Bipolar Disorders: 2nd Stanley Symposium, Freiburg, November by J. Walden, H. Grunze

By J. Walden, H. Grunze

Complement factor: Neuropsychobiology 2002, Vol. forty five, Suppl. 1

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Extra info for Bipolar Disorders: 2nd Stanley Symposium, Freiburg, November 2000 (Neuropsychobiology)

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Scores have to be processed graphically to be interpretable, especially for the patient. Documentation of medication, life events, comorbidity and clinician ratings is not included; the latter would probably enhance the validity of rating in the manic spectrum of bipolar disorder. The clear advantage of the Social Rhythm Metric is of course its direct psychotherapeutic usability. It is kind of really working with the registered data, but it neglects also the important aspects of medication, co-morbidity and life events.

In this open and prospective study, 13 patients were treated with bupropion as an add-on strategy mainly to other antidepressants and to various mood stabilizers. Our data support the idea that bupropion is a first-line antidepressant in the treatment of severe bipolar depression. Eight of 13 patients showed a 150% reduction of Montgomery-Asberg Depression Scale ratings within 4 weeks. Co-medication with drugs commonly used in treatment-resistant bipolar disorder including venlafaxine, clozapine, lithium, topiramate and sodium valproate was safe in our small sample.

Being purely retrospective and clinician rated, the documented data are not sufficient for an effective long-term monitoring. All points regarding interpretability and value for clinical decision support are offered in the NIMH LCM, which is self and clinician rated as well as retro- and prospective and which is suitable to document several possible triggering or modulating mechanisms in the life of the patient. The initial documentation of the treatment history and current compliance with medication offers an excellent survey over the response of the patient.

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