Study Confirms High Relapse Rates For Bipolar Disorder Patients
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.