Personality profile and therapeutic response to lithium carbonate and sodium valproate in mania with psychotic features

Abstract

Bipolar disorder is one of the major psychiatric disorders. Therefore, determining the factors that predict mood stabilizer response is important. This study aimed to investigate the relationship between personality profile and the response to lithium carbonate and sodium valproate in patients with psychotic mania. In this study, 50 patients with bipolar I disorder (manic episode with psychotic features) were randomly assigned to receive lithium carbonate (up to a serum level of 0.8-1.5 mEq/L) or sodium valproate (20 mg/kg). After stabilization of acute manic phase, Temperament and Character Inventory was completed by the patients themselves. Fifty subjects completed this study. The mean age ± SD of participants in the sodium valproate group and lithium carbonate group was 32.99 ± 9.94 and 30.73±7.94 years, respectively. The responders to sodium valproate had significantly higher scores in novelty seeking, harm avoidance (P = 0.003 and 0.004, respectively) and lower scores in persistence (P = 0.006) than the non-responders, but the responders to lithium carbonate did not have significantly different personality profiles. The results of the present study revealed that the personality profiles in the inpatients with psychotic mania are related to the responses to sodium valproate, but are irrelevant to the responses to lithium carbonate.

На Крок Попереду Хвороби: Як Покращити Результати Терапії При Біполярному Розладі?

“…Є дані й щодо індивідуальних психологічних особливостей. Так, у пацієнтів, у яких було зафіксовано відповідь на вальпроат, були значно вищими бали за показниками пошуку новизни та уникнення шкоди (р=0,003 і 0,004 відповідно) і нижчим -у наполегливості (р=0,006) за Опитувальником структури темпераменту та характеру (Temperament and Character Inventory), порівняно з особами, що не відпові-, порівняно з особами, що не відповіли на нього [30].…”

Innovation in psychopharmacology

“…Various studies in this journal investigated this issue, aiming to find possible alternative treatments for manic episodes. Levetiracetam showed a potential benefit as combination treatment (Zarezadeh et al ., 2022), oxcarbazepine alone was superior to valproate (Talaei et al ., 2022), while lamotrigine, a useful adjunctive antidepressant treatment, may induce manic episodes (Anmella et al ., 2022) and personality is a possible modulating factor of response (Akbarzadeh et al ., 2022). In any case, further research is important to improve the treatment options for manic episodes.…”

Modulating factors in mood disorders treatment

“…Among the most relevant factors, personality disorders, or personality profiles in general, stand out. Indeed, personality can strongly modulate the presentation and treatment of mood disorders (Quilty et al , 2008; Takahashi et al , 2014; Aluoja et al , 2018; Balestri et al , 2019; Akbarzadeh et al , 2022; Sarmiento et al , 2023). One of the most relevant personality disorders is borderline personality disorder (BPD).…”