Cost-Effectiveness of Treatment for Bipolar Disorders

Lima, Ana Flávia Barros da Silva; Cruz, Luciane Nascimento; Cohen, Mírian; Zimmermann, J.; Miguel, Sandro René Pinto de Sousa

doi:10.1007/978-3-319-55266-8_19

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…There are no published data for the cost-effectiveness of OXC and ESL in BD. In general, cost-effectiveness analyses for classical mood stabilizers are scarce in comparison to second-generation antipsychotics [ 110 ]. In epilepsies, CBZ is considered a cost-effective treatment choice [ 111 ].…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Grunze¹,

Amann

Grunze

2021

Medicina

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Background and Objectives: This review is dedicated to the use of carbamazepine and its derivatives oxcarbazepine and eslicarbazepine in bipolar disorder and their relative strengths in treating and preventing new depressive or manic episodes. This paper will discuss the evidence of their efficacy relative to the polarity of relapse from controlled acute and maintenance/relapse prevention studies in bipolar patients. Materials and Methods: A Medline search was conducted for controlled acute and maintenance studies with carbamazepine, oxcarbazepine, and eslicarbazepine in bipolar disorder. In addition, abstracts reporting on controlled studies with these medications from key conferences were taken into consideration. Results: Information was extracted from 84 articles on the acute and prophylactic efficacy of the medications under consideration. They all appear to have stronger efficacy in treating acute mania than depression, which also translates to better protection against manic than depressive relapses for carbamazepine. Still, there is a paucity of controlled acute studies on bipolar depression for all and, with the exception of carbamazepine, a lack of long-term monotherapy maintenance data. For eslicarbazepine, the efficacy in bipolar disorder remains largely unknown. Especially with carbamazepine, tolerability issues and drug–drug interactions need to be kept in mind. Conclusions: Two of the medications discussed in this review, carbamazepine and oxcarbazepine, match Class A criteria according to the criteria proposed by Ketter and Calabrese, meaning acute antimanic efficacy, prevention of manic relapses, and not causing or worsening depression.

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Section: Methodsmentioning

confidence: 99%

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Grunze¹,

Amann

Grunze

2021

Medicina

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“…Bipolar disorder (BD) is a severe and disabling mental disorder, characterized by an early onset and recurrent, severe episodes or a chronic course with poor psychosocial functioning in a proportion of patients (Ferrari et al 2016;Fagiolini et al 2013). Although efficacious psychopharmacological and psychosocial treatments for manifest BD exist (da Silva Lima et al, 2017;Pfennig et al, 2012a), BD is often diagnosed and treated with a significant delay (up to ten years on average) (Baldessarini et al 2003;Pfennig et al 2011;Dagani et al 2017). Treatment delay is associated with a worse functional outcome, an elevated risk of suicide (Chen and Dilsaver 1996;Miller et al 2014;Post et al 2010) and…”

Section: Backgroundsmentioning

confidence: 99%

Improving early recognition and intervention in people at increased risk for the development of bipolar disorder - Study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife)

Pfennig

Leopold

Martini

et al. 2020

Preprint

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Abstract Background Bipolar disorders (BD) belong to the most severe mental disorders, characterized by an early onset and recurrent, severe episodes or a chronic course with poor psychosocial functioning in a proportion of patients. Many patients with BD experience substantial symptomatology months or even years before full BD manifestation. Adequate diagnosis and treatment is often delayed, which is associated with a worse outcome. This study aims to prospectively evaluate and improve early recognition and intervention strategies for persons at-risk for BD. Methods and Results Early-BipoLife is a prospective-longitudinal cohort study of 1,419 participants (aged 15-35 years) with at least five waves of assessment over a period of at least 2 years (baseline, 6, 12, 18 and 24 months). A research consortium of ten university and teaching hospitals across Germany conducts this study. The following risk groups (RGs) were recruited: RG I: help-seeking youth & young adults consulting early recognition centres/facilities presenting ≥1 of the proposed risk factors for BD, RG II: in-/outpatients with unipolar depressive syndrome, and RG III: in-/ outpatients with attention-deficit/hyperactivity disorder (ADHD). The reference cohort was selected from the German representative IMAGEN cohort. Over the study period, the natural course of risk and resilience factors, early symptoms of BD and changes of symptom severity (including conversion to manifest BD) are observed. Psychometric properties of recently developed, structured instruments on potential risk factors for conversion to BD and subsyndromal symptomatology (Bipolar Prodrome Symptom Scale, Bipolar at-risk criteria, EPI bipolar ) and biomarkers that potentially improve prediction are investigated. Moreover, actual treatment recommendations are monitored in the participating specialized services and compared to recently postulated clinical categorization and treatment guidance in the field of early BD. Conclusion Findings from this study will contribute to an improved knowledge about the natural course of BD, from the onset of first noticeable symptoms (precursors) to fully developed BD, and about mechanisms of conversion from subthreshold to manifest BD. Moreover, these generated data will provide information for the development of evidence-based guidelines for early-targeted detection and preventive intervention for people at risk for BD.

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“…Bipolar disorder (BD) is a severe and disabling mental disorder, characterized by an early onset and recurrent, severe episodes or a chronic course with poor psychosocial functioning in a proportion of patients (Ferrari et al 2016;Fagiolini et al 2013). Although efficacious psychopharmacological and psychosocial treatments for manifest BD exist (da Silva Lima et al 2017;Pfennig et al 2012a), BD is often diagnosed and treated with a significant delay (up to 10 years on average) (Baldessarini et al 2003;Pfennig et al 2011;Dagani et al 2017). Treatment delay is associated with a worse functional outcome, an elevated risk of suicide (Chen and Dilsaver 1996;Miller et al 2014;Post et al 2010) and an inferior response to mood stabilizing drug treatment (Kessing et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Improving early recognition and intervention in people at increased risk for the development of bipolar disorder: study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife)

Pfennig

Leopold

Martini

et al. 2020

Int J Bipolar Disord

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Background: Bipolar disorders (BD) belong to the most severe mental disorders, characterized by an early onset and recurrent, severe episodes or a chronic course with poor psychosocial functioning in a proportion of patients. Many patients with BD experience substantial symptomatology months or even years before full BD manifestation. Adequate diagnosis and treatment is often delayed, which is associated with a worse outcome. This study aims to prospectively evaluate and improve early recognition and intervention strategies for persons at-risk for BD. Methods: Early-BipoLife is a prospective-longitudinal cohort study of 1419 participants (aged 15-35 years) with at least five waves of assessment over a period of at least 2 years (baseline, 6, 12, 18 and 24 months). A research consortium of ten university and teaching hospitals across Germany conducts this study. The following risk groups (RGs) were recruited: RG I: help-seeking youth and young adults consulting early recognition centres/facilities presenting ≥ 1 of the proposed risk factors for BD, RG II: in-/outpatients with unipolar depressive syndrome, and RG III: in-/outpatients with attention-deficit/hyperactivity disorder (ADHD). The reference cohort was selected from the German representative IMAGEN cohort. Over the study period, the natural course of risk and resilience factors, early symptoms of BD and changes of symptom severity (including conversion to manifest BD) are observed. Psychometric properties of recently developed, structured instruments on potential risk factors for conversion to BD and subsyndromal symptomatology (Bipolar Prodrome Symptom Scale, Bipolar at-risk criteria, EPIbipolar) and biomarkers that potentially improve prediction are investigated. Moreover, actual treatment recommendations are monitored in the participating specialized services and compared to recently postulated clinical categorization and treatment guidance in the field of early BD.

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Cost-Effectiveness of Treatment for Bipolar Disorders

Cited by 4 publications

References 28 publications

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Improving early recognition and intervention in people at increased risk for the development of bipolar disorder - Study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife)

Improving early recognition and intervention in people at increased risk for the development of bipolar disorder: study protocol of a prospective-longitudinal, naturalistic cohort study (Early-BipoLife)

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