The management of individuals with bipolar disorder : a review of the evidence and its integration into clinical practice

Malhi, Gin S, Adams, Danielle, Cahill, Catherine M, Dodd, Seetal and Berk, Michael 2009, The management of individuals with bipolar disorder : a review of the evidence and its integration into clinical practice, Drugs, vol. 69, no. 15, pp. 2063-2101.

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Title The management of individuals with bipolar disorder : a review of the evidence and its integration into clinical practice
Author(s) Malhi, Gin S
Adams, Danielle
Cahill, Catherine M
Dodd, SeetalORCID iD for Dodd, Seetal
Berk, MichaelORCID iD for Berk, Michael
Journal name Drugs
Volume number 69
Issue number 15
Start page 2063
End page 2101
Total pages 39
Publisher ADIS International
Place of publication London, England
Publication date 2009
ISSN 0012-6667
Summary Bipolar disorder is a common, debilitating, chronic illness that emerges early in life and has serious consequences such as long-term unemployment and suicide. It confers considerable functional disability to the individual, their family and society as a whole and yet it is often undetected, misdiagnosed and treated poorly. In the past decade, many new treatment strategies have been trialled in the management of bipolar disorder with variable success. The emerging evidence, for pharmacological agents in particular, is promising but when considered alone does not directly translate to real-world clinical populations of bipolar disorder. Data from drug trials are largely based on findings that identify difterences between groups determined in a time-limited manner, whereas clinical management concerns the treatment of individuals over the life-long course of the illness. Considering the findings in the context of the individual and their particular needs perhaps besl bridges the gap between the evidence from research studies and their application in clinical practice. Specifically, only lithium and valproate have moderate or strong evidence for use across all three phases of bipolar disorder, Anticonvulsants, such as lamotrigine. have strong evidence in maintenance; whereas antipsychotics largely have strong evidence in acute mania, with the exception of quetiapine, which has strong evidence in bipolar depression. Maintenance data for antipsychotics is emerging but at present remains weak. Combinations have strong evidence in acute phases of illness but maintenance data is urgently needed. Conventional antidepressants only have weak evidence in bipolar depression and do not have a role in maintenance therapy. Therefore, this paper summarizes the efficacy data for treating bipolar disorder and also applies clinical considerations to these data when
Language eng
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Adis Data Information BV
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