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Pharmacopsychiatry 2019; 52(02): 70-77
DOI: 10.1055/s-0044-100521
Original Paper
© Georg Thieme Verlag KG Stuttgart · New York

Response to Lithium in Patients with Bipolar Disorder: What are Psychiatrists’ Experiences and Practices Compared to Literature Review?

Claire Montlahuc
1   Service de Biostatistique et Information médicale, Hôpital Saint Louis, AP-HP, Paris, France
2   ECSTRA Team (Épidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
,
Emmanuel Curis
1   Service de Biostatistique et Information médicale, Hôpital Saint Louis, AP-HP, Paris, France
3   UMR-S 1144, INSERM, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, F-75013, France
4   Laboratoire de Biomathématiques, Plateau iB², Faculté de Pharmacie de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
,
Diane Grillault Laroche
3   UMR-S 1144, INSERM, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, F-75013, France
5   AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France
,
Gérald Bagoe
1   Service de Biostatistique et Information médicale, Hôpital Saint Louis, AP-HP, Paris, France
,
Bruno Etain
3   UMR-S 1144, INSERM, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, F-75013, France
5   AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France
6   Fondation FondaMental, CHU de Créteil, Créteil, France
,
Frank Bellivier
3   UMR-S 1144, INSERM, Université Paris Descartes, Université Paris Diderot, Sorbonne Paris Cité, Paris, F-75013, France
5   AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France
6   Fondation FondaMental, CHU de Créteil, Créteil, France
,
Sylvie Chevret
1   Service de Biostatistique et Information médicale, Hôpital Saint Louis, AP-HP, Paris, France
2   ECSTRA Team (Épidémiologie Clinique et Statistiques pour la Recherche en Santé), UMR 1153 INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
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Publikationsverlauf

received 04. November 2017
revised 28. Dezember 2017

accepted 04. Januar 2018

Publikationsdatum:
27. Februar 2018 (online)

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Abstract

Background This study aims at characterizing French psychiatrists’ opinions regarding definition criteria and factors associated with lithium prophylactic response in patients with bipolar disorders.

Methods After a literature review, an online survey targeted French psychiatrists in 2016.

Results Literature review showed inconsistencies in reported definition criteria and clinical predictors of lithium prophylactic response. A total of 104 psychiatrists, mostly working in hospitals, completed the survey. The inconsistencies regarding definition criteria and predictors of lithium response were confirmed. Five factors were commonly reported by psychiatrists as positively associated with successful response (family history of lithium response and of bipolar I disorder, and lithium efficacy in acute mood phases treatment) or with an unsuccessful response (rapid cycling and alcohol misuse).

Discussion The divergence in psychiatrists’ opinions surely plays a major role in the variability of lithium prescriptions among psychiatrists. Currently, the large variations in response definitions, and in study designs used to quantify each factor’s effect, preclude synthesizing the findings. A standardization of response measures is needed to explore factors that influence the prophylactic lithium efficacy.

Key words

bipolar disorder - lithium - prophylactic response - survey - opinion
 

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