Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-23T05:19:54.141Z Has data issue: false hasContentIssue false

Chapter 8 - Bipolar Disorders

Published online by Cambridge University Press:  07 November 2024

By
Prabhleen Jaggi ,
David M. L. Branford  and
Regi T. Alexander
Edited by
David M. L. Branford ,
Satheesh K. Gangadharan ,
Mary Barrett  and
Regi T. Alexander
David M. L. Branford
Affiliation:
Independent Pharmacy Consultant
Satheesh K. Gangadharan
Affiliation:
Leicestershire Partnership NHS Trust
Mary Barrett
Affiliation:
Leicestershire Partnership NHS Trust
Regi T. Alexander
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust
Get access

Summary

Bipolar disorders are episodic mood disorders defined by the occurrence of manic, mixed, or hypomanic episodes or symptoms. Manic and hypomanic symptoms are characterised by a subjective experience of increased energy and activity, along with various other symptoms. These episodes typically alternate over the course of these disorders with depressive episodes or periods of depressive symptoms such as lowering of mood, decreased energy and activity (ICD-11, 2019; DSM-5, 2013). Both the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders DSM-5 and the International Classification of Diseases ICD-11 broadly subclassify the condition as follows: bipolar I disorder: one or more manic episodes or mixed episodes. Individuals often have one or more major depressive episodes; bipolar II disorder: one or more major depressive episodes accompanied by at least one hypomanic episode. Bipolar affective disorders present a major diagnostic and treatment challenge to services for people with intellectual disability. The chapter presents an overview of the condition, the treatments with medication available, and their relevance. The chapter includes the use of mood stabilisers such as sodium valproate.

Keywords

bipolar disordermood disordermood stabilisersantipsychotic medications
Type
Chapter
Information
The Frith Prescribing Guidelines for People with Intellectual Disability , pp. 102 - 117
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ali, A., Blickwedel, J., & Hassiotis, A. (2014) Interventions for challenging behaviour in intellectual disability, Advances in Psychiatric Treatment: Cambridge University Press, 20(3), 184–92. https://doi.org/10.1192/apt.bp.113.011577.CrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association.Google Scholar
Bahji, A., Ermacora, D., Stephenson, C., Hawken, E. R., & Vazquez, G. (2020) Comparative efficacy and tolerability of pharmacological treatments for the treatment of acute bipolar depression: A systematic review and network meta-analysis, Journal of Affective Disorders, 269, 154–84. https://doi.org/10.1016/j.jad.2020.03.030.CrossRefGoogle ScholarPubMed
Berk, L., Hallam, K. T., Colom, F., et al. (2010). Enhancing medication adherence in patients with bipolar disorder. Human Psychopharmacology: Clinical and Experimental, 25(1), 1–16.CrossRefGoogle ScholarPubMed
Bertelli, M. O., Deb, S., Munir, K., Hassiotis, A., & Salvador-Carulla, L. (2022) Textbook of psychiatry for intellectual disability and autism spectrum disorder. Springer.CrossRefGoogle Scholar
Bhaumik, S., Gangadharan, S., Branford, D., & Barrett, M. (2015) The Frith prescribing guidelines for people with intellectual disability. John Wiley & Sons, Ltd.CrossRefGoogle Scholar
Bowden, C. L. et al. (1999) ‘The efficacy of lamotrigine in rapid cycling and non–rapid cycling patients with bipolar disorder’, Biological Psychiatry, 45(8), 953–8. https://doi.org/10.1016/s0006-3223(99)00013-x.CrossRefGoogle ScholarPubMed
Cain, N. N., Davidson, P. W., Burhan, A. M., et al. (2003) Identifying bipolar disorders in individuals with intellectual disability, Journal of Intellectual Disability Research, 47(1), 31–8. https://doi.org/10.1046/j.1365-2788.2003.00458.x.CrossRefGoogle ScholarPubMed
Calabrese, J. R., Keck, P. E., Macfadden, W., et al. (2005) A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression, American Journal of Psychiatry, 162(7), 1351–60. https://doi.org/10.1176/appi.ajp.162.7.1351.CrossRefGoogle ScholarPubMed
Charles, E. F., Lambert, C. G., & Kerner, B. (2016) Bipolar disorder and diabetes mellitus: evidence for disease-modifying effects and treatment implications. International Journal of Bipolar Disorder, Dec; 4(1), 13. https://doi.org/10.1186/s40345-016-0054-4. Epub 2016 Jul 7. PMID: 27389787; PMCID: PMC4936996.CrossRefGoogle ScholarPubMed
Cooper, S. A., McLean, G., Guthrie, B., et al. (2015). Multiple physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis. BMC Family Practice, 16, 1–11.CrossRefGoogle ScholarPubMed
Cooper, S.-A. et al. (2007) An epidemiological investigation of affective disorders with a population-based cohort of 1023 adults with intellectual disabilities, Psychological Medicine, 37(6), 873–82. https://doi.org/10.1017/s0033291707009968.CrossRefGoogle ScholarPubMed
Cooper, S.-A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2018) Incidence of unipolar and bipolar depression, and mania in adults with intellectual disabilities: Prospective cohort study, British Journal of Psychiatry, 212(5), 295–300. https://doi.org/10.1192/bjp.2018.12.CrossRefGoogle ScholarPubMed
Detke, H. C., DelBello, M., Landry, J., & Usher, R. (2015) Olanzapine/fluoxetine combination in children and adolescents with bipolar I depression: A randomized, double-blind, placebo-controlled trial, Journal of the American Academy of Child & Adolescent Psychiatry, 54(3), 217–24. https://doi.org/10.1016/j.jaac.2014.12.012.Google ScholarPubMed
Geddes, J. R., Calabrese, J. R., & Goodwin, G. M. (2009a) Lamotrigine for treatment of Bipolar Depression: Independent meta-analysis and meta-regression of individual patient data from five randomised trials, British Journal of Psychiatry, 194(1), 4–9. https://doi.org/10.1192/bjp.bp.107.048504.CrossRefGoogle ScholarPubMed
Geddes, J. R., Gardiner, A., & Rendell, J. et al. (2016) Comparative evaluation of Quetiapine plus lamotrigine combination versus quetiapine monotherapy (and folic acid versus placebo) in bipolar depression (CEQUEL): A 2 × 2 factorial randomised trial, The Lancet Psychiatry, 3(1), 31–9. https://doi.org/10.1016/s2215-0366(15)00450-2.CrossRefGoogle Scholar
Geddes, J. R., Goodwin, G. M., & Rendell, J. (2009b). Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): A randomised open-label trial. The Lancet, 375(9712).Google Scholar
Goes, F. S. (2023). Diagnosis and management of bipolar disorders. BMJ (Clinical research ed.), 381, e073591. https://doi.org/10.1136/bmj-2022-073591.Google ScholarPubMed
Goodwin, G., Haddad, P. M. & Ferrier, I. N. (2016) Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology, Journal of Psychopharmacology, 30(6), 495–553. https://doi.org/10.1177/0269881116636545.CrossRefGoogle ScholarPubMed
Grunze, A., Amann, B. L. & Grunze, H. (2021) Efficacy of carbamazepine and its derivatives in the treatment of bipolar disorder, Medicina, 57(5), 433. https://doi.org/10.3390/medicina57050433.CrossRefGoogle ScholarPubMed
Hayes, J. F., Marston, L., Walters, K., et al. (2016) Lithium vs. valproate vs. olanzapine vs. quetiapine as maintenance monotherapy for bipolar disorder: A population-based UK cohort study using Electronic Health Records, World Psychiatry, 15(1), 53–8. https://doi.org/10.1002/wps.20298.CrossRefGoogle ScholarPubMed
Iacobucci, G. (2023) Clinicians should withdraw antidepressants gradually, says NICE, BMJ (Clinical research ed.), 380, 130. https://doi.org/10.1136/bmj.p130.Google ScholarPubMed
Kazdin, A. E. (1983) Assessment of depression in mentally retarded adults, American Journal of Psychiatry, 140(8), 1040–3. https://doi.org/10.1176/ajp.140.8.1040.Google ScholarPubMed
Kessing, L. V., Hellmund, G., Geddes, J. R., Goodwin, G. M., & Andersen, P. K. (2011). Valproate v. lithium in the treatment of bipolar disorder in clinical practice: Observational nationwide register-based cohort study. The British Journal of Psychiatry, 199, 47–63. https://doi.org/10.1192/bjp.bp.110.084822.CrossRefGoogle ScholarPubMed
Lowry, M. A. (1998) Assessment and treatment of mood disorders in persons with developmental disabilities. Journal of Developmental and Physical Disabilities, 10(4), 387–406. https://doi.org/10.1023/a:1021858622501.CrossRefGoogle Scholar
Marcus, R., Khan, A. & Rollin, L. (2011) Efficacy of aripiprazole adjunctive to lithium or valproate in the long-term treatment of patients with bipolar I disorder with an inadequate response to lithium or valproate monotherapy: A multicenter, double-blind, randomized study, Bipolar Disorders, 13(2), 133–44. https://doi.org/10.1111/j.1399-5618.2011.00898.x.CrossRefGoogle ScholarPubMed
Matson, J. (1998) The convergent validity of the Matson Evaluation of social skills for individuals with severe retardation (messier), Research in Developmental Disabilities, 19(6), 493–500. https://doi.org/10.1016/s0891-4222(98)00020-1.CrossRefGoogle ScholarPubMed
Matson, J. L. & Smiroldo, B. B. (1997) Validity of the mania subscale of the Diagnostic Assessment for the severely handicapped-II (Dash-ii), Research in Developmental Disabilities, 18(3), 221–5. https://doi.org/10.1016/s0891-4222(97)00005-x.CrossRefGoogle ScholarPubMed
Matson, J. L., Gonzalez, M. L., Terlonge, C., Thorsn, R. B., & Laud, R. B. (2007) What symptoms predict the diagnosis of mania in persons with severe/profound intellectual disability in clinical practice?, Journal of Intellectual Disability Research, 51(1), 25–31. https://doi.org/10.1111/j.1365-2788.2006.00897.x.CrossRefGoogle ScholarPubMed
McElroy, S. L., Weisler, R. & Chang, W. (2010) A double-blind, placebo-controlled study of Quetiapine and paroxetine as monotherapy in adults with bipolar depression (embolden II), The Journal of Clinical Psychiatry, 71(2), 163–74. https://doi.org/10.4088/jcp.08m04942gre.CrossRefGoogle ScholarPubMed
Moss, S., Emerson, E., Kiernan, C., et al. (2000). Psychiatric symptoms in adults with learning disability and challenging behaviour. British Journal of Psychiatry, 177, 452–6. https://doi.org/10.1192/bjp.177.5.452.CrossRefGoogle ScholarPubMed
National Institute for Health and Care Excellence (2020). Bipolar disorder: Assessment and management. [NICE Clinical Guideline CG185]. www.nice.org.uk/guidance/cg185.Google Scholar
Popovic, D., Reinares, M., Goikolea, J. M., et al. (2012) Polarity index of pharmacological agents used for maintenance treatment of bipolar disorder, European Neuropsychopharmacology, 22(5), 339–46. https://doi.org/10.1016/j.euroneuro.2011.09.008.CrossRefGoogle ScholarPubMed
Popovic, D., Torrent, C., Goikolea, J. M., et al. (2013) Clinical implications of predominant polarity and the polarity index in bipolar disorder: A naturalistic study, Acta Psychiatrica Scandinavica, 129(5), 366–74. https://doi.org/10.1111/acps.12179.Google ScholarPubMed
Royal College of Psychiatrists (2001). DC-LD: Diagnostic criteria for psychiatric disorders for use with adults with learning disabilities/mental retardation, London, Royal College of Psychiatrists, Occasional Paper OP 48.Google Scholar
Sturmey, P., Laud, R. B., Cooper, C. L., Matson, J. L., & Fodstad, J. C. (2010) Mania and behavioral equivalents: A preliminary study, Research in Developmental Disabilities, 31(5), 1008–14. https://doi.org/10.1016/j.ridd.2010.04.017.CrossRefGoogle ScholarPubMed
Suppes, T. & Vieta, E., Liu, S., Brecher, M., & Paulsson, B. (2009). Maintenance treatment for patients with bipolar I disorder: Results from a North American study of quetiapine in combination with lithium or divalproex (Trial 127). American Journal of Psychiatry, 166, 476–88. https://doi.org/10.1176/appi.ajp.2008.08020189.CrossRefGoogle ScholarPubMed
Suppes, T., Vieta, E., Gustafsson, U., & Ekholm, B. (2013) Maintenance treatment with quetiapine when combined with either lithium or divalproex in bipolar I disorder: Analysis of two large randomized, placebo-controlled trials, Depression and Anxiety, 30(11), 1089–98. https://doi.org/10.1002/da.22136.CrossRefGoogle ScholarPubMed
Taylor, D. M., Barnes, T. R., & Young, A. H. (2021) The Maudsley prescribing guidelines in psychiatry. Wiley Blackwell.CrossRefGoogle Scholar
Taylor, J. L., Hatton, C., Dixon, L., & Douglas, C. (2004) Screening for psychiatric symptoms: PAS-add checklist norms for adults with intellectual disabilities, Journal of Intellectual Disability Research, 48(1), 37–41. https://doi.org/10.1111/j.1365-2788.2004.00585.x.CrossRefGoogle ScholarPubMed
Thase, M. E., Macfadden, W., Weisler, R. H., et al. (2006) Efficacy of quetiapine monotherapy in bipolar I and II depression, Journal of Clinical Psychopharmacology, 26(6), 600–9. https://doi.org/10.1097/01.jcp.0000248603.76231.b7.CrossRefGoogle ScholarPubMed
Tohen, M., Calabrese, J. R., Sachs, G. S., et al. (2006) Randomized, placebo-controlled trial of olanzapine as maintenance therapy in patients with bipolar I disorder responding to acute treatment with olanzapine, American Journal of Psychiatry, 163(2), 247–56. https://doi.org/10.1176/appi.ajp.163.2.247.CrossRefGoogle ScholarPubMed
Valdovinos, M. G., Seibert, H. N., Piersma, D., et al. (2019) Characterizing mood states in individuals diagnosed with bipolar disorder and intellectual disability, Journal of Mental Health Research in Intellectual Disabilities, 12(1–2), 26–44. https://doi.org/10.1080/19315864.2018.1561770.CrossRefGoogle ScholarPubMed
Valentí, M., Pacchiarotti, I., Undurraga, J., et al. (2015) Risk factors for rapid cycling in bipolar disorder, Bipolar Disorders, 17(5), 549–59. https://doi.org/10.1111/bdi.12288.CrossRefGoogle ScholarPubMed
Vieta, E., Günther, O., Locklear, J. (2011). Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder: a meta-analysis of randomized controlled trials. International Journal of Neuropsychopharmacology, 14(8), 1029–49. https://doi.org/10.1017/S1461145711000885.CrossRefGoogle ScholarPubMed
Vieta, E., Montgomery, S., Sulaiman, A. H., et al. (2012) A randomized, double-blind, placebo-controlled trial to assess prevention of mood episodes with risperidone long-acting injectable in patients with bipolar I disorder, European Neuropsychopharmacology, 22(11), 825–35. https://doi.org/10.1016/j.euroneuro.2012.03.004.CrossRefGoogle ScholarPubMed
Watkins, L., Cock, H., Angus-Leppan, H., et al. (2019) Valproate MHRA guidance: Limitations and opportunities, Frontiers in Neurology, 10. https://doi.org/10.3389/fneur.2019.00139.CrossRefGoogle ScholarPubMed
World Health Organization (2019) ICD-11: International Statistical Classification of Diseases and Related Health Problems.Google Scholar
Yatham, L. N., Kennedy, S. H., Parikh, S. V., et al. (2018) 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 Disorders, 20(2), 97–170. https://doi.org/10.1111/bdi.12609.CrossRefGoogle Scholar
Yatham, L., Beaulieu, S., Schaffer, A. et al. (2016). Optimal duration of risperidone or olanzapine adjunctive therapy to mood stabilizer following remission of a manic episode: A CANMAT randomized double-blind trial. Molecular Psychiatry, 21(1), 1050–6. https://doi.org/10.1038/mp.2015.158.CrossRefGoogle Scholar
Yen, S., Stout, R., Hower, H., et al. (2016). The influence of comorbid disorders on the episodicity of bipolar disorder in youth. Acta Psychiatrica Scandinavica, 133(4), 324–34.CrossRefGoogle ScholarPubMed
Youngstrom, E. A., Gracious, B. L., Danielson, C. K., Findling, R. L., & Calabrese, J. (2003). Toward an integration of parent and clinician report on the Young Mania Rating Scale. Journal of Affective Disorders, 77(2), 179–90. https://doi.org/10.1016/S0165-0327(02)00108-8.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×