Bipolar Disorder: A Clinician's Guide to Treatment Management
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First published in 2009. Routledge is an imprint of Taylor & Francis, an informa company.
Winokur, 1977; Avery & Lubrano, 1979; Black, Winokur, & Nasrallah, 1987; Bratfos & Haug, 1965; Greenblatt, Grosser, & Wechsler, 1962, 1964; Perris, 1966). There have been no published studies directly comparing ECT with lithium in the treatment of acute bipolar depression nor have there been any studies of electroconvulsive therapy plus an antidepressant and ECT plus lithium. Electroconvulsive therapy-induced switches (to mania/hypomania) are felt by most practicing clinicians, to be milder, more
thickness of the arrows and percentage figures roughly indicate the relative proportions going through various pathways. Adapted with permission from (Potter & Ketter, 1993). Source: W. Z. Potter & T. A. Ketter (1993, April). Canadian Journal of Psychiatry, 38. 551–556. Valproate has a somewhat more favorable therapeutic index than lithium or CBZ, with a lower incidence of neurotoxicity being an important advantage. This favorable therapeutic index, along with the existence of three principal
(2001, December). Divalproex versus placebo for the treatment of bipolar depression. Poster presentation. American College of Neuropsychopharmacology, Hawaii. Shelton, R., Tollefson, G., Tohen, M., Stahl, S., Gannon, K. S., Jacobs, T. G., et al. (2001). A novel augmentation strategy for treating resistant major depression. American Journal of Psychiatry, 158(1), 131–134. Short, C., & Cooke, L. (1995). Hypomania induced by gabapentin. British Journal of Psychiatry, 166, 679–680. Srisurapanont,
disorder, owing not only to very high risks of suicide, but also to accidents and medical complications of commonly comorbid substance use disorders, as well as to stress-sensitive general medical disorders (Baldessarini & Jamison, 1999; Baldessarini, Tondo, & Hennen, 2001; Tondo, Hennen, & Baldessarini, 2001). In addition, rates of sustained disability and poor outcome are much more common than formerly suspected (Tohen et al., 2000). Bipolar disorder is both a major public health problem and a
provided data directly pertinent to this issue and the topic is a controversial one (Kleindienst, Griel, Ruger, & Moller, 1999). The question of whether to continue maintenance treatment at a given point in time involves other considerations as well. Patients vary greatly as to the side-effects they experience and, in many cases, difficulties persist despite dose adjustments. Also important to this decision is the characteristic severity of a patient’s manic episodes, the usual level of insight