Study Confirms High Relapse Rates For Bipolar Disorder Patients

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High relapse rates for bipolar disorder patients undergoing treatment have long suspected by mental health practitioners based on anecdotal observation, and now a naturalistic study has confirmed the high risk among bipolar patients, especially if their medication is altered or stopped.

Out of 300 individuals with bipolar I or II disorder, who were evaluated once per year via an outpatient clinic, more than two-thirds (68%) relapsed within the 4-year follow-up period, according to the researchers.

In this instance, relapses were defined as a deterioration or change in state requiring pharmacological intervention and/or hospitalization. The researchers noted that the relapses in study participants correlated with changes in medication prescription by the treating physician or the patient stopping their medication.

“[W]e propose that psychiatrists act with caution when replacing or stopping drugs and explain to patients that stopping their medication caries a high risk of relapse”, said researcher Benedikt Amann (FIDMAG Research Foundation, Sant Boi de Llobregat, Spain) and colleagues.

There was little difference between relapse rates for bipolar I and II patients.

The researchers noted in the Journal of Clinical Psychiatry that patients treated with a traditional mineral mood stabilizer had longer times between relapse, with a mean of 940 days, compared with their counterparts treated with antipsychotics (606 days), anticonvulsants (549 days), and combined prophylactic medication (598 days).

“[N]ew substances should be tested long-term in bipolar disorder by way of long-term naturalistic studies”, conclude Amann et al, who suggest that results from naturalistic studies as well as randomised controlled trials should be incorporated into recommended treatment guidelines.

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