Response and remission rates during 24 weeks of mood-stabilizing treatment for bipolar depression depending on early non-response
•Among 592 patients with bipolar depression, initial non-response was high.•Among patients with non-response after 6 weeks, only one-third eventually responded by 24 weeks.•The findings did not improve among patients with additional guideline-based treatment. We aimed to study the probability of bip...
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| Veröffentlicht in: | Psychiatry research 2021-11, Vol.305, p.114194-114194, Article 114194 |
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| creator | Köhler-Forsberg, Ole Sloth, Kirstine H. Sylvia, Louisa G. Thase, Michael Calabrese, Joseph R. Tohen, Mauricio Bowden, Charles L. McInnis, Melvin Kocsis, James H. Friedman, Edward S. Ketter, Terence A. McElroy, Susan L. Shelton, Richard C Iosifescu, Dan V Ostacher, Michael J. Nierenberg, Andrew A. |
| description | •Among 592 patients with bipolar depression, initial non-response was high.•Among patients with non-response after 6 weeks, only one-third eventually responded by 24 weeks.•The findings did not improve among patients with additional guideline-based treatment.
We aimed to study the probability of bipolar depression response at 24 weeks given initial non-response.
We combined two multi-site, 24-week trials including similar populations following the same evidence-based guidelines randomizing patients to lithium or quetiapine. Additional mood-stabilizing treatment was possible if clinically indicated. We report cumulative proportions of response (>50% improvement in MADRS) and remission (MADRS |
| doi_str_mv | 10.1016/j.psychres.2021.114194 |
| format | Article |
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We aimed to study the probability of bipolar depression response at 24 weeks given initial non-response.
We combined two multi-site, 24-week trials including similar populations following the same evidence-based guidelines randomizing patients to lithium or quetiapine. Additional mood-stabilizing treatment was possible if clinically indicated. We report cumulative proportions of response (>50% improvement in MADRS) and remission (MADRS<10).
We included 592 participants with bipolar depression (mean 39 years, 59% female, mean MADRS 25). Among 393 (66%) participants without response after 2 weeks, 46% responded by 24 weeks; for 291 (49%) without response at 4 weeks, 40% responded and 33% remitted by 24 weeks; for 222 (38%) without a response at 6 weeks, 36% responded and 29% remitted by 24 weeks; for 185 (31%) without a response at 8 weeks, 29% responded and 24% remitted by 24 weeks. Rates were similar for participants who had started an additional mood-stabilizing drug during the first 6 or 8 weeks.
Among patients with bipolar depression and non-response after 6 weeks treatment, representing an adequate bipolar depression trial, only one-third responded by 24 weeks. These results highlight the need for better treatment alternatives for non-responders to evidence-based treatments for bipolar depression.</description><identifier>ISSN: 0165-1781</identifier><identifier>EISSN: 1872-7123</identifier><identifier>DOI: 10.1016/j.psychres.2021.114194</identifier><identifier>PMID: 34500184</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Affect ; Antidepressant treatment ; Antipsychotic Agents - therapeutic use ; Bipolar depression ; Bipolar Disorder - chemically induced ; Bipolar Disorder - drug therapy ; Double-Blind Method ; Early non-response ; Female ; Humans ; Lithium ; Lithium - therapeutic use ; Male ; Mood-stabilizing ; Quetiapine ; Quetiapine Fumarate - therapeutic use ; Response ; Treatment Outcome</subject><ispartof>Psychiatry research, 2021-11, Vol.305, p.114194-114194, Article 114194</ispartof><rights>2022 The Authors</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-a3cfa1436126b9c3d2e5302abbfd736a2a667ffbe1c5f2566052865eb09b413d3</citedby><cites>FETCH-LOGICAL-c416t-a3cfa1436126b9c3d2e5302abbfd736a2a667ffbe1c5f2566052865eb09b413d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.psychres.2021.114194$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34500184$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Köhler-Forsberg, Ole</creatorcontrib><creatorcontrib>Sloth, Kirstine H.</creatorcontrib><creatorcontrib>Sylvia, Louisa G.</creatorcontrib><creatorcontrib>Thase, Michael</creatorcontrib><creatorcontrib>Calabrese, Joseph R.</creatorcontrib><creatorcontrib>Tohen, Mauricio</creatorcontrib><creatorcontrib>Bowden, Charles L.</creatorcontrib><creatorcontrib>McInnis, Melvin</creatorcontrib><creatorcontrib>Kocsis, James H.</creatorcontrib><creatorcontrib>Friedman, Edward S.</creatorcontrib><creatorcontrib>Ketter, Terence A.</creatorcontrib><creatorcontrib>McElroy, Susan L.</creatorcontrib><creatorcontrib>Shelton, Richard C</creatorcontrib><creatorcontrib>Iosifescu, Dan V</creatorcontrib><creatorcontrib>Ostacher, Michael J.</creatorcontrib><creatorcontrib>Nierenberg, Andrew A.</creatorcontrib><title>Response and remission rates during 24 weeks of mood-stabilizing treatment for bipolar depression depending on early non-response</title><title>Psychiatry research</title><addtitle>Psychiatry Res</addtitle><description>•Among 592 patients with bipolar depression, initial non-response was high.•Among patients with non-response after 6 weeks, only one-third eventually responded by 24 weeks.•The findings did not improve among patients with additional guideline-based treatment.
We aimed to study the probability of bipolar depression response at 24 weeks given initial non-response.
We combined two multi-site, 24-week trials including similar populations following the same evidence-based guidelines randomizing patients to lithium or quetiapine. Additional mood-stabilizing treatment was possible if clinically indicated. We report cumulative proportions of response (>50% improvement in MADRS) and remission (MADRS<10).
We included 592 participants with bipolar depression (mean 39 years, 59% female, mean MADRS 25). Among 393 (66%) participants without response after 2 weeks, 46% responded by 24 weeks; for 291 (49%) without response at 4 weeks, 40% responded and 33% remitted by 24 weeks; for 222 (38%) without a response at 6 weeks, 36% responded and 29% remitted by 24 weeks; for 185 (31%) without a response at 8 weeks, 29% responded and 24% remitted by 24 weeks. Rates were similar for participants who had started an additional mood-stabilizing drug during the first 6 or 8 weeks.
Among patients with bipolar depression and non-response after 6 weeks treatment, representing an adequate bipolar depression trial, only one-third responded by 24 weeks. These results highlight the need for better treatment alternatives for non-responders to evidence-based treatments for bipolar depression.</description><subject>Adult</subject><subject>Affect</subject><subject>Antidepressant treatment</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Bipolar depression</subject><subject>Bipolar Disorder - chemically induced</subject><subject>Bipolar Disorder - drug therapy</subject><subject>Double-Blind Method</subject><subject>Early non-response</subject><subject>Female</subject><subject>Humans</subject><subject>Lithium</subject><subject>Lithium - therapeutic use</subject><subject>Male</subject><subject>Mood-stabilizing</subject><subject>Quetiapine</subject><subject>Quetiapine Fumarate - therapeutic use</subject><subject>Response</subject><subject>Treatment Outcome</subject><issn>0165-1781</issn><issn>1872-7123</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhi1ERZfCX6h85JLFYydOcgNVfEmVkKpytvwxBi-JHewsaLnxz-tlt1w52ZafmXfmIeQa2BYYyNe77VIO9lvGsuWMwxaghbF9QjYw9LzpgYunZFPBroF-gEvyvJQdY5Ucx2fkUrQdYzC0G_LnDsuSYkGqo6MZ51BKSJFmvWKhbp9D_Ep5S38hfi80eTqn5JqyahOm8Pv4uWbU64xxpT5lasKSJp2pw6XO9rdVvWJ0R7Q-UOfpQGOKTT4HvyAXXk8FX57PK_Ll_bv7m4_N7ecPn27e3ja2Bbk2WlivoRUSuDSjFY5jJxjXxnjXC6m5lrL33iDYzvNOStbxQXZo2GhaEE5ckVenvktOP_ZYVlV3tThNOmLaF8W7HkbeCzZUVJ5Qm1MpGb1acph1Pihg6qhf7dSjfnXUr076a-H1OWNvZnT_yh59V-DNCcC66c-AWRUbMFp0IaNdlUvhfxkPdkKcqQ</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Köhler-Forsberg, Ole</creator><creator>Sloth, Kirstine H.</creator><creator>Sylvia, Louisa G.</creator><creator>Thase, Michael</creator><creator>Calabrese, Joseph R.</creator><creator>Tohen, Mauricio</creator><creator>Bowden, Charles L.</creator><creator>McInnis, Melvin</creator><creator>Kocsis, James H.</creator><creator>Friedman, Edward S.</creator><creator>Ketter, Terence A.</creator><creator>McElroy, Susan L.</creator><creator>Shelton, Richard C</creator><creator>Iosifescu, Dan V</creator><creator>Ostacher, Michael J.</creator><creator>Nierenberg, Andrew A.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202111</creationdate><title>Response and remission rates during 24 weeks of mood-stabilizing treatment for bipolar depression depending on early non-response</title><author>Köhler-Forsberg, Ole ; Sloth, Kirstine H. ; Sylvia, Louisa G. ; Thase, Michael ; Calabrese, Joseph R. ; Tohen, Mauricio ; Bowden, Charles L. ; McInnis, Melvin ; Kocsis, James H. ; Friedman, Edward S. ; Ketter, Terence A. ; McElroy, Susan L. ; Shelton, Richard C ; Iosifescu, Dan V ; Ostacher, Michael J. ; Nierenberg, Andrew A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-a3cfa1436126b9c3d2e5302abbfd736a2a667ffbe1c5f2566052865eb09b413d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Affect</topic><topic>Antidepressant treatment</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Bipolar depression</topic><topic>Bipolar Disorder - chemically induced</topic><topic>Bipolar Disorder - drug therapy</topic><topic>Double-Blind Method</topic><topic>Early non-response</topic><topic>Female</topic><topic>Humans</topic><topic>Lithium</topic><topic>Lithium - therapeutic use</topic><topic>Male</topic><topic>Mood-stabilizing</topic><topic>Quetiapine</topic><topic>Quetiapine Fumarate - therapeutic use</topic><topic>Response</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Köhler-Forsberg, Ole</creatorcontrib><creatorcontrib>Sloth, Kirstine H.</creatorcontrib><creatorcontrib>Sylvia, Louisa G.</creatorcontrib><creatorcontrib>Thase, Michael</creatorcontrib><creatorcontrib>Calabrese, Joseph R.</creatorcontrib><creatorcontrib>Tohen, Mauricio</creatorcontrib><creatorcontrib>Bowden, Charles L.</creatorcontrib><creatorcontrib>McInnis, Melvin</creatorcontrib><creatorcontrib>Kocsis, James H.</creatorcontrib><creatorcontrib>Friedman, Edward S.</creatorcontrib><creatorcontrib>Ketter, Terence A.</creatorcontrib><creatorcontrib>McElroy, Susan L.</creatorcontrib><creatorcontrib>Shelton, Richard C</creatorcontrib><creatorcontrib>Iosifescu, Dan V</creatorcontrib><creatorcontrib>Ostacher, Michael J.</creatorcontrib><creatorcontrib>Nierenberg, Andrew A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatry research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Köhler-Forsberg, Ole</au><au>Sloth, Kirstine H.</au><au>Sylvia, Louisa G.</au><au>Thase, Michael</au><au>Calabrese, Joseph R.</au><au>Tohen, Mauricio</au><au>Bowden, Charles L.</au><au>McInnis, Melvin</au><au>Kocsis, James H.</au><au>Friedman, Edward S.</au><au>Ketter, Terence A.</au><au>McElroy, Susan L.</au><au>Shelton, Richard C</au><au>Iosifescu, Dan V</au><au>Ostacher, Michael J.</au><au>Nierenberg, Andrew A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Response and remission rates during 24 weeks of mood-stabilizing treatment for bipolar depression depending on early non-response</atitle><jtitle>Psychiatry research</jtitle><addtitle>Psychiatry Res</addtitle><date>2021-11</date><risdate>2021</risdate><volume>305</volume><spage>114194</spage><epage>114194</epage><pages>114194-114194</pages><artnum>114194</artnum><issn>0165-1781</issn><eissn>1872-7123</eissn><abstract>•Among 592 patients with bipolar depression, initial non-response was high.•Among patients with non-response after 6 weeks, only one-third eventually responded by 24 weeks.•The findings did not improve among patients with additional guideline-based treatment.
We aimed to study the probability of bipolar depression response at 24 weeks given initial non-response.
We combined two multi-site, 24-week trials including similar populations following the same evidence-based guidelines randomizing patients to lithium or quetiapine. Additional mood-stabilizing treatment was possible if clinically indicated. We report cumulative proportions of response (>50% improvement in MADRS) and remission (MADRS<10).
We included 592 participants with bipolar depression (mean 39 years, 59% female, mean MADRS 25). Among 393 (66%) participants without response after 2 weeks, 46% responded by 24 weeks; for 291 (49%) without response at 4 weeks, 40% responded and 33% remitted by 24 weeks; for 222 (38%) without a response at 6 weeks, 36% responded and 29% remitted by 24 weeks; for 185 (31%) without a response at 8 weeks, 29% responded and 24% remitted by 24 weeks. Rates were similar for participants who had started an additional mood-stabilizing drug during the first 6 or 8 weeks.
Among patients with bipolar depression and non-response after 6 weeks treatment, representing an adequate bipolar depression trial, only one-third responded by 24 weeks. These results highlight the need for better treatment alternatives for non-responders to evidence-based treatments for bipolar depression.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>34500184</pmid><doi>10.1016/j.psychres.2021.114194</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Affect Antidepressant treatment Antipsychotic Agents - therapeutic use Bipolar depression Bipolar Disorder - chemically induced Bipolar Disorder - drug therapy Double-Blind Method Early non-response Female Humans Lithium Lithium - therapeutic use Male Mood-stabilizing Quetiapine Quetiapine Fumarate - therapeutic use Response Treatment Outcome |
| title | Response and remission rates during 24 weeks of mood-stabilizing treatment for bipolar depression depending on early non-response |
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