Clinical correlates associated with the long-term response of bipolar disorder patients to lithium, valproate or lamotrigine: A retrospective study

English version

Autoři: Young Sup Woo ^aff001; Bo-Hyun Yoon ^aff002; Jye-Heon Song ^aff002; Jeong Seok Seo ^aff003; Beomwoo Nam ^aff003; Kwanghun Lee ^aff004; Jonghun Lee ^aff005; Young-Eun Jung ^aff006; Moon-Doo Kim ^aff006; Jung Goo Lee ^aff007; Sheng-Min Wang ^aff001; Young-Joon Kwon ^aff009; Won-Myong Bahk ^aff001
Působiště autorů: Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea ^aff001; Department of Psychiatry, Naju National Hospital, Naju, Republic of Korea ^aff002; Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Republic of Korea ^aff003; Department of Psychiatry, College of Medicine, Dongguk University, Gyeongju, Republic of Korea ^aff004; Department of Psychiatry, School of Medicine, Catholic University of Daegu, Daegu, Republic of Korea ^aff005; Department of Psychiatry, School of Medicine, Jeju National University, Jeju, Republic of Korea ^aff006; Department of Psychiatry, Haeundae Paik Hospital, Paik Institute for Clinical Research, College of Medicine, Inje University, Busan, Republic of Korea ^aff007; Department of Health Science and Technology, Graduate School of Inje University, Busan, Republic of Korea ^aff008; Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea ^aff009
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0227217

Souhrn

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.

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).

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).

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.

Klíčová slova:

Drug therapy – Drug metabolism – Cognitive impairment – Depression – Antipsychotics – Bipolar disorder – Antidepressants – Lithium

Zdroje

1. Hayes JF, Miles J, Walters K, King M, Osborn DP. A systematic review and meta-analysis of premature mortality in bipolar affective disorder. Acta Psychiatr Scand. 2015;131(6):417–25. doi: 10.1111/acps.12408 25735195; PubMed Central PMCID: PMC4939858.

2. Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. World J Biol Psychiatry. 2013;14(3):154–219. doi: 10.3109/15622975.2013.770551 23480132.

3. Berk M, Berk L, Dodd S, Cotton S, Macneil C, Daglas R, et al. Stage managing bipolar disorder. Bipolar Disord. 2014;16(5):471–7. doi: 10.1111/bdi.12099 23782499.

4. Rosa AR, Gonzalez-Ortega I, Gonzalez-Pinto A, Echeburua E, Comes M, Martinez-Aran A, et al. One-year psychosocial functioning in patients in the early vs. late stage of bipolar disorder. Acta Psychiatr Scand. 2012;125(4):335–41. doi: 10.1111/j.1600-0447.2011.01830.x 22283440.

5. Magalhaes PV, Dodd S, Nierenberg AA, Berk M. Cumulative morbidity and prognostic staging of illness in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Aust N Z J Psychiatry. 2012;46(11):1058–67. doi: 10.1177/0004867412460593 23015748.

6. Lewandowski KE, Cohen BM, Ongur D. Evolution of neuropsychological dysfunction during the course of schizophrenia and bipolar disorder. Psychol Med. 2011;41(2):225–41. doi: 10.1017/S0033291710001042 20836900.

7. Cipriani A, Hawton K, Stockton S, Geddes JR. Lithium in the prevention of suicide in mood disorders: updated systematic review and meta-analysis. BMJ. 2013;346:f3646. doi: 10.1136/bmj.f3646 23814104.

8. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20(2):97–170. Epub 2018/03/15. doi: 10.1111/bdi.12609 29536616; PubMed Central PMCID: PMC5947163.

9. Fountoulakis KN, Grunze H, Vieta E, Young A, Yatham L, Blier P, et al. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines. Int J Neuropsychopharmacol. 2017;20(2):180–95. Epub 2016/12/13. doi: 10.1093/ijnp/pyw109 27941079; PubMed Central PMCID: PMC5408976.

10. Alda M, Manchia M. Personalized management of bipolar disorder. Neurosci Lett. 2018;669:3–9. Epub 2017/12/07. doi: 10.1016/j.neulet.2017.12.005 29208408.

11. Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A, et al. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol. 2016;30(6):495–553. Epub 2016/03/17. doi: 10.1177/0269881116636545 26979387; PubMed Central PMCID: PMC4922419.

12. Kleindienst N, Engel R, Greil W. Which clinical factors predict response to prophylactic lithium? A systematic review for bipolar disorders. Bipolar Disord. 2005;7(5):404–17. Epub 2005/09/24. doi: 10.1111/j.1399-5618.2005.00244.x 16176433.

13. Grof P, Duffy A, Cavazzoni P, Grof E, Garnham J, MacDougall M, et al. Is response to prophylactic lithium a familial trait? J Clin Psychiatry. 2002;63(10):942–7. Epub 2002/11/06. doi: 10.4088/jcp.v63n1013 12416605.

14. Backlund L, Ehnvall A, Hetta J, Isacsson G, Agren H. Identifying predictors for good lithium response—a retrospective analysis of 100 patients with bipolar disorder using a life-charting method. Eur Psychiatry. 2009;24(3):171–7. Epub 2009/03/17. doi: 10.1016/j.eurpsy.2008.12.009 19286354.

15. Sportiche S, Geoffroy PA, Brichant-Petitjean C, Gard S, Khan JP, Azorin JM, et al. Clinical factors associated with lithium response in bipolar disorders. Aust N Z J Psychiatry. 2017;51(5):524–30. doi: 10.1177/0004867416664794 27557821.

16. Gyulai L, Bowden CL, McElroy SL, Calabrese JR, Petty F, Swann AC, et al. Maintenance efficacy of divalproex in the prevention of bipolar depression. Neuropsychopharmacology. 2003;28(7):1374–82. Epub 2003/06/05. doi: 10.1038/sj.npp.1300190 12784116.

17. Suppes T, Brown E, Schuh LM, Baker RW, Tohen M. Rapid versus non-rapid cycling as a predictor of response to olanzapine and divalproex sodium for bipolar mania and maintenance of remission: post hoc analyses of 47-week data. J Affect Disord. 2005;89(1–3):69–77. Epub 2005/10/29. doi: 10.1016/j.jad.2005.07.011 16253344.

18. Calabrese JR, Delucchi GA. Spectrum of efficacy of valproate in 55 patients with rapid-cycling bipolar disorder. Am J Psychiatry. 1990;147(4):431–4. Epub 1990/04/01. doi: 10.1176/ajp.147.4.431 2107762.

19. Salloum IM, Cornelius JR, Daley DC, Kirisci L, Himmelhoch JM, Thase ME. Efficacy of valproate maintenance in patients with bipolar disorder and alcoholism: a double-blind placebo-controlled study. Arch Gen Psychiatry. 2005;62(1):37–45. Epub 2005/01/05. doi: 10.1001/archpsyc.62.1.37 15630071.

20. Brady KT, Myrick H, Henderson S, Coffey SF. The use of divalproex in alcohol relapse prevention: a pilot study. Drug Alcohol Depend. 2002;67(3):323–30. Epub 2002/07/20. doi: 10.1016/s0376-8716(02)00105-9 12127203.

21. Ketter TA, Calabrese JR. Stabilization of mood from below versus above baseline in bipolar disorder: a new nomenclature. J Clin Psychiatry. 2002;63(2):146–51. Epub 2002/03/05. doi: 10.4088/jcp.v63n0210 11874216.

22. Popovic D, Reinares M, Goikolea JM, Bonnin CM, Gonzalez-Pinto A, Vieta E. Polarity index of pharmacological agents used for maintenance treatment of bipolar disorder. Eur Neuropsychopharmacol. 2012;22(5):339–46. Epub 2011/10/18. doi: 10.1016/j.euroneuro.2011.09.008 22000157.

23. Fornaro M, De Berardis D, Anastasia A, Novello S, Fusco A, Cattaneo CI, et al. The identification of biomarkers predicting acute and maintenance lithium treatment response in bipolar disorder: A plea for further research attention. Psychiatry Res. 2018;269:658–72. Epub 2018/09/15. doi: 10.1016/j.psychres.2018.08.034 30216918.

24. Jeong JH, Bahk WM, Woo YS, Lee JG, Kim MD, Sohn I, et al. Korean Medication Algorithm for Bipolar Disorder 2018: Comparisons with Other Treatment Guidelines. Clin Psychopharmacol Neurosci. 2019;17(2):155–69. Epub 2019/03/25. doi: 10.9758/cpn.2019.17.2.155 30905116; PubMed Central PMCID: PMC6478090.

25. Dell'Osso B, Buoli M, Riundi R, D'Urso N, Pozzoli S, Bassetti R, et al. Clinical characteristics and long-term response to mood stabilizers in patients with bipolar disorder and different age at onset. Neuropsychiatr Dis Treat. 2009;5:399–404. Epub 2009/08/04. doi: 10.2147/ndt.s5970 19649214; PubMed Central PMCID: PMC2714289.

26. Geoffroy PA, Bellivier F, Leboyer M, Etain B. Can the response to mood stabilizers be predicted in bipolar disorder? Front Biosci (Elite Ed). 2014;6:120–38. Epub 2014/01/07. doi: 10.2741/e696 24389147.

27. Tighe SK, Mahon PB, Potash JB. Predictors of lithium response in bipolar disorder. Ther Adv Chronic Dis. 2011;2(3):209–26. Epub 2011/05/01. doi: 10.1177/2040622311399173 23251751; PubMed Central PMCID: PMC3513882.

28. Swann AC, Bowden CL, Calabrese JR, Dilsaver SC, Morris DD. Pattern of response to divalproex, lithium, or placebo in four naturalistic subtypes of mania. Neuropsychopharmacology. 2002;26(4):530–6. Epub 2002/04/03. doi: 10.1016/S0893-133X(01)00390-6 11927177.

29. Belizario GO, Silva M, Lafer B. Impact of predominant polarity on long-term outcome in bipolar disorder: A 7-year longitudinal cohort study. J Affect Disord. 2018;241:37–40. Epub 2018/08/11. doi: 10.1016/j.jad.2018.07.086 30096590.

30. Carvalho AF, Quevedo J, McIntyre RS, Soeiro-de-Souza MG, Fountoulakis KN, Berk M, et al. Treatment implications of predominant polarity and the polarity index: a comprehensive review. Int J Neuropsychopharmacol. 2014;18(2). Epub 2014/12/19. doi: 10.1093/ijnp/pyu079 25522415; PubMed Central PMCID: PMC4368897.

31. Sentissi O, Popovic D, Moeglin C, Stukalin YB, Mosheva M, Vieta E, et al. Predominant polarity in bipolar disorder patients: The COPE bipolar sample. J Affect Disord. 2019;250:43–50. Epub 2019/03/04. doi: 10.1016/j.jad.2019.02.053 30826493.

32. Steardo L Jr., Fabrazzo M, Sampogna G, Monteleone AM, D'Agostino G, Monteleone P, et al. Impaired glucose metabolism in bipolar patients and response to mood stabilizer treatments. J Affect Disord. 2019;245:174–9. Epub 2018/11/06. doi: 10.1016/j.jad.2018.10.360 30391773.

33. Bai YM, Li CT, Tsai SJ, Tu PC, Chen MH, Su TP. Metabolic syndrome and adverse clinical outcomes in patients with bipolar disorder. BMC Psychiatry. 2016;16(1):448. Epub 2016/12/17. doi: 10.1186/s12888-016-1143-8 27978821; PubMed Central PMCID: PMC5159954.

34. Judd LL, Schettler PJ, Akiskal HS, Maser J, Coryell W, Solomon D, et al. Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol. 2003;6(2):127–37. Epub 2003/08/02. doi: 10.1017/S1461145703003341 12890306.

35. Vinberg M, Mikkelsen RL, Kirkegaard T, Christensen EM, Kessing LV. Differences in clinical presentation between bipolar I and II disorders in the early stages of bipolar disorder: A naturalistic study. J Affect Disord. 2017;208:521–7. Epub 2016/11/07. doi: 10.1016/j.jad.2016.10.031 27816324.

36. Rybakowski JK. Response to lithium in bipolar disorder: clinical and genetic findings. ACS Chem Neurosci. 2014;5(6):413–21. Epub 2014/03/15. doi: 10.1021/cn5000277 24625017; PubMed Central PMCID: PMC4063501.

37. Post RM, Leverich GS, Kupka R, Keck PE Jr., McElroy SL, Altshuler LL, et al. Clinical correlates of sustained response to individual drugs used in naturalistic treatment of patients with bipolar disorder. Compr Psychiatry. 2016;66:146–56. Epub 2016/03/21. doi: 10.1016/j.comppsych.2016.01.009 26995248.

38. Okuma T. Effects of carbamazepine and lithium on affective disorders. Neuropsychobiology. 1993;27(3):138–45. Epub 1993/01/01. doi: 10.1159/000118969 8232828.

39. Kato T, Inubushi T, Kato N. Prediction of lithium response by 31P-MRS in bipolar disorder. Int J Neuropsychopharmacol. 2000;3(1):83–5. Epub 2001/05/10. doi: 10.1017/S1461145799001674 11343583.

40. Yazici O, Kora K, Ucok A, Tunali D, Turan N. Predictors of lithium prophylaxis in bipolar patients. J Affect Disord. 1999;55(2–3):133–42. Epub 2000/01/11. doi: 10.1016/s0165-0327(98)00216-x 10628882.

41. Tondo L, Baldessarini RJ, Floris G. Long-term clinical effectiveness of lithium maintenance treatment in types I and II bipolar disorders. Br J Psychiatry Suppl. 2001;41:s184–90. Epub 2001/07/14. 11450181.

42. Hartong EG, Moleman P, Hoogduin CA, Broekman TG, Nolen WA, LitCar G. Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients. J Clin Psychiatry. 2003;64(2):144–51. Epub 2003/03/14. doi: 10.4088/jcp.v64n0206 12633122.

43. Fountoulakis KN, Yatham L, Grunze H, Vieta E, Young A, Blier P, et al. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm. Int J Neuropsychopharmacol. 2017;20(2):121–79. Epub 2016/11/07. doi: 10.1093/ijnp/pyw100 27816941; PubMed Central PMCID: PMC5409012.

44. Woo YS, Bahk WM, Lee JG, Jeong JH, Kim MD, Sohn I, et al. Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth Revision. Clin Psychopharmacol Neurosci. 2018;16(4):434–48. Epub 2018/11/24. doi: 10.9758/cpn.2018.16.4.434 30466216; PubMed Central PMCID: PMC6245301.

45. Colom F, Vieta E, Daban C, Pacchiarotti I, Sanchez-Moreno J. Clinical and therapeutic implications of predominant polarity in bipolar disorder. J Affect Disord. 2006;93(1–3):13–7. Epub 2006/05/03. doi: 10.1016/j.jad.2006.01.032 16650901.

46. Nivoli AM, Colom F, Pacchiarotti I, Murru A, Scott J, Valenti M, et al. Treatment strategies according to clinical features in a naturalistic cohort study of bipolar patients: a principal component analysis of lifetime pharmacological and biophysic treatment options. Eur Neuropsychopharmacol. 2013;23(4):263–75. Epub 2012/09/04. doi: 10.1016/j.euroneuro.2012.07.015 22939529.

47. Calkin CV, Ruzickova M, Uher R, Hajek T, Slaney CM, Garnham JS, et al. Insulin resistance and outcome in bipolar disorder. Br J Psychiatry. 2015;206(1):52–7. Epub 2014/10/18. doi: 10.1192/bjp.bp.114.152850 25323142.