Relapse prevention in bipolar disorder: a critical review of current guidelines

2006 ◽  
Vol 20 (2_suppl) ◽  
pp. 12-16 ◽  
Author(s):  
R. Hamish McAllister-Williams
Keyword(s):  
Bipolar Disorder ◽  
Critical Review ◽  
Relapse Prevention ◽  
Current Guidelines

Current issues in bipolar disorder: A critical review

2007 ◽  
Vol 17 (11) ◽  
pp. 687-695 ◽  
Author(s):  
Pierre Oswald ◽  
Daniel Souery ◽  
Siegfried Kasper ◽  
Yves Lecrubier ◽  
Stuart Montgomery ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Critical Review

scholarly journals Timing of onset of lithium relapse prevention in bipolar disorder: evidence from randomised trials

2018 ◽  
Vol 213 (5) ◽  
pp. 664-666 ◽  
Author(s):  
Matthew J. Taylor
Keyword(s):  
Bipolar Disorder ◽  
Relapse Prevention ◽  
Early Onset ◽  
Hazard Ratio ◽  
Randomised Trials ◽  
Mood Episode ◽  
Early Effects ◽  
Timing Of Onset

SummaryLithium is widely prescribed, but the timing of key effects remains uncertain. The timing of onset of its relapse prevention effects is clarified by placebo-controlled randomised trials (3 studies, n = 1120). Lithium reduced relapse into any mood episode over the first 2 weeks of treatment (hazard ratio 0.40, 95% CI 0.16–0.97). Fewer manic relapses were evident within the first 4 weeks, however, early effects on depressive relapse were not demonstrated. There is an early onset of lithium relapse prevention effects in bipolar disorder, particularly against manic relapse. Full effects against depressive relapse may develop over a longer period.Declaration of interestM.J.T. reports personal fees from Sunovion, Otsuka, Lundbeck, outside the submitted work.

Electroconvulsive therapy awareness as approach for psychology students

2021 ◽  
Vol 11 (73) (1) ◽  
pp. 226-233
Author(s):  
Simona Trifu ◽  
Elena Mănicu ◽  
Milu Petruţ ◽  
Adrian Nicu Lupu
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Psychology Students ◽  
Epidemiological Evidence ◽  
Clinical Literature ◽  
Growing Body ◽  
Current Guidelines ◽  
Over Time

Electroconvulsive therapy (ECT) generated many controversies over time. The clinical literature establishing the efficacy of ECT is among the most solid for any medical treatment, and has been extensively reviewed; however, both practitioners and patients seem to be still reluctant on this issue. In the following review we are aiming at raising the level of awareness among the interested parties regarding ECT. Epidemiological evidence shows that there are a growing number of cases in which ECT has a great benefit, among the most notable being pharmacological resistant depressive disorder, bipolar disorder, schizophrenia, catatonia and others. Current guidelines seem to be overly-prudent regarding ECT indications, in spite of a growing body of research attesting to its importance. Side effects of ECT range from somatic to cognitive and, with a careful prior examination, most are acute and can be managed in a few minutes. An exception to this is the cognitive impairment, which can last from a few hours to a few weeks and presents a reason to reconsider ECT in elderly patients with an important preexisting cognitive impairment.

Treatment guidelines for bipolar disorder: A critical review

2005 ◽  
Vol 86 (1) ◽  
pp. 1-10 ◽  
Author(s):  
K.N. Fountoulakis ◽  
E. Vieta ◽  
J. Sanchez-Moreno ◽  
S.G. Kaprinis ◽  
J.M. Goikolea ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Critical Review ◽  
Treatment Guidelines

The treatment of bipolar disorder in children and adolescents

2017 ◽  
Author(s):  
Philip Hazell
Keyword(s):  
Clinical Trial ◽  
Bipolar Disorder ◽  
Young People ◽  
Relapse Prevention ◽  
Bipolar Depression ◽  
Mood Stabilizer ◽  
Acute Mania ◽  
Clinical Trial Evidence ◽  
Second Generation Antipsychotic ◽  
Trial Evidence

The presentation of bipolar disorder in young people can be different from that of adults; therefore, the approach to treatment differs slightly. Treatment is described for early intervention, acute mania, bipolar depression, relapse prevention, and refractory bipolar disorder. A strong therapeutic alliance with the patient and engagement and involvement of the patient’s family is critical to successful intervention. The evidence informing treatment is limited, but there is emerging research focused on the management of acute mania favouring monotherapy with a second-generation antipsychotic (SGA) over a mood stabilizer. Preliminary data favour a combination of an SGA and antidepressant over monotherapy with an SGA for the treatment of bipolar depression. Guidelines endorse electroconvulsive therapy for refractory mania and bipolar depression but there is no clinical trial evidence to support this practice. The development of algorithms to guide the management of all phases of bipolar disorder is a work in progress.

Relapse Prevention in Patients With Bipolar Disorder: Cognitive Therapy Outcome After 2 Years

2005 ◽  
Vol 162 (2) ◽  
pp. 324-329 ◽  
Author(s):  
Dominic H. Lam ◽  
Peter Hayward ◽  
Edward R. Watkins ◽  
Kim Wright ◽  
Pak Sham
Keyword(s):  
Bipolar Disorder ◽  
Cognitive Therapy ◽  
Relapse Prevention ◽  
Therapy Outcome

Psychoeducation: improving outcomes in bipolar disorder

2005 ◽  
Vol 20 (5-6) ◽  
pp. 359-364 ◽  
Author(s):  
Francesc Colom ◽  
Dominic Lam
Keyword(s):  
Bipolar Disorder ◽  
Health Beliefs ◽  
Relapse Prevention ◽  
Treatment Guidelines ◽  
Bipolar Affective Disorder ◽  
Mood Stabilizers ◽  
Psychological Interventions ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Positive Results

AbstractBackgroundA relevant paradigm shift in the treatment of bipolar disorder started a few years ago; crucial findings on the usefulness of psychological interventions clearly support switching from an exclusively pharmacological therapeutic approach to a combined yet hierarchical model in which pharmacotherapy plays a central role, but psychological interventions may help cover the gap that exists between theoretical efficacy and “real world” effectiveness. Hereby we review the efficacy of several adjunctive psychotherapies in the maintenance treatment of bipolar patients.MethodsA systematic review of the literature on the issue was performed, using MEDLINE and CURRENT CONTENTS databases. “Bipolar”, “Psychotherapy”, “Psychoeducation”, “Cognitive-behavioral” and “Relapse prevention” were entered as keywords.ResultsPsychological treatments specifically designed for relapse prevention in bipolar affective disorder are useful tools in conjunction with mood stabilizers. Most of the psychotherapy studies recently published report positive results on maintenance as an add-on treatment, and efficacy on the treatment of depressive episodes. Interestingly, several groups from all over the world reported similar positive results and reached very similar conclusions; almost every intervention tested contains important psychoeducative elements including both compliance enhancement and early identification of prodromal signs — stressing the importance of life-style regularity — and exploring patients' health beliefs and illness-awareness.ConclusionsThe usefulness of psychotherapy for improving treatment adherence and clinical outcome of bipolar patients is nowadays unquestionable, and future treatment guidelines should promote its regular use amongst clinicians. As clinicians, it is our major duty, to offer the best treatment available to our patients and this includes both evidence-based psychoeducation programs and newer pharmacological agents.

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