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Ahn SW, Baek JH, Yang SY, et al. Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study. Int J Bipolar Disord. 2017;5(1):24doi: 10.1186/s40345-017-0093-5.
Ahn, S. W., Baek, J. H., Yang, S. Y., Kim, Y., Cho, Y., Choi, Y., Lee, K., Park, T., & Hong, K. S. (2017). Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study. International journal of bipolar disorders, 5(1), 24. https://doi.org/10.1186/s40345-017-0093-5
Ahn, Sung Woo, et al. "Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study." International journal of bipolar disorders vol. 5,1 (2017): 24. doi: https://doi.org/10.1186/s40345-017-0093-5
Ahn SW, Baek JH, Yang SY, Kim Y, Cho Y, Choi Y, Lee K, Park T, Hong KS. Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study. Int J Bipolar Disord. 2017 Dec;5(1):24. doi: 10.1186/s40345-017-0093-5. Epub 2017 Jul 09. PMID: 28480482; PMCID: PMC5502006.
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Int J Bipolar Disord. 2017 Dec;5(1):24. doi: 10.1186/s40345-017-0093-5. Epub 2017 Jul 09.

Long-term response to mood stabilizer treatment and its clinical correlates in patients with bipolar disorders: a retrospective observational study.

International journal of bipolar disorders

Sung Woo Ahn, Ji Hyun Baek, So-Yung Yang, Yongkang Kim, Youngah Cho, Yujin Choi, Kounseok Lee, Taesung Park, Kyung Sue Hong

Affiliations

  1. Department of Psychiatry, Sunkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
  2. Department of Statistics, Seoul National University, Seoul, Republic of Korea.
  3. Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  4. Center for Clinical Research, Samsung Biomedical Research Institute, Seoul, Republic of Korea.
  5. Department of Psychiatry, St. Andrew's Hospital, Icheon-si, Republic of Korea.
  6. Department of Psychiatry, Sunkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea. [email protected].

PMID: 28480482 PMCID: PMC5502006 DOI: 10.1186/s40345-017-0093-5

Abstract

BACKGROUND: The efficacy and utility of long-term prophylactic treatment in patients with bipolar disorders (BDs) have not been fully explored. This study aims to estimate the long-term clinical response of patients with BDs to mood stabilizer treatment and to identify the clinical factors associated with that response.

METHODS: The study subjects consisted of 80 patients with bipolar I or bipolar II disorder who had been receiving treatment with lithium and/or valproate for more than 2 years at a single bipolar disorder clinic. The long-term response to the best treatment option based on treatment algorithms was evaluated using the Alda scale. Clinical characteristics were evaluated on a lifetime basis. Patients were classified into two response groups based on frequentist mixture analysis using the total Alda scale score.

RESULTS: Thirty-four percent of the patients were good responders, with a total Alda score of 5 or higher. The treatment response rate did not differ between the lithium and valproate groups, but lithium and valproate combination therapy was associated with poorer response. The number of previous mixed episodes was associated with a worse response (p = 0.026). Of individual symptoms, delusions during manic episodes (p = 0.008) and increased appetite (p = 0.035) during depressive episodes were more common in moderate/poor responders than in good responders. Co-morbid anxiety disorders were more frequently observed in the moderate/poor response group (p = 0.008).

CONCLUSIONS: Psychotic, mixed, and atypical features of BDs were found to be correlated with long-term treatment outcomes. Lithium and valproate showed similar efficacy but moderate/poor responders preferred to use polypharmacy.

Keywords: Alda scale; Bipolar disorders; Lithium; Treatment response; Valproate

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