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Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice

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Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice

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Título Pharmacological treatment and staging in bipolar disorder : evidence from clinical practice
Autor Goi, Pedro Domingues
Bücker, Joana
Sulzbach, Miréia Fortes Vianna
Rosa, Adriane Ribeiro
Grande, Iria
Chendo, Inês
Sodré, Leonardo de Almeida
Sant’Anna, Marcia Kauer
Silveira, Leonardo Evangelista da
Kunz, Maurício
Ceresér, Keila Maria Mendes
Gama, Clarissa Severino
Massuda, Raffael
Abstract Objective: Staging models for medical diseases are widely used to guide treatment and prognosis. Bipolar disorder (BD) is a chronic condition and it is among the most disabling disorders in medicine. The staging model proposed by Kapczinski in 2009 presents four progressive clinical stages of BD. Our aim was to evaluate pharmacological maintenance treatment across these stages in patients with BD. Methods: One hundred and twenty-nine subjects who met DSM-IV criteria for BD were recruited from the Bipolar Disorders Program at Hospital de Clı´nicas de Porto Alegre, Brazil. All patients were in remission. The subjects were classified according to the staging model: 31 subjects were classified as stage I, 44 as stage II, 31 as stage III, and 23 as stage IV. Results: Patterns of pharmacological treatment differed among the four stages (p = 0.001). Monotherapy was more frequent in stage I, and two-drug combinations in stage II. Patients at stages III and IV needed three or more medications or clozapine. Impairment in functional status (Functioning Assessment Short Test [FAST] scale scores) correlated positively with the number of medications prescribed. Conclusions: This study demonstrated differences in pharmacological treatment in patients with stable BD depending on disease stage. Treatment response can change with progression of BD. Clinical guidelines could consider the staging model to guide treatment effectiveness.
Contido em Revista brasileira de psiquiatria (1999). São Paulo. Vol. 37, n. 2 (abr./jun. 2015), p. 121-125
Assunto Anticonvulsivantes
Antidepressivos
Antipsicoticos
Transtorno bipolar : Classificação
Transtorno bipolar : Diagnóstico
[en] Anticonvulsants
[en] Antidepressants
[en] Antipsychotics
[en] Bipolar mood disorders
[en] Diagnosis and classification
Origem Nacional
Tipo Artigo de periódico
URI http://hdl.handle.net/10183/129426
Arquivos Descrição Formato
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