics may also have mood-stabilizing properties and might become standard for long-term therapy in the new future. The role of psychoeducation in improving adherence to medication in long-term treatment and overall patient outcomes is also crucial.

Author information

Author/s: Vieta, Eduard (E); Rosa, Adriane R (AR);

Affiliation: Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain. evieta(-atsign-)clinic.ub.es

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry (World J Biol Psychiatry), published in Scotland. (Language: eng)

Reference: 2007-; vol 8 (issue 1) : pp 4-11

Dates: Created 2007/03/16; Completed 2007/05/02; Revised 2007/11/15;

PMID: 17366344, status: MEDLINE (last retrieved date: 2/18/2009)

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