Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi

Oral, Esat Timuçin; Atagün, Murat İlhan

doi:10.29399/npa.27411

Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi

Murat İlhan ATAGÜN, (İzmir Bakırçay Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, İzmir, Türkiye)

Timuçin ORAL (Girilmemişş)

Nöropsikiyatri Arşivi

34 3

Yıl: 2021 Cilt: 58 Sayı: 1 Sayfa Aralığı: 24 - 30 Metin Dili: Türkçe DOI: 10.29399/npa.27411 İndeks Tarihi: 30-12-2021

Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi

Öz:

Bipolar bozukluk erken ölüm ve engelliliğe sebep olabilen psikiyatrik bir bozukluktur. Yeni gelişmelere rağmen, tedavide kısmen başarı sağlanabilmekte ve yanıt yetersiz kaldığında yaşam kalitesi kaybı ortaya çıkabilmektedir. Günümüzde yaygın yaklaşım hastalığın belirtileri, hastanın tedavi geçmişi ve deneyimlerini birlikte göz önünde bulundurularak kişiye özel planlama yapılması biçimindedir. Bu yazında manik dönem tedavisinde antipsikotik ilaçlar, ve duygudurum dengeleyicilerin bilimsel çalışmalar ışığında etki/yan etkileri incelenmiş, kanıta dayalı tedavi kılavuzlarında yer alan basamaklı algoritmalar kısaca incelenmiş ve yazının klinisyenlere yönelik güncel, özet bir kaynak olması hedeflenmiştir. Literatürde karma dönemler, psikotik belirtilerle ilgili gelişmeler olmakla birlikte kanıta dayalı tedavi seçeneklerinin hala kısıtlı olduğu görülmektedir. Duygudurum dengeleyicilerin etkilerinin uzun sürede ortaya çıkması ve ek tedavilere sıklıkla ihtiyaç duyulması ve antipsikotiklerin yan etkileri, kullanımlarını kısıtlayan faktörler olarak göze çarpmaktadır. Bu nedenle tedavi kararlarında klinisyenin tecrübesi ve hastanın tedavi öyküsü önemlerini korumaktadırlar.

Anahtar Kelime:

Acute and Long Term Treatment of Manic Episodes in Bipolar Disorder

Öz:

Bipolar disorder is a disabling psychiatric disorder which causes premature death and loss of quality of life. Despite the developments, novel treatments are partially effective and insufficient responses to treatment may cause loss of quality of life. Contemporary approaches to treatment planning is done by taking current symptoms and personal treatment history of the patient into account and tailoring them to treatment for each patient, i.e. individualized treatment. In this article, effects and side effects of antipsychotics, mood stabilizers and sedative hypnotic medications are reviewed and presented briefly for clinicians. Although novel developments have been observed in the literature about mixed states and psychotic symptoms, evidence based options are still limited. Efficacy of mood stabilizers may be prolonged and additional medications may also be needed frequently in patients, treated with mood stabilizers. Antipsychotics may cause several side effects and cannot be maintained for a long time in some of those patients. These factors may limit the use of mood stabilizers or antipsychotics. Therefore, the experience of the clinician and personal history of the patient still have importance in the procedure.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Merikangas KR, Akiskal HS, Angst J, Greenberg PE, Hirschfeld RM, Petukhova M, Kessler RC. Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 2007;64:543–552.
2. American Psychiatric Association - APA. Diagnostic and statistical manual of mental disorders. Arlington, VA, USA: American Psychiatric Association; 2013.
3. Goodwin FK, Jamison KR. In: Goodwin FK, Jamison KR, editors. ManicDepressive iIllness: Bipolar disorders and recurrent depression. New York: Oxford University Press; 2007. p.29–86.
4. Solomon DA, Leon AC, Endicott J, Coryell WH, Mueller TI, Posternak MA, Keller BM. Unipolar mania over the course of a 20-year follow-up study. Am J Psychiatry 2003;160:2049–2051.
5. Yazici O. Unipolar mania: a distinct entity? J Affect Disord 2014;152–154:52– 56.
6. Koukopoulos A, Ghaemi SN. The primacy of mania: a reconsideration of mood disorders. Eur Psychiatry 2009;24:125–134.
7. Janicak PG, Marder SR, Pavuluri MN. Principles and Practice of Psychopharmacotherapy. Philadelphia, Pennsylvania, USA: Wolters Kluwer Health / Lippincott Williams and Wilkins; 2011. p.367–462.
8. Oral TE. Treatment of acute mania. Neuro Endocrinol Lett 2005;26 Suppl 1:9–25. https://pubmed.ncbi.nlm.nih.gov/16361986/
9. Fountoulakis KN, Yatham LN, Grunze H, Vieta E, Young AH, Blier P, Tohen M, Kasper S, Moeller HJ. The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder. Int J Neuropsychopharmacol 2020;23:230–256.
10. Malhi GS, Bassett D, Boyce P, Bryant R, Fitzgerald PB, Fritz K, Hopwood M, Lyndon B, Mulder R, Murray G, Porter R, Singh AB. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry 2015;49:1087–1206.
11. Karadag F, Oral T, Yalçın FA, Erten E. Young Mani Derecelendirme Ölçeği’nin Türkiye’de geçerlik ve güvenirliği. Turk Psikiyatri Derg 2001;13:107–114.
12. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, Sharma V, Goldstein BI, Rej S, Beaulieu S, Alda M, MacQueen G, Milev RV, Ravindran A, O’Donovan C, McIntosh D, Lam RW, Vazquez G, Kapczinski F, McIntyre RS, Kozicky J, Kanba S, Lafer B, Suppes T, Calabrese JR, Vieta E, Malhi G, Post RM, Berk M. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD)2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 2018;20:97–170.
13. Ashok AH, Marques TR, Jauhar S, Nour MM, Goodwin GM, Young AH, Howes OD. The dopamine hypothesis of bipolar affective disorder: the state of the art and implications for treatment. Mol Psychiatry 2017;22:666–679.
14. Rosa AR, Fountoulakis K, Siamouli M, Gonda X, Vieta E. Is anticonvulsant treatment of mania a class effect? Data from randomized clinical trials. CNS Neurosci Ther 2011;17:167–177.
15. Fountoulakis KN, Grunze H, Vieta E, Young A, Yatham L, Blier P, Kasper S, Moeller HJ. The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 3: The Clinical Guidelines. Int J Neuropsychopharmacol 2017;20:180–195.
16. McKnight RF, de La Motte de Broons de Vauvert S, Chesney E, Amit BH, Geddes J, Cipriani A. Lithium for acute mania. Cochrane Database Syst Rev 2019;6:CD004048.
17. Simonetti A, Koukopoulos AE, Kotzalidis GD, Janiri D, De Chiara L, Janiri L, Sani G. Stabilization Beyond Mood: Stabilizing Patients With Bipolar Disorder in the Various Phases of Life. Front Psychiatry 2020;11:247.
18. Lenox RH, Newhouse PA, Creelman WL, Whitaker TM. Adjunctive treatment of manic agitation with lorazepam versus haloperidol: a double-blind study. J Clin Psychiatry 1992;53:47–52. https://pubmed.ncbi.nlm.nih.gov/1541605/
19. Kusalic M. Grade II and grade III hypothyroidism in rapid-cycling bipolar patients. Neuropsychobiology 1992;25:177–181.
20. Bowden CL, Brugger AM, Swann AC, Calabrese JR, Janicak PG, Petty F, Dilsaver SC, Davis JM, Rush AJ, Small JG, Garza-Treviño ES, Risch SC, Goodnick PJ, Morris DD, Shu V, Johnson P, Blake M, Javors M, Ereshefsky L, McLeod T, Shoaib A, Johnson M, Kimmel S, Wesley A, Qualtiere R, Trivedi C, Javaid J, Peterson J, Lambert M, Zielinski M, Orsulak P, Sharp L, Akers L, Miller M, Kellams J, Woodham G, Frazer A. Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. JAMA 1994;271:918–924.
21. Jochim J, Rifkin-Zybutz RP, Geddes J, Cipriani A. Valproate for acute mania. Cochrane Database Syst Rev 2019;10:CD004052.
22. Muller-Oerlinghausen B, Retzow A, Henn FA, Giedke H, Walden J. Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania: a prospective, randomized, double-blind, placebocontrolled, multicenter study. European Valproate Mania Study Group. J Clin Psychopharmacol 2000;20:195–203.
23. Boyce P, Irwin L, Morris G, Hamilton A, Mulder R, Malhi GS, Porter RJ. Longacting injectable antipsychotics as maintenance treatments for bipolar disorder-A critical review of the evidence. Bipolar Disord 2018;20:25–36.
24. Weisler RH, Kalali AH, Ketter TA, Group SPDS. A multicenter, randomized, double-blind, placebo-controlled trial of extended-release carbamazepine capsules as monotherapy for bipolar disorder patients with manic or mixed episodes. J Clin Psychiatry 2004;65:478–484.
25. Small JG, Klapper MH, Milstein V, Kellams JJ, Miller MJ, Marhenke JD, Small IF. Carbamazepine compared with lithium in the treatment of mania. Arch Gen Psychiatry 1991;48:915–921.
26. Lerer B, Moore N, Meyendorff E, Cho SR, Gershon S. Carbamazepine versus lithium in mania: a double-blind study. J Clin Psychiatry 1987;48:89–93. https://pubmed.ncbi.nlm.nih.gov/3546274/
27. Okuma T, Yamashita I, Takahashi R, Itoh H, Otsuki S, Watanabe S, Sarai K, Hazama H, Inanaga K. A double-blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders. Acta Psychiatr Scand 1989;80:250–259.
28. Lusznat RM, Murphy DP, Nunn CM. Carbamazepine vs lithium in the treatment and prophylaxis of mania. Br J Psychiatry 1988;153:198–204.
29. Tohen M, Vieta E. Antipsychotic agents in the treatment of bipolar mania. Bipolar Disord 2009;11:45–54.
30. Scherk H, Pajonk FG, Leucht S. Second-generation antipsychotic agents in the treatment of acute mania: a systematic review and meta-analysis of randomized controlled trials. Arch Gen Psychiatry 2007;64:442–455.
31. Nour H, Baslet G, Janicak PG. The Role of Second-Generation Antipsychotics in the Treatment of Mood Disorders Part I: Acute Bipolar Mania. Janicak PG, Pavuluri MN, editors. Contemporary Psychiatry 2003;2:1–8.
32. Cipriani A, Barbui C, Salanti G, Rendell J, Brown R, Stockton S, Purgato M, Spineli LM, Goodwin GM, Geddes JR. Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis. Lancet 2011;378:1306–1315.
33. Goodwin GM, Haddad PM, Ferrier IN, Aronson JK, Barnes T, Cipriani A, Coghill DR, Fazel S, Geddes JR, Grunze H, Holmes EA, Howes O, Hudson S, Hunt N, Jones I, Macmillan IC, McAllister-Williams H, Miklowitz DR, Morriss R, Munafò M, Paton C, Saharkian BJ, Saunders K, Sinclair J, Taylor D, Vieta E, Young AH. Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2016;30:495–553.
34. Yildiz A, Vieta E, Leucht S, Baldessarini RJ. Efficacy of antimanic treatments: meta-analysis of randomized, controlled trials. Neuropsychopharmacology 2011;36:375–389.
35. Pinto JV, Saraf G, Vigo D, Keramatian K, Chakrabarty T, Yatham LN. Cariprazine in the treatment of Bipolar Disorder: A systematic review and meta-analysis. Bipolar Disord 2020;22:360–371.
36. Stahl SM, Laredo S, Morrissette DA. Cariprazine as a treatment across the bipolar I spectrum from depression to mania: mechanism of action and review of clinical data. Ther Adv Psychopharmacol 2020;10:2045125320905752.
37. Chakrabarty T, Keramatian K, Yatham LN. Treatment of Mixed Features in Bipolar Disorder: an Updated View. Curr Psychiatry Rep 2020;22:15.
38. Calabrese JR, Kimmel SE, Woyshville MJ, Rapport DJ, Faust CJ, Thompson PA, Meltzer HY. Clozapine for treatment-refractory mania. Am J Psychiatry 1996;153:759–764.
39. Suppes T, McElroy SL, Gilbert J, Dessain EC, Cole JO. Clozapine in the treatment of dysphoric mania. Biol Psychiatry 1992;32:270–280.
40. Frye MA, Altshuler LL, Bitran JA. Clozapine in rapid cycling bipolar disorder. J Clin Psychopharmacol 1996;16:87–90.
41. Zarate CA Jr, Tohen M, Banov MD, Weiss MK, Cole JO. Is clozapine a mood stabilizer? J Clin Psychiatry 1995;56:108–112. https://pubmed.ncbi.nlm.nih. gov/7883728/
42. Kando JC, Tohen M, Castillo J, Centorrino F. Concurrent use of clozapine and valproate in affective and psychotic disorders. J Clin Psychiatry 1994;55:255– 257.
43. Pigott K, Galizia I, Vasudev K, Watson S, Geddes J, Young AH. Topiramate for acute affective episodes in bipolar disorder in adults. Cochrane Database Syst Rev 2016;9:CD003384.
44. Vasudev A, Macritchie K, Vasudev K, Watson S, Geddes J, Young AH. Oxcarbazepine for acute affective episodes in bipolar disorder. Cochrane Database Syst Rev 2011:CD004857.
45. Bartoli F, Crocamo C, Clerici M, Carra G. Allopurinol as add-on treatment for mania symptoms in bipolar disorder: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry 2017;210:10–15.
46. Palacios J, Yildiz A, Young AH, Taylor MJ. Tamoxifen for bipolar disorder: Systematic review and meta-analysis. J Psychopharmacol 2019;33:177–184.
47. Moghaddam HS, Bahmani S, Bayanati S, Mahdavinasa M, Rezaei F, Akhondzadeh S. Efficacy of melatonin as an adjunct in the treatment of acute mania: a double-blind and placebo-controlled trial. Int Clin Psychopharmacol 2020;35:81–88.
48. Behzadi AH, Omrani Z, Chalian M, Asadi S, Ghadiri M. Folic acid efficacy as an alternative drug added to sodium valproate in the treatment of acute phase of mania in bipolar disorder: a double-blind randomized controlled trial. Acta Psychiatr Scand 2009;120:441–445.
49. Bag S, Canbek O, Atagun IM, Kutlar TM. Early effects of modern electroconvulsive therapy on subjective memory in patients with mania or depression. Indian J Psychiatry 2016;58:198–203.
50. Perugi G, Medda P, Toni C, Mariani MG, Socci C, Mauri M. The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features. Curr Neuropharmacol 2017;15:359–371.
51. Canbek O, Menges OO, Atagun MI, Kutlar MT, Kurt E. Report on 3 years’ experience in electroconvulsive therapy in bakirkoy research and training hospital for psychiatric and neurological diseases:2008–2010. J ECT 2013;29:51–57.
52. Praharaj SK, Ram D, Arora M. Efficacy of high frequency (rapid) suprathreshold repetitive transcranial magnetic stimulation of right prefrontal cortex in bipolar mania: a randomized sham controlled study. J Affect Disord 2009;117:146–150.
53. Pathak V, Sinha VK, Praharaj SK. Efficacy of Adjunctive High Frequency Repetitive Transcranial Magnetic Stimulation of Right Prefrontal Cortex in Adolescent Mania: A Randomized Sham-Controlled Study. Clin Psychopharmacol Neurosci 2015;13:245–249.
54. Gold AK, Ornelas AC, Cirillo P, Caldieraro MA, Nardi AE, Nierenberg AA, Kinrys G. Clinical applications of transcranial magnetic stimulation in bipolar disorder. Brain Behav 2019;9:e01419.
55. Schestatsky P, Janovik N, Lobato MI, Belmonte-de-Abreu P, Schestatsky S, Shiozawa P, Fregni F. Rapid therapeutic response to anodal tDCS of right dorsolateral prefrontal cortex in acute mania. Brain Stimul 2013;6:701–703.
56. Donde C, Neufeld NH, Geoffroy PA. The Impact of Transcranial Direct Current Stimulation (tDCS) on Bipolar Depression, Mania, and Euthymia: a Systematic Review of Preliminary Data. Psychiatr Q 2018;89:855–867.
57. Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Azorin JM, Yatham L, Mosolov S, Möller HJ, Kasper S; WFSBP Task Force on Bipolar Affective Disorders. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Acute and long-term treatment of mixed states in bipolar disorder. World J Biol Psychiatry 2018;19:2–58.
58. Ogawa Y, Tajika A, Takeshima N, Hayasaka Y, Furukawa TA. Mood stabilizers and antipsychotics for acute mania: a systematic review and meta-analysis of combination/augmentation therapy versus monotherapy. CNS Drugs 2014;28:989–1003.
59. Machado-Vieira R, Soares JC, Lara DR, Luckenbaugh DA, Busnello JV, Marca G, Cunha A, Souza DO, Zarate CA Jr, Kapczinski F. A double-blind, randomized, placebo-controlled 4-week study on the efficacy and safety of the purinergic agents allopurinol and dipyridamole adjunctive to lithium in acute bipolar mania. J Clin Psychiatry 2008;69:1237–1245.
60. Green AI, Tohen M, Patel JK, Banov M, DuRand C, Berman I, Chang H, Zarate C Jr, Posener J, Lee H, Dawson R, Richards C, Cole JO, Schatzberg AF. Clozapine in the treatment of refractory psychotic mania. Am J Psychiatry 2000;157:982–986.
61. Ciapparelli A, Dell’Osso L, Pini S, Chiavacci MC, Fenzi M, Cassano GB. Clozapine for treatment–refractory schizophrenia, schizoaffective disorder, and psychotic bipolar disorder: a 24-month naturalistic study. J Clin Psychiatry 2000;61:329–334.

APA	Atagün M, Oral E (2021). Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. , 24 - 30. 10.29399/npa.27411
Chicago	Atagün Murat İlhan,Oral Esat Timuçin Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. (2021): 24 - 30. 10.29399/npa.27411
MLA	Atagün Murat İlhan,Oral Esat Timuçin Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. , 2021, ss.24 - 30. 10.29399/npa.27411
AMA	Atagün M,Oral E Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. . 2021; 24 - 30. 10.29399/npa.27411
Vancouver	Atagün M,Oral E Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. . 2021; 24 - 30. 10.29399/npa.27411
IEEE	Atagün M,Oral E "Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi." , ss.24 - 30, 2021. 10.29399/npa.27411
ISNAD	Atagün, Murat İlhan - Oral, Esat Timuçin. "Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi". (2021), 24-30. https://doi.org/10.29399/npa.27411

APA	Atagün M, Oral E (2021). Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. Nöropsikiyatri Arşivi, 58(1), 24 - 30. 10.29399/npa.27411
Chicago	Atagün Murat İlhan,Oral Esat Timuçin Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. Nöropsikiyatri Arşivi 58, no.1 (2021): 24 - 30. 10.29399/npa.27411
MLA	Atagün Murat İlhan,Oral Esat Timuçin Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. Nöropsikiyatri Arşivi, vol.58, no.1, 2021, ss.24 - 30. 10.29399/npa.27411
AMA	Atagün M,Oral E Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. Nöropsikiyatri Arşivi. 2021; 58(1): 24 - 30. 10.29399/npa.27411
Vancouver	Atagün M,Oral E Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi. Nöropsikiyatri Arşivi. 2021; 58(1): 24 - 30. 10.29399/npa.27411
IEEE	Atagün M,Oral E "Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi." Nöropsikiyatri Arşivi, 58, ss.24 - 30, 2021. 10.29399/npa.27411
ISNAD	Atagün, Murat İlhan - Oral, Esat Timuçin. "Bipolar Bozukluk-Manik Dönemin Akut ve İdame Tedavisi". Nöropsikiyatri Arşivi 58/1 (2021), 24-30. https://doi.org/10.29399/npa.27411