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Antipsychotic Treatment for Bipolar Disorder Not Always Effective After Six Months

Ok first of all, sorry, but I have to say this, is Dr. Yatham the Indian cousin of (ugh) Donald Trump? Wow excellent combover, Lakshmi!

Alright, got that out of my system, lets get on to business, in this study they say that patients with bipolar 1 who stayed on mood stabilizers (lithium or Valproate) and antipsychotics (risperidone or olanzapine) for over a year did no better than patients who only stayed on the medications for 24 weeks. These are typical antipsychotics. They have severe side effects like bad weight gain and tardive dyskenisia, normally these antipsychotics are prescribed for schizoaffective disorder and schizophrenia as well.

“beyond six months of use, those taking risperidone experienced manic or depressive episodes as frequently as the placebo group. Those taking olanzapine, on the other hand, had the fewest episodes when using the medication over a whole year rather than stopping use after 24 weeks, making the year-long treatment most effective for that drug. Risperidone tended to delay mania, while olanzapine tended to delay depression.”

My personal experience: taking 900 mg/day of Lithium Carbonate ER, and 100 mg of Quetiapine Fumarate has kept me stable for over a year now. That is, mood-wise. Of course the childhood abandonment and abuse issues are no picnic, none at all, they are unpleasant, painful, not any fun! But if I hadn’t been stable mood-wise, I would not have been able to tackle these. And time it is, to tackle these.

So gratitude and love and laughter for all.

 

https://bbrfoundation.org/brain-matters-discoveries/antipsychotic-treatment-for-bipolar-disorder-not-always-effective-after

Lakshmi N. Yatham, M.D. - Brain & Behavior Research Expert on Bipolar Disorder

Lakshmi N. Yatham, M.D.

Some antipsychotic medicines commonly used to treat a type of bipolar disorder may not have clear benefits after six months of use, researchers have found.

Some antipsychotic medicines commonly used to treat a type of bipolar disorder may not have clear benefits after six months of use, researchers have found.

There are different types of bipolar disorder. Bipolar I — what most people associate with the illness — is characterized by periods of mania (intense elevated mood, increased energy and speed of thinking, reduced sleep etc) and severedepression (low mood, no interest or motivation, lack of pleasure, suicidal thoughts etc) . This new study is the first to compare the effectiveness of certain antipsychotics in treating this type of bipolar disorder longer-term, following a period of mania.

Publishing their findings online October 13 in Molecular Psychiatry, the research team was led by Lakshmi N. Yatham, M.D., of the University of British Columbia, a 1996 NARSAD Young Investigator (YI) grantee who went on to receive Independent Investigator (II) grants in 1999 and 2003.

The study focused on people with Bipolar I being treated with a combination of an antipsychotic (risperidone or olanzapine) and a mood stabilizer (lithium or valproate). The patients enrolled in the study had recently experienced manic episodes. To compare how the antipsychotics worked over long periods, some patients continued on whichever antipsychotic they were already taking, for another six months or one year in conjunction with lithium or valproate. Others, serving as controls, took placebos (or dummy pills) instead of antipsychotics along with lithium or valproate. Then, the three groups were compared: How long did it take before each patient experienced another depressive or manic episode?

Overall, the researchers found, patients were less likely to have a mood episode if they continued on antipsychotics for 24 weeks rather than taking placebos . However, the benefits of continuing antipsychotics beyond 24 weeks were not apparent as the proportion of patients that had a mood episode was not different between 24 and 52 groups.

The team noted that extended use of both antipsychotics was accompanied by weight gain in patients — clinically significant weight gain on olanzapine in 35% of patients after a year of use, and some weight gain in 15%-17% of patients on risperidone with any length of use. This suggests that the relief provided by these drugs should be considered against the potential for significant weight gain.

The researchers also observed some differences between the two types of antipsychotics as regards their longer-term usefulness, and the types of mood episodes each antipsychotic medicine helped to prevent , although they caution that these findings must be considered preliminary . For instance, beyond six months of use, those taking risperidone experienced manic or depressive episodes as frequently as the placebo group. Those taking olanzapine, on the other hand, had the fewest episodes when using the medication over a whole year rather than stopping use after 24 weeks, making the year-long treatment most effective for that drug. Risperidone tended to delay mania, while olanzapine tended to delay depression. To unpack the effects of different treatments, the researchers say, future work should examine other types of antipsychotics as well as non-antipsychotic treatments like psychotherapy, and do so in a larger patient group.

21 thoughts on “Antipsychotic Treatment for Bipolar Disorder Not Always Effective After Six Months”

  2. This headline totally intrigues me.

    I starting taking Seroquel along with lithium & Parnate back in late 2013.

    I suspect the Seroquel kicked me into mild hypomania/hypergraphia, because after I added that med to the mix I went on a four or five-month-long writing streak. I’d wrote for several hours every single day and had no problem coming up with ideas. The whole thing seemed to peter out around 6 months.

    I’ve had hypergraphia before, but it was much more dramatic. For more info. read “The Midnight Disease” by neurologist Dr. Alice W. Flaherty. Like me, she had postpartum mania and hypergraphia. I had the good fortune of calling and getting this brilliant Harvard medical professor on the phone after I Googled “nonstop writing” and “postpartum mania”a mere 2 weeks after Rilla was born. Thank God for the internet! She shed some light on what was happening to me….for free! :0

    At the end of the day, who knows????

    Meds are still often a matter of Russian Roulette when they collide with our brain chemistry!

    XOXOOXXOXOXO

    Liked by 3 people

    • I’m sure I’ve had hypergraphia as well. I wrote oodles and oodles in approximately 2007, when I was trying to come up with a unified theory of immunology, neurology, psychiatry, and yoga principles. Yup! Believe it or not. I think I still have my hyper graphic theories somewhere. How about that in a commercial: finish your novels overnight, no problem.
      Wow so great that you got someone from Harvard to give you a consultation. Im sick of this illness, wish it would just go away. XXXXOOOO

      Liked by 2 people

  4. Argh, I can’t figure out how to make hyperlinks on this phone! Oh well.

    I had a few nice stable years on Lithium, lamotrigine, and Seroquel, until I started having horrible extrapyramidal symptoms. Now I am back to ultradian cycling, driving myself crazy with brilliant new schemes only to find myself smashed to bits the next moment. Fuck, fuck, fuck.

    Liked by 1 person

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