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The Role of Polypharmacy in Bipolar Disorder Treatment Guidelines

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Polypharmacy in Psychiatry Practice, Volume II

Abstract

Polypharmacy is rather the rule than the exception in the real world treatment of bipolar disorder. Guidelines do support combination treatments, but with a solitary focus of efficacy. This leads to an apparent discrepancy between the recommendations of combination treatment in guidelines and the treatment plan in clinical patient samples where factors influencing choices are more complex and not resembled by randomised controlled studies (RCTs). This article highlights the treatment recommendations of three major, up- to date guidelines and the positioning of combination treatments in acute mania, bipolar depression and maintenance treatment.

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Abbreviations

AAP:

Atypical antipsychotic

AD:

Antidepressant

AM:

Antimanic agent

AMSP:

Arzneimittelsicherheit in der Psychiatrie (Surveillance study of drug safety in Psychiatry)

BAP:

British Association of Psychopharmacology

BD:

Bipolar Disorder

CANMAT:

Canadian Network for Mood and Anxiety Treatments

ISBD:

International Society for Bipolar Disorders

Li:

Lithium

RCT:

Randomised Controlled Studies

STEP-BD:

Systematic Treatment Enhancement Program for Bipolar Disorder

TEAE:

Treatment emergent affective episodes

VPA:

Valproate

WFSBP:

World Federation of Societies of Biological Psychiatry

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Authors and Affiliations

  1. Institute of Neuroscience, Academic Psychiatry, Campus of Aging and Vitality, Wolfson Research Centre, Newcastle University, Newcastle upon Tyne, UK

    Heinz Grunze

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  1. Heinz Grunze
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Correspondence to Heinz Grunze .

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Editors and Affiliations

  1. Sha'ar Menashe Mental Health Center, Hadera, 38814, Israel

    Michael S. Ritsner

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Grunze, H. (2013). The Role of Polypharmacy in Bipolar Disorder Treatment Guidelines. In: Ritsner, M. (eds) Polypharmacy in Psychiatry Practice, Volume II. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5799-8_14

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