Bipolar Psychopharmacotherapy: Caring for the Patient

Cover......Page 1
Bipolar Psychopharmacotherapy: Caring for the Patient......Page 4
Dedication......Page 6
Contents......Page 8
List of Contributors......Page 10
Preface......Page 14
DIAGNOSTIC AND PUBLIC HEALTH ASPECTS......Page 16
PSYCHOLOGICAL AND SOCIAL ASPECTS......Page 19
APPENDIX: LABORATORY CONSIDERATIONS IN THE CLINICAL USE OF LITHIUM......Page 20
REFERENCES......Page 21
INTRODUCTION......Page 24
DISCOVERY OF THE PROPHYLACTIC ACTION OF LITHIUM......Page 25
DEBATE......Page 28
CONCERNS ABOUT SIDE EFFECTS AND RISKS......Page 30
USE DURING PREGNANCY AND LACTATION......Page 31
ARE NEW AND BETTER PROPHYLACTIC AGENTS ABOUT TO OUST LITHIUM?......Page 32
PROPHYLAXIS IN RECURRENT DEPRESSIVE DISORDER......Page 34
THE EFFECT OF LITHIUM ON THE PATIENTS’ SUICIDAL BEHAVIOR......Page 35
BENEFITS OF PROPHYLACTIC LITHIUM TREATMENT......Page 36
REFERENCES......Page 37
MANIA......Page 42
COMBINATION TREATMENT......Page 43
FACTORS ASSOCIATED WITH ACUTE RESPONSE TO VALPROATE......Page 44
MAINTENANCE TREATMENT FOR BIPOLAR DISORDER......Page 45
FACTORS ASSOCIATED WITH RESPONSE IN MAINTENANCE TREATMENT......Page 46
TOLERABILITY......Page 49
EFFECTS ON SUICIDALITY......Page 50
MECHANISMS OF ACTION......Page 51
SUMMARY......Page 53
REFERENCES......Page 54
INTRODUCTION......Page 58
CLINICAL PHARMACOLOGY OF LAMOTRIGINE......Page 59
LAMOTRIGINE AND AFFECTIVE DISORDERS......Page 61
CLINICAL APPLICATIONS FOR LAMOTRIGINE IN MOOD DISORDERS......Page 69
REFERENCES......Page 74
ANTICONVULSANTS......Page 78
ANTIDEPRESSANTS IN BIPOLAR DISORDER......Page 85
OTHER POTENTIALLY USEFUL AGENTS IN BIPOLAR DISORDER......Page 88
REFERENCES......Page 90
6. Olanzapine in Treatment for Bipolar Disorder......Page 100
RATIONALE BEHIND THE CLINICAL TRIAL DEVELOPMENT OF OLANZAPINE......Page 101
EFFICACY IN THE TREATMENT FOR ACUTE MANIA......Page 102
EFFICACY IN THE TREATMENT FOR BIPOLAR DEPRESSION......Page 107
EFFICACY IN BIPOLAR MAINTENANCE/RELAPSE PREVENTION......Page 110
SAFETY AND TOLERABILITY......Page 112
REFERENCES......Page 115
ACUTE TRANQUILLIZATION IN MANIA......Page 120
HALOPERIDOL IN MANIA......Page 121
HORMONE CHANGES AND MECHANISMS OF ANTIMANIC EFFECTS OF ANTIPSYCHOTICS......Page 123
RISPERIDONE......Page 124
RISPERIDONE IN MANIA AND HYPOMANIA......Page 126
CONCLUSIONS......Page 134
REFERENCES......Page 135
INTRODUCTION......Page 140
PHARMACOLOGICAL MECHANISMS ASSOCIATED WITH THYMOLEPTIC ACTIVITY......Page 141
RANDOMIZED CONTROLLED TRIALS IN ACUTE BIPOLAR MANIA......Page 142
RANDOMIZED CONTROLLED LONG-TERM TREATMENT TRIALS......Page 145
SUMMARY......Page 146
REFERENCES......Page 147
INTRODUCTION: PREVALENCE AND RATIONALES......Page 150
THE INADEQUACY OF TWO MOOD STABILIZERS IN COMBINATION IN SYSTEMATIC STUDIES......Page 156
DEPRESSION AND CORRELATES OF POOR RESPONSE TO NATURALISTIC POLYTHERAPY......Page 157
CASE EXAMPLES OF RESPONSE TO COMPLEX COMBINATION THERAPY......Page 160
SOME TREATMENT PRINCIPLES FOR COMPLEX COMBINATION THERAPY......Page 162
EMPIRICAL AND THEORETICAL RATIONALES FOR POLYPHARMACY......Page 169
REFERENCES......Page 175
THE HISTORICAL CONTEXT......Page 184
OBSERVATIONS FROM PHARMACOTHERAPY......Page 188
OTHER SOURCES OF EVIDENCE......Page 194
THERAPEUTIC IMPLICATIONS......Page 195
DISCUSSION......Page 196
REFERENCES......Page 202
INTRODUCTION......Page 208
BIPOLAR DEPRESSION......Page 209
BIPOLAR II AND RELATED fiCOMORBDfl DISORDERS......Page 210
DEPRESSIVE MIXED STATES......Page 214
PHARMACOTHERAPY......Page 217
Lamotrigine......Page 220
Topiramate......Page 221
Olanzapine and Quetiapine......Page 222
CONSIDERATIONS FOR CLINICAL SUBTYPES AND THEIR COMORBIDITY......Page 233
CONCLUDING REMARKS......Page 237
REFERENCES......Page 239
EPIDEMIOLOGY AND GENDER DISTRIBUTION OF THE BIPOLAR SPECTRUM......Page 250
GENDER DIFFERENCES IN PHENOMENOLOGY......Page 252
IS FEMALE BIPOLARITY CHARACTERIZED BY MIXED STATES (MIXITY)?......Page 254
GENDER DIFFERENCES IN COURSE AND OUTCOME......Page 258
GENDER DIFFERENCES IN COMORBIDITY......Page 259
BIPOLAR DISORDER AND THE REPRODUCTIVE CYCLE......Page 261
TREATMENT OF BIPOLAR DISORDER IN FEMALES......Page 264
EVALUATION OF WOMEN FOR AND WITH BIPOLARITY......Page 273
SUMMARY......Page 274
REFERENCES......Page 275
THE ATYPICALITY OF PEDIATRIC MANIA......Page 294
COMORBIDITY WITH ADHD......Page 296
COMORBIDITY WITH CONDUCT DISORDER (CD)......Page 298
COMORBIDITY WITH ANXIETY DISORDERS......Page 299
CORRESPONDENCE BETWEEN CATEGORICAL AND DIMENSIONAL MEASURES......Page 300
PEDIATRIC MANIA AND TRAUMA......Page 301
TREATMENT CONSIDERATIONS......Page 302
SUMMARY......Page 307
REFERENCES......Page 308
CLASSIFICATION ISSUES AND SUBTYPES......Page 316
GENERAL PRINCIPLES OF PHARMACOLOGIC MANAGEMENT IN OLD AGE......Page 318
MOOD STABILIZERS IN ELDERLY BIPOLARS......Page 319
REFERENCES......Page 324
INTRODUCTORY OVERVIEW......Page 328
RATIONALE FOR COMBINING MEDICATION AND PSYCHOTHERAPY......Page 329
COMMON OBJECTIVES OF DISORDER-SPECIFIC PSYCHOTHERAPIES......Page 330
EMPIRICAL STUDIES OF PSYCHOSOCIAL INTERVENTION......Page 332
IMPLEMENTING PSYCHOSOCIAL INTERVENTIONS IN COMMUNITY PRACTICE......Page 340
CONCLUSIONS AND FUTURE DIRECTIONS......Page 341
REFERENCES......Page 343
INTRODUCTION......Page 348
INTERVENTION IN AN ACUTE EPISODE......Page 350
INTERVENTION IN MAINTENANCE......Page 352
WHERE DO WE GO NOW?......Page 357
REFERENCES......Page 358
IMPLEMENTATION OF DRUG TREATMENT ACCORDING TO PHASE AND SEVERITY OF ILLNESS......Page 362
PRETREATMENT EVALUATION AND MONITORING OF PHARMACOTHERAPY......Page 363
DRUG RESPONSE AND TREATMENT SETTING......Page 364
FROM EFFICACY TO EFFICIENCY OF PHARMACOTHERAPY IN BIPOLAR ILLNESS......Page 365
REFERENCES......Page 366
MOOD DISORDERS AND SUICIDE......Page 368
SUICIDE RISK IN BIPOLAR DISORDERS......Page 369
SUICIDE PREVENTION IN BIPOLAR DISORDERS......Page 372
THE ROLE OF PSYCHOPHARMACONS IN SUICIDE PREVENTION OF BIPOLAR PATIENTS......Page 373
THE ROLE OF PSYCHOSOCIAL INTERVENTIONS IN SUICIDE PREVENTION OF BIPOLAR PATIENTS......Page 376
REFERENCES......Page 377
INTRODUCTION......Page 382
THE MAJOR PLAYERS IN BIPOLAR DISORDER......Page 383
THE PSYCHIATRIST AND OTHER CLINICIANS......Page 385
THE MOOD CLINIC......Page 386
MENTAL HEALTH ADVOCACY ORGANIZATIONS......Page 387
CARING FOR BIPOLAR PATIENTS......Page 388
SPECIAL CONSIDERATIONS FOR HYPOMANIC AND CYCLOTHYMIC PATIENTS......Page 397
CONCLUSION......Page 399
REFERENCES......Page 400
Index......Page 404