Lithium response and the sequence of episode polarities: Preliminary report on a hamilton sample

Grof, Eva; Haag, M.; Grof, Paul; Haag, H.

doi:10.1016/0278-5846(87)90060-1

Cited by 42 publications

(19 citation statements)

References 4 publications

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“…Regarding treatment response, the absence of a free interval identifies a bipolar sub-population with poor response to maintenance treatment, not only to lithium therapy, as shown in previous studies (Haag et al, 1986;Grof et al, 1987;Maj et al, 1989;Koukopoulos et al, 1995), but also to modern and complex polypharmacy, as shown in our study. However, the absence of full response to maintenance therapy does not mean absence of response as demonstrated by the absence of differences between CCC and N-CCC groups regarding secondary outcomes, i.e.…”

Section: Discussionsupporting

confidence: 59%

“…Other European authors have subsequently confirmed that on average 27% (range 6%-38%) of bipolar patients experienced continuous circular cycling without free intervals (Haag et al, 1986;Grof et al, 1987;Maj et al, 1989;Azorin et al, 2011), and that this presentation was in fact associated with low response rates to long-term treatment with lithium (Haag et al, 1986;Grof et al, 1987;Maj et al, 1989;Koukopoulos et al, 1995).…”

Section: Introductionmentioning

confidence: 84%

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Continuous circular cycling in bipolar disorder as a predictor of poor outcome

Tundo

Calabrese

Marchetti

et al. 2013

Journal of Affective Disorders

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Section: Discussionsupporting

confidence: 59%

Section: Introductionmentioning

confidence: 84%

Continuous circular cycling in bipolar disorder as a predictor of poor outcome

Tundo

Calabrese

Marchetti

et al. 2013

Journal of Affective Disorders

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“…The negative influence of this feature on lithium response has been confirmed in several retrospective studies [46,47]. Similarly, the negative association between psychiatric comorbidity [47,48] and lithium response and the positive influence of an episode sequence MDI [49][50][51] have been found previously. Further clinical features that have been reported to be negative predictors for lithium prophylaxis are rapid cycling and mixed states [52].…”

Section: Discussionsupporting

confidence: 49%

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

Kleindienst¹,

Greil

2000

Neuropsychobiology

105

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In a randomized clinical trial with an observation period of 2.5 years, the differential efficacy of lithium versus carbamazepine was compared in 171 bipolar patients (DSM-IV). In order to investigate the efficacy of the two drugs in clearly defined subsamples, a series of subgroup analyses was carried out. First, patients with a bipolar I disorder (n = 114) were analyzed separately. In these patients, lithium was superior to carbamazepine. In contrast, carbamazepine was at least equally as efficacious as lithium in the subsample of patients with bipolar II disorder or bipolar disorder not otherwise specified (n = 57). In a second analysis on differential efficacy, the whole sample was subdivided into a classical subgroup (bipolar I patients without mood-incongruent delusions and without comorbidity; n = 67) and a nonclassical subgroup including all other patients (n = 104). Classical bipolar patients had a significantly lower hospitalization rate under lithium than under carbamazepine prophylaxis (26 vs. 62%, p = 0.012). For the nonclassical group, a tendency in favor of carbamazepine was found. In a third step, we analyzed the impact of episode sequence on differential efficacy. In a global view, the episode sequence prior to the index episode was not correlated to differential efficacy. Our results might, however, indicate that patients with an episode sequence of mania-depression-free interval responded better to lithium. Besides differential efficacy, suicidal behavior and patients’ satisfaction with treatment were investigated. Regarding suicidal behavior, a trend in favor of lithium was found. The data on patients’ satisfaction were significantly in favor of carbamazepine. In conclusion, lithium appears to be superior to carbamazepine in classical bipolar cases and might have additional impact on proneness to suicide. The distinctly larger group of patients with nonclassical features might profit more from carbamazepine which seems to be well accepted by the patients. Hence, treatment alternatives to lithium are desirable for the majority of bipolar patients.

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“…Perhaps not so surprising, given that the affectiveologist in the newer academic and ⁄ or research bipolar centers no longer have the luxury to ÔselectÕ the most suitable patients for lithium prophylaxis, i.e. those with the mania-depression-free course pattern (83,84). At least one European report suggests that lithium applied to the treatment of a spectrum of mood disorders might fare much better in general medical practice (85).…”

Section: Protective Factors and Treatment-adherencementioning

confidence: 99%

Targeting suicide prevention to modifiable risk factors: has bipolar II been overlooked?

Akiskal

2007

Acta Psychiatr Scand

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Lithium response and the sequence of episode polarities: Preliminary report on a hamilton sample

Cited by 42 publications

References 4 publications

Continuous circular cycling in bipolar disorder as a predictor of poor outcome

Continuous circular cycling in bipolar disorder as a predictor of poor outcome

Differential Efficacy of Lithium and Carbamazepine in the Prophylaxis of Bipolar Disorder: Results of the MAP Study

Targeting suicide prevention to modifiable risk factors: has bipolar II been overlooked?

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