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10 - The use of atypical antipsychotic drugs in Bipolar II Disorder

Published online by Cambridge University Press:  13 August 2009

By
David Fresno  and
Eduard Vieta
Edited by
Gordon Parker
David Fresno
Affiliation:
Bipolar Disorders Programme, University of Barcelona, Hospital Clinic, Barcelona, Spain
Eduard Vieta
Affiliation:
Bipolar Disorders Programme, University of Barcelona Hospital Clinic, Barcelona, Spain
Gordon Parker
Affiliation:
University of New South Wales, Sydney
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Summary

Introduction

The bipolar disorders are common, severe long-term conditions, with the World Health Organization reporting in 2001 that bipolar disorder was the fifth cause of ‘life years lived with a disability’ among young adults (WHO, 2001). Atypical antipsychotics are established as the main treatment for schizophrenia, but recently a growing number of trials have indicated that they may provide a therapeutic option for bipolar disorder, as both alternative and adjunctive treatments to traditional mood stabilisers (Vieta and Goikolea, 2005; Berk and Dodd, 2005). While they have been most commonly assessed as treatments for mania, there is increasing evidence of their efficacy and safety in the treatment of bipolar depression and as maintenance treatments of bipolar disorder.

The availability of atypical antipsychotics has brought important changes in the management of the bipolar disorders. Firstly, methodologically more rigorous trials have been developed in order to research their efficacy and safety as a treatment for the different bipolar phases. Secondly, the use of atypical antipsychotics in patients with schizophrenia has given short-term and long-term results suggesting that they provide a safer option than typical antipsychotics. Thirdly, it has been suggested that atypical antipsychotics, via neuronal plasticity determinant molecules, may relate to the therapeutic response process observed in drugs more commonly used as a treatment of affective disorders (Vieta, 2003). Fourthly, some atypical antipsychotics may have mood-stabilising properties (Yatham et al., 2005).

Special characteristics of Bipolar II Disorder

There are several special characteristics of Bipolar II (BP II) Disorder that have important clinical consequences.

Type
Chapter
Information
Bipolar II Disorder
Modelling, Measuring and Managing
 , pp. 133 - 140
Publisher: Cambridge University Press
Print publication year: 2008

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