All About Bipolar

Posted By atorturedsoul on December 1, 2009

A Turkish study indicates that patients with bipolar disorder that experience psychotic features have a worse prognosis and are less likely to respond to lithium.

Previous studies suggest that approximately 50% of patients with bipolar disorder experience psychosis during an acute manic episode. Children and adolescents are more likely to experience psychosis than adults. Until now, the impact of psychosis on prognosis has not been investigated.

I Özyildirim, from Ünye State Hospital in Ordu, and colleagues studied 97 bipolar I disorder patients. Participants had suffered from the condition for at least 4 years and had at least three mood episodes. The clinical features and response to long-term prophylaxis between those with and without psychosis was compared.

There were no significant differences between the psychotic and non-psychotic groups in terms of age, gender distribution, age of onset, and cycling interval. A family history of bipolar disorder was significantly more common in the non-psychotic than psychotic group, at 29.6% versus 11.6%.

Non-psychotic patients were also significantly more likely to have a predominantly depressive episode type than psychotic patients, at 25.0% versus 5.0%, and were significantly less likely to having a predominantly manic/mixed episode type, at 68.8% versus 85.0%.

Psychotic patients were significantly more likely to have severe mood episodes and had significantly more hospitalizations than non-psychotic patients, at 100% versus 27.8% and 1.9 versus 1.4, respectively.

Psychotic patients were significantly less likely to have a response to lithium monotherapy and more likely to have a response to anticonvulsant plus antipsychoctic therapy than non-psychotic patients, at 43.3% versus 89.7% and 100% versus 55.6%, respectively.

The team concludes: “Determination of psychotic subtype might be predictive for the clinical course of illness and establishing the optimum prophylactic treatment.”

Source: MedWire News

This suggests that patients who experience psychosis are more likely to benefit from anticonvulsant medication with an antipsychotic. It more or less confirms what I thought about my own medication. I take an anticonvulsant (lamictal) and have considered asking for an antipsychotic in addition to what I am currently taking to control my symptoms.

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Categories: About Bipolar Disorder, Bipolar 1, Bipolar 2, Cyclothymia, My Personal Experiences, NOS, Psychosis, Symptoms
Tags: all about bipolar, anticonvulsant, antipsychotic, bipolar disorder, lamictal, lithium, Psychosis, psychotic features, research, study