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Stabilization in the treatment of mania, depression and mixed states

Published online by Cambridge University Press:  18 September 2015

D.J. Kupfer ,
E. Frank ,
V.J. Grochocinski ,
J.F. Luther ,
P.R. Houck ,
H.A. Swartz  and
A.G. Mailinger
D.J. Kupfer*
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
E. Frank
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
V.J. Grochocinski
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
J.F. Luther
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
P.R. Houck
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
H.A. Swartz
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
A.G. Mailinger
Affiliation:
University of Pittsburgh School of Medicine, Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, U.S.A.
*
Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic 3811 O'Hara Street, Pittsburgh PA 15213, United StatesTel 412-624-2353, Fax 412-624-8015, E-mail kupferdj@msx.upmc.edu
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Abstract

While one major need for improved therapeutic approaches in bipolar disease is the development of long-term treatment strategies, a systematic approach during the acute phase of bipolar disorder is also required. In our own studies we have arbitrarily divided the initial treatment of subjects by the predominant polarity for which they are treated acutely: manic, depressed, or mixed/cycling.1 In this larger investigation of over 150 patients with bipolar disorder, we now demonstrated again that the time to initial stabilization is generally the shortest with a manic episode and the longest with a mixed/cycling episode with the depressed episode in the middle (although almost as long as the mixed/cycling episode). These findings indicate the difficulty of treating both the depressed phase and mixed/cycling episodes in bipolar disorder. It is also noteworthy that gender does not have a significant effect on time to stabilization. Such findings in the acute phase have profound implications in designing and carrying out long-term therapeutic strategies for this disorder.

Keywords

stabilizationmanicdepressedmixed/cyclingsurvival analysisgender
Type
Articles
Information
Acta Neuropsychiatrica , Volume 12 , Issue 3 , September 2000 , pp. 110 - 114
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2000

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