Bipolar Psychopharmacotherapy: Caring for the Patient

400 Pages·2006·9.001 MB·English

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Bipolar Psychopharmacotherapy
Bipolar Psychopharmacotherapy: Caring for the Patient Edited by Hagop S. Akiskal and Mauricio Tohen
# 2006 John Wiley & Sons, Ltd ISBN: 0-470-85607-6
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Bipolar
Psychopharmacotherapy
Caring for the Patient
Editors
Hagop S. Akiskal
International Mood Center,
University of California at San Diego, La Jolla, CA, USA
and
Mauricio Tohen
Lilly Research Laboratories, Indianapolis, IN and McLean Hospital,
Harvard Medical School, Belmont, MA, USA
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Copyright © 2006 John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester,
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Library of Congress Cataloging in Publication Data
Bipolar psychopharmacotherapy:caring for the patient/editors, Hagop S. Akiskal and Mauricio Tohen.
p. cm.
Includes bibliographical references and index.
ISBN-13 978-0-470-85607-9 (cloth: alk. paper)
ISBN-10 0-470-85607-6 (cloth:alk. paper)
1. Manic-depressive illness—Chemotherapy. 2. Lithium—Therapeutic use. 3. Antipsychotic drugs.
4. Psychopharmacology. [DNLM: 1. Bipolar Disorder—drug therapy. 2. Anticonvulsants—therapeutic use.
3. Antimanic Agents—therapeutic use. 4. Antipsychotic Agents—therapeutic use. 5. Bipolar
Disorder—prevention & control. WM 207 B6176 2006] I. Akiskal, Hagop S. II. Tohen, Mauricio.
RC516.B529 2006
616.89′5061—dc22
2005013978
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN-13 978-0-470-85607-9 (HB)
ISBN-10 0-470-85607-6 (HB)
Typeset in 11/13pt Times by Integra Software Services Pvt. Ltd, Pondicherry, India
Printed and bound in Great Britain by Antony Rowe Ltd, Chippenham, Wiltshire
This book is printed on acid-free paper responsibly manufactured from sustainable forestry in which
at least two trees are planted for each one used for paper production.
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Dedication
This book is dedicated to bipolar patients and their families, for the privilege of
caring for them.
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Contents
List of Contributors ix
Preface xiii
Chapter 1 The Scope of Bipolar Disorders 1
Hagop S. Akiskal
Chapter 2 Lithium Treatment: Focus on Long-Term
Prophylaxis 9
Mogens Schou and Paul Grof
Chapter 3 Valproate: Clinical Pharmacological Profile 27
Charles L. Bowden and Vivek Singh
Chapter 4 Pharmacological Profile and Clinical Utility of
Lamotrigine in Bipolar Disorders 43
David J. Muzina, Joseph R. Calabrese
Chapter 5 Carbamazepine, Other Anticonvulsants and
Augmenting Agents 63
Heinz Grunze
Chapter 6 Olanzapine in Treatment for Bipolar Disorder 85
Mauricio Tohen, Giedra Campbell, and Daniel Lin
Chapter 7 Haloperidol and Risperidone in Mania 105
John Cookson
Chapter 8 A Comparison of “Second Generation Antipsychotics”
in the Treatment for Bipolar Disorder: Focus
on Clozapine, Quetiapine, Ziprasidone
and Aripiprazole 125
Paul E. Keck, Jr. and Susan L. McElroy
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viii Contents
Chapter 9 Complex Combination Therapy: The Evolution
Toward Rational Polypharmacy in Lithium-Resistant
Bipolar Illness 135
Robert M. Post, Andrew M. Speer and Gabriele S. Leverich
Chapter 10 The Primacy of Mania 169
Athanasios Koukopoulos
Chapter 11 Diagnostic and Clinical Management Approaches
to Bipolar Depression, Bipolar II and Their Comorbidities 193
Giulio Perugi, S. Nassir Ghaemi and Hagop S. Akiskal
Chapter 12 Bipolarity in Women: Therapeutic Issues 235
Susan L. McElroy, Lesley M. Arnold and Lori L. Altshuler
Chapter 13 Pediatric Bipolar Disorder: The Promise of
Psychopharmacotherapy 279
Joseph Biederman
Chapter 14 Treatment for Bipolar Disorder in Older Adults 301
Kenneth I. Shulman
Chapter 15 Psychosocial Interventions in Bipolar Disorders:
Rationale and Effectiveness 313
David J. Miklowitz
Chapter 16 The Pivotal Role of Psychoeducation in the
Long-Term Treatment of Bipolar Disorder 333
Francesc Colom and Eduard Vieta
Chapter 17 The Role of Treatment Setting in the
Pharmacotherapy of Bipolar Disorder 347
Jean-Michel Azorin
Chapter 18 Suicide Prevention 353
Zoltán Rihmer
Chapter 19 Principles of Caring for Bipolar Patients 367
Hagop S. Akiskal and Kareen K. Akiskal
Index 389
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List of Contributors
Hagop S. Akiskal, International Mood Center, Department of Psychiatry at the
University of San Diego and Veterans Administration Medical Center, 3350 La Jolla
Village Dr. (116-A), San Diego, CA 92161, USA
Kareen K. Akiskal, International Mood Center, University of California at San
Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA
Lori L. Altshuler, UCLA Mood Disorders Research Program, UCLA, USA
Lesley M. Arnold, Women’s Health Research Program, University of Cincinnati
College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA
Jean-Michel Azorin, Department of Psychiatry, Ste Marguerite Hospital, 13274
Marseille Cedex 9, France
Joseph Biederman, Pediatric Psychopharmacology Unit (ACC 725), Massachusetts
General Hospital, 15 Parkman Street, Boston, MA 02114-3139, USA
Charles L. Bowden, Department of Psychiatry, Mail Code 7792, University
of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio TX
78229-3900, USA
Joseph R. Calabrese, Case Western Reserve University, School of Medicine,
Cleveland, Ohio 44106, USA
Giedra Campbell Lilly, Research Laboratories, Eli Lilly & Co, 525 S. Meridian
Street, Indianapolis, IN 46225, USA
Francesc Colom, Bipolar Disorders Program, Stanley Research Center, IDIBAPS,
Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain
John Cookson, Royal London Hospital, St Clement’s, 2A Bow Road, London E3
4LL, UK
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x List of Contributors
S. Nassir Ghaemi, Bipolar Disorder Research Program, Cambridge Hospital,
Department of Psychiatry and Harvard University, Cambridge, MA 02139, USA
Paul Grof, Deparmtent of Psychiatry, University of Ottawa, Royal Ottawa Hospital,
1145 Carling Avenue, Ottawa, Ontario K2E 7L2, Canada
Heinz Grunze, Psychiatrische Klinik und Poliklinik LMU München, Ludwig
Maximilians Universität München, Nussbaumstrasse 7, D-80336 Munich,
Germany
Paul E. Keck, University of Cincinnati College of Medicine, Department of
Psychiatry, 231 Albert Sabin Way, ML 559, Cincinnati, OH 45267-0559, USA
Athanasios Koukopoulos, Centro Lucio Bini, Via Crescenzio 42, 00193 Rome, Italy
Gabriele S. Leverich, Biological Psychiatry Branch, National Institute of Mental
Health, Bldg. 10, 10 Center Drive MSC 1272, Bethesda, MD 20892-1272, USA
Daniel Lin Lilly, Research Laboratories, Eli Lilly & Co, 525 S. Meridian Street,
Indianapolis, IN 46225, USA
Susan L. McElroy, Psychopharmacology Research Program, Department of
Psychiatry, University of Cincinnati College of Medicine, 231 Albert Sabin Way,
Cincinnati, OH 45267, USA
David J. Miklowitz, Department of Psychology, Davie Hall CB#3270, University
of North Carolina, Chapel Hill, NC 27599-3270, USA
David Muzina, Department of Psychiatry and Psychology, Desk P-57, 9500
Euclid Avenue, Cleveland, Ohio 44195, USA
Giulio Perugi, Institute of Psychiatry, Via Roma 67, 56100 Pisa, Italy
Robert M. Post, Biological Psychiatry Branch, National Institute of Mental
Health, Bldg. 10, Rm. 3s239, 10 Center Drive MSC 1272, Bethesda, MD
20892-1272, USA
Zoltán Rihmer, National Institute for Psychiatry and Neurology, Budapest 27,
POB 1, 1281 Hungary
Mogens Schou, The Psychiatric Hospital, Skovagervej 2, DK-8240 Risskov,
Denmark
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List of Contributors xi
Kenneth I. Shulman, Department of Psychiatry, Sunnybrook & Women’s College
Health Sciences Center, University of Toronto, 2075 Bayview Avenue, Toronto,
ON M4N 3M5, Canada
Vivek Singh, Department of Psychiatry, University of Texas Health Science Center,
7703 Floyd Curl Drive, San Antonio TX 78229-3900, USA
Andrew Speer, Biological Psychiatry Branch, National Institute of Mental
Health, Bldg. 10, 10 Center Drive MSC 1272, Bethesda, MD 20892-1272, USA
Mauricio Tohen, McLean Hospital, Harvard Medical School, Belmont, MA and
Lilly Research Laboratories, Eli Lilly & Co, 525 S. Meridian Street, Indianapolis,
IN 46225, USA
Eduardo Vieta, Clinical Institute of Psychiatry and Psychology, Hospital Clinic,
University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
fpref.fm Page xiii Wednesday, October 19, 2005 9:13 AM
Preface
Bipolar disorder has emerged as a major public health problem. Its prevalence,
phenomenology, subtypes, treatment and outcome are all under reevaluation.
A burgeoning research-based literature has appeared and continues to grow.
New therapeutic modalities, both psychopharmacologic and psychosocial, have
been introduced. The clinical and scientific challenges presented by this condition
have created the psychiatric subspecialty for bipolar disorders. One of the major chal-
lenges for this subspecialty is to integrate the emerging clinical science of bipolar
treatments.
The idea for this book was born in October 1998 at the ECNP Congress in Paris.
One of the topics discussed at that meeting was the fact that clinicians in both
Europe and the United States used antipsychotics in bipolar disorder, yet US
guidelines gave priority to lithium or anticonvulsants. The two editors decided to
hold an international conference in Paris, France, on bipolar disorder at the 50th
anniversary of the introduction of chlorpromazine in the same city in 1952. It
would be recalled that the first patients treated with this agent suffered from
bipolar mania.
For a variety of logistic reasons, the conference was held in Monte Carlo
instead of Paris in February 2002. Presided by the present editors and supported
by an unrestricted educational grant from Eli Lilly, the conference covered the
clinical psychopharmacology and related topics dealing with all agents available
at that time for the treatment of bipolar disorder. With a roster of 24 of the top
experts in the field and over 500 opinion leaders and researchers from all over the
world in attendance, to the best of our knowledge, it was the largest freestanding
conference on bipolar disorder.
As we were editing the book on the material presented at the Monte Carlo con-
ference, the field of bipolar psychopharmacology virtually exploded into a revolu-
tion. With so many new agents approved for bipolar disorder between 2002 and
2005, we had to revise the plans for this book in a radical way. The 19 chapters of
the present book now overlap no more than 20% with the original conference in
Monte Carlo. All chapters have been independently peer reviewed and updated
through April 2005. We have endeavored – and we believe we have succeeded –
in recruiting contributors who are the pioneers in bipolar psychopharmacotherapy
and its clinical applications in children, the elderly and women. Special attention