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Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study.
- Source :
-
PloS one [PLoS One] 2020 Jan 10; Vol. 15 (1), pp. e0227217. Date of Electronic Publication: 2020 Jan 10 (Print Publication: 2020). - Publication Year :
- 2020
-
Abstract
- Background: Although mood stabilizers such as lithium (LIT), valproate (VAL), and lamotrigine (LMT) appear to be efficacious treatments for bipolar disorder (BD) in research settings, the long-term response to these mood stabilizers in clinical practice is highly variable among individuals. Thus, the present study examined the characteristics associated with good or insufficient responses to long-term treatment with LIT, VAL, or LMT for BD.<br />Methods: This study retrospectively analyzed the medical records of patients who visited an outpatient clinic with a diagnosis of BD I or II. Data from patients who were treated with one of three mood stabilizing medications (LIT, VAL, or LMT) for more than 6 months were selected, and the long-term treatment responses were evaluated using the Alda scale. For the purposes of this study, two response categories were formed: insufficient response (ISR), including non-response or poor response (Alda total score ≤ 6), and good response (GR; Alda total score ≥ 7).<br />Results: Of the 645 patients included in the present study, 172 were prescribed LIT, 320 were prescribed VAL, and 153 were prescribed LMT for at least 6 months. A binary logistic regression analysis revealed that a diagnosis of BD II (odds ratio [OR], 8.868; 95% confidence interval [CI], 1.123-70.046; p = 0.038), comorbid alcohol/substance use disorder (OR, 4.238; 95% CI, 1.154-15.566; p = 0.030), and a history of mixed episodes (OR, 4.363; 95% CI, 1.191-15.985; p = 0.026) were significant predictors of LIT-ISR. Additionally, a depressive-predominant polarity significantly predicted LMT-GR (OR, 8.586; 95% CI, 2.767-26.644; p < 0.001).<br />Conclusion: The present findings demonstrated that patients with a diagnosis of BD II, a comorbid alcohol/substance problem, or a history of mixed episodes were not likely to respond to LIT treatment. Additionally, LMT might be a better treatment choice for patients with a depressive-predominant polarity.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Adult
Comorbidity
Female
Follow-Up Studies
Humans
Lithium Compounds adverse effects
Male
Middle Aged
Retrospective Studies
Seoul epidemiology
Treatment Outcome
Alcoholism epidemiology
Antimanic Agents therapeutic use
Antipsychotic Agents therapeutic use
Bipolar Disorder drug therapy
Bipolar Disorder epidemiology
Lamotrigine therapeutic use
Lithium Compounds therapeutic use
Valproic Acid therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 15
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 31923220
- Full Text :
- https://doi.org/10.1371/journal.pone.0227217