Relationship of acute mania symptomatology to maintenance treatment response.
ABSTRACT Most treatment of bipolar disorders addresses maintenance objectives. In the past 4 years, several large, blinded, randomized, placebo-controlled maintenance studies involving more than 3000 patients with bipolar I illness have been published, with analyses of background, symptomatic, and acute treatment factors contributing to maintenance effectiveness. This article summarizes these findings. Generally, indices of greater severity predict lower response rates to most monotherapy treatments. Some findings have been unexpected. Mixed mania did not predict different maintenance response to divalproex or lithium but predicted more side effects with either drug, and reduced efficacy of olanzapine or lamotrigine.
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ABSTRACT: Up to 50% of first-episode psychosis patients suffer from long-term incomplete remission or treatment resistance. Different definitions for these terms have been used in psychiatric research, making generalized statements about the prevalence and predictors of treatment resistance difficult. The aim of this study was to give an overview on state-of-the-art definitions of treatment resistance for each of the diagnoses making up the inhomogeneous diagnostic entity 'psychosis' and to analyze the factors leading to treatment resistance. A computerized and manual literature search for relevant articles published within recent years was undertaken. In addition to symptomatic criteria, patients' functional level and quality of life have to be considered in the definition of treatment resistance. Patient-related, illness-related and treatment-related predictors of treatment resistance and incomplete remission might help to identify subjects at risk and optimize interventions.Expert Opinion on Pharmacotherapy 09/2008; 9(12):2027-38. · 2.86 Impact Factor