Do benzodiazepines extend the duration of follow-up treatment in patients with bipolar disorder?

Hwang, Gul; Kim, Hag-Ryul; Park, Sang-Hag; Kim, Sang-Hoon; Park, Sung-Rok; Kim, Gyung-Hwan

doi:10.1002/hup.774

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Adjunctive benzodiazepines are also commonly used during longer-term treatment (Clark, Xie, and Brunette, 2004), but few studies have evaluated the effectiveness of adjunctive benzodiazepines outside of the acute setting. One retrospective chart-review of 70 hospitalized patients with bipolar I disorder showed that administration of benzodiazepines during admission and after discharge was associated with a significantly higher number of outpatient follow-up days, as compared with no benzodiazepine administration (Hwang et al, 2006). A smaller retrospective chart-review of 15 outpatients patients with bipolar I disorder showed no significant difference in clinical outcome between patients who received concomitant clonazepam treatment and those who did not (Winkler et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: Results from the Bipolar CHOICE trial

Bobo

Reilly-Harrington

Ketter

et al. 2014

Journal of Affective Disorders

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Background Little is known about the longer-term effects of adjunctive benzodiazepines on symptom response during treatment in patients with bipolar disorders. Methods The study sample consisted of 482 patients with bipolar I or II disorder enrolled in a 6-month, randomized, multi-site comparison of lithium- and quetiapine-based treatment. Changes in clinical measures (BISS total and subscales, CGI-BP, and CGI-Efficacy Index) were compared between participants who did and did not receive benzodiazepine treatment at baseline or during follow-up. Selected outcomes were also compared between patients who did and did not initiate benzodiazepines during follow-up using stabilized inverse probability weighted analyses. Results Significant improvement in all outcome measures occurred within each benzodiazepine exposure group. Benzodiazepine users (at baseline or during follow-up) experienced significantly less improvement in BISS total, BISS irritability, and CGI-BP scores than did benzodiazepine non-users. There were no significant differences in these measures between patients who did and did not initiate benzodiazepines during follow-up in the weighted analyses. There was no significant effect of benzodiazepine use on any outcome measure in patients with comorbid anxiety or substance use disorders. Limitations This is a secondary analysis of data from a randomized effectiveness trial that was not designed to address differential treatment response according to benzodiazepine use. Conclusions Adjunctive benzodiazepines may not significantly affect clinical outcome in lithium- or quetiapine-treated patients with bipolar I or II disorder over 6 months, after controlling for potential confounding factors.

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Section: Discussionmentioning

confidence: 99%

Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: Results from the Bipolar CHOICE trial

Bobo

Reilly-Harrington

Ketter

et al. 2014

Journal of Affective Disorders

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“…Furthermore, both substance abuse and a high level of affective symptoms are associated with an increased risk of benzodiazepine abuse [56,57]. However, a recent retrospective study found that adjunctive benzodiazepines may extend the duration of outpatient follow-up for patients with bipolar disorder [58].…”

Section: Discussionmentioning

confidence: 99%

Relationship between adjunctive medications for anxiety and time spent ill in patients with bipolar disorder

Bauer

Glenn²,

Grof

et al. 2009

International Journal of Psychiatry in Clinical Practice

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Objective. Many patients with bipolar disorder take adjunctive medications for anxiety. Using naturalistic data, we investigated the relationship between the use of adjunctive anxiolytics and the time spent in episodes or with subsyndromal mood symptoms. Methods. This was a post-hoc analysis of 310 patients with bipolar disorder who previously recorded mood and medications daily for 5 months using ChronoRecord software. One hundred patients were taking adjunctive anxiolytics for at least 50% of days; 210 were not. Of the 100 patients, 73 were taking a benzodiazepine. All patients taking anxiolytics were also receiving treatments for bipolar disorder. Results. Patients with bipolar disorder who were taking adjunctive medications for anxiety spent more time ill. Comparing patients who were taking or not taking anxiolytics, the mean days spent either in any episode or with subsyndromal symptoms was 45.6 vs. 29.6%, respectively (P<0.001), the mean days in any episode was 17.1 vs. 9.2%, respectively (P=0.016), and the mean days with subsyndromal depression was 26.4 vs. 16.2%, respectively (P=0.004). Conclusion. While this methodology cannot determine causality, these findings highlight the need for controlled studies of the long-term impact of adjunctive medications for anxiety on mood symptoms in patients being treated for bipolar disorder.

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Mise à jour sur les considérations pharmacocinétiques, pharmacodynamiques et les interactions médicamenteuses dans le choix d’une benzodiazépine

Landry

Gervais

O’Connor

2008

Annales Médico-psychologiques, revue psychiatrique

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Do benzodiazepines extend the duration of follow-up treatment in patients with bipolar disorder?

Abstract: In the present study, BZDs are suggested as a possible adjunctive therapy for extending follow-up and thus preventing recurrence in patients with bipolar disorder.

Cited by 5 publications

References 25 publications

Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: Results from the Bipolar CHOICE trial

Effect of adjunctive benzodiazepines on clinical outcomes in lithium- or quetiapine-treated outpatients with bipolar I or II disorder: Results from the Bipolar CHOICE trial

Relationship between adjunctive medications for anxiety and time spent ill in patients with bipolar disorder

Mise à jour sur les considérations pharmacocinétiques, pharmacodynamiques et les interactions médicamenteuses dans le choix d’une benzodiazépine

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