Fortschr Neurol Psychiatr 2013; 81(S 01): S3-S8
DOI: 10.1055/s-0033-1335240
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Differenzialdiagnostik und Psychopharmakotherapie bipolarer Störungen

Differential Diagnosis of and Pharmacotherapy for Bipolar Disorder
H. Grunze
1   Academic Psychiatry, Institute of Neuroscience, Newcastle upon Tyne, UK
,
A. Grunze
2   Northeast CMHT, NTW NHS Foundation Trust, Newcastle upon Tyne, UK
,
B. L. Amann
3   Research Unit, FIDMAG, Sant Boi de Llobregat, Spanien
› Author Affiliations
Further Information

Publication History

Publication Date:
16 May 2013 (online)

Zusammenfassung

Bipolare Störungen sind eine häufige, chronische und das Leben des Patienten auf das Schwerste beeinträchtigende psychiatrische Erkrankung. Ihre Verläufe können dabei sehr individuell und heterogen sein, die bekanntesten und häufigsten sind dabei die klassische Bipolar-I-Störung sowie die Bipolar-II-Störung. Jedoch selbst typische Bipolar-I-Störungen sind in Deutschland noch deutlich unterdiagnostiziert und entsprechend unterbehandelt. Dabei steht in den letzten Jahren eine Vielzahl neuer pharmakologischer Therapieoptionen zur Verfügung, sowohl im Bereich der Antiepileptika als auch der atypischen Antipsychotika. Daraus ergeben sich schon jetzt neue Therapieansätze, nicht nur in der akuten Behandlung der Manie, sondern auch in der Behandlung bipolarer Depression sowie der Phasenprophylaxe, die gewiss in den nächsten Jahren auch noch weiter zunehmen werden.

Abstract

Bipolar disorders constitute a group of frequent, chronic psychiatric illnesses with a most severe impact on the patient’s life. The course can be very individual and heterogeneous, the best known and most frequent manifestations include the classical bipolar I and bipolar II disorders. However, in Germany even typical bipolar I disorders are underdiagnosed and, consequently, undertreated. This is true despite the fact that the number of pharmacological treatment options has rapidly increased during recent years, both in the field of anticonvulsants and atypical antipsychotics. This supplies us today with new therapeutic strategies, not only for acute mania, but also for bipolar depression and maintenance treatment, and it is feasible to assume that there will be more options available within the next few years.

 
  • Literatur

  • 1 Weissman MM, Bland RC, Canino GJ et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996; 276: 293-299
  • 2 Deutsche Gesellschaft für Bipolare Störungen e.V. Weißbuch bipolare Störungen in Deutschland. Norderstedt: Books on Demand GmbH; 2003
  • 3 Angst F, Stassen HH, Clayton PJ et al. Mortality of patients with mood disorders: follow-up over 34-38 years. J Affect Disord 2002; 68: 167-181
  • 4 Kraepelin E. Das manisch-depressive Irresein. 8 ed. Leipzig: Johann Ambrosius Verlag; 1913
  • 5 Kupfer DJ, Frank E, Grochocinski VJ et al. Stabilization in the treatment of mania, depression and mixed states. Acta Neuropsychiatrica 2000; 12: 3-114
  • 6 Tohen M, Zarate CA, Hennen J et al. The McLean-Harvard First-Episode Mania Study: prediction of recovery and first recurrence. Am J Psychiatry 2003; 160: 2099-2107
  • 7 Severus E, Grunze H. Bipolare Mischzustände – diagnostische und therapeutische Herausforderung. PPT 2003; 10: 87-93
  • 8 Swann AC, Bowden CL, Morris D et al. Depression during mania. Treatment response to lithium or divalproex. Arch Gen Psychiatry 1997; 54: 37-42
  • 9 Weygandt W. Über die Mischzustände des manisch-depressiven Irreseins. Habilitationsschrift. München: JF Lehmann; 1899
  • 10 Koukopoulos A, Girardi P, Proietti R et al. Diagnostic and therapeutic considerations on agitated depression understood as a mixed affective state. Minerva Psichiatr 1989; 30: 283-286
  • 11 Angst J, Felder W, Frey R et al. The course of affective disorders. I. Change of diagnosis of monopolar, unipolar, and bipolar illness. Arch Psychiatr Nervenkr 1978; 226: 57-64
  • 12 Akiskal HS, Cassano GB, Musetti L et al. Psychopathology, temperament, and past course in primary major depressions. 1. Review of evidence for a bipolar spectrum. Psychopathology 1989; 22: 268-277
  • 13 Judd LL, Akiskal HS, Schettler PJ et al. The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002; 59: 530-537
  • 14 Kupka R, Leverich G, Nolen W et al. Similar Depression-to-Mania Ratios in Bipolar I and Bipolar II Disorder. Arch Gen Psychiatry In press.
  • 15 Calabrese JR, Hirschfeld RM, Frye MA et al. Impact of depressive symptoms compared with manic symptoms in bipolar disorder: results of a U. S. community-based sample. J Clin Psychiatry 2004; 65: 1499-1504
  • 16 Bowden CL, Brugger AM, Swann AC et al. Efficacy of divalproex vs lithium and placebo in the treatment of mania. The Depakote Mania Study Group. JAMA 1994; 271: 918-924
  • 17 Bowden CL, Grunze H, Mullen J et al. A Randomized, Double-Blind, Placebo-Controlled Efficacy and Safety Study of Quetiapine or Lithium as Monotherapy for Mania in Bipolar Disorder. J Clin Psychiatry 2005; 66: 111-121
  • 18 Kushner SF, Khan A, Lane R et al. Topiramate monotherapy in the management of acute mania: results of four double-blind placebo-controlled trials. Bipolar Disord 2006; 8: 15-27
  • 19 Vieta E, Gunther O, Locklear J et al. Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder: a meta-analysis of randomized controlled trials. Int J Neuropsychopharmacol 2011; 14: 1029-1049
  • 20 Kleindienst N, Greil W. Lithium in the long-term treatment of bipolar disorders. Eur Arch Psychiatry Clin Neurosci 2003; 253: 120-125
  • 21 Gitlin MJ, Swendsen J, Heller TL et al. Relapse and impairment in bipolar disorder. Am J Psychiatry 1995; 152: 1635-1640
  • 22 Tondo L, Baldessarini RJ, Hennen J et al. Lithium maintenance treatment of depression and mania in bipolar I and bipolar II disorders. Am J Psychiatry 1998; 155: 638-645
  • 23 Müller-Oerlinghausen B. Arguments for the specificity of the antisuicidal effect of lithium. Eur Arch Psychiatry Clin Neurosci 2001; 251 (Suppl. 02) II72-II75
  • 24 Weisler RH, Kalali AH, Ketter TA. 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 Weisler RH, Keck PE Jr, Swann AC et al. Extended-release carbamazepine capsules as monotherapy for acute mania in bipolar disorder: a multicenter, randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 2005; 66: 323-330
  • 26 Grunze H. Carbamazepine, other anticonvulsants, antidepressants and augmenting agents. In: Akiskal H, Tohen M, (Hrsg) Bipolar Psychopharmacotherapy. Chichester: John Wiley; 2005: 63-82
  • 27 Vasudev K, Goswami U, Kohli K. Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in manic disorder. Psychopharmacology Berl 2000; 150: 15-23
  • 28 Greil W, Ludwig-Mayerhofer W, Erazo N et al. Lithium versus carbamazepine in the maintenance treatment of bipolar disorders – a randomised study. J Affect Disord 1997; 43: 151-161
  • 29 Hartong EG, Moleman P, Hoogduin CA et al. Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients. J Clin Psychiatry 2003; 64: 144-151
  • 30 Greil W, Kleindienst N, Erazo N et al. Differential response to lithium and carbamazepine in the prophylaxis of bipolar disorder. J Clin Psychopharmacol 1998; 18: 455-460
  • 31 Spina E, Pisani F, Perucca E. Clinically significant pharmacokinetic drug interactions with carbamazepine. An update. Clin Pharmacokinet 1996; 31: 198-214
  • 32 Dietrich DE, Kropp S, Emrich HM. Oxcarbazepine in affective and schizoaffective disorders. Pharmacopsychiatry 2001; 34: 242-250
  • 33 Pope HG, McElroy SL, Keck PE et al. Valproate in the treatment of acute mania. A placebo-controlled study. Arch Gen Psychiatry 1991; 48: 62-68
  • 34 Freeman TW, Clothier JL, Pazzaglia P et al. A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992; 149: 108-111
  • 35 McElroy SL, Keck PE, Stanton SP et al. A randomized comparison of divalproex oral loading versus haloperidol in the initial treatment of acute psychotic mania. J Clin Psychiatry 1996; 57: 142-146
  • 36 Zajecka JM, Weisler R, Sachs G et al. A comparison of the efficacy, safety, and tolerability of divalproex sodium and olanzapine in the treatment of bipolar disorder. J Clin Psychiatry 2002; 63: 1148-1155
  • 37 Hirschfeld RM, Baker JD, Wozniak P et al. The safety and early efficacy of oral-loaded divalproex versus standard-titration divalproex, lithium, olanzapine, and placebo in the treatment of acute mania associated with bipolar disorder. J Clin Psychiatry 2003; 64: 841-846
  • 38 Bowden CL, Calabrese JR, McElroy SL et al. A randomized, placebo-controlled 12-month trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry 2000; 57: 481-489
  • 39 Lambert PA. Acute and prophylactic therapies of patients with affective disorders using valpromide (dipropylacetamide). In: Emrich HM, Okuma T, Müller AA, (Hrsg) Anticonvulsants in affective disorders. Amsterdam, Oxford, Princeton: Elsevier Science Publishers; 1984: 33-44
  • 40 Geddes JR, Goodwin GM, Rendell J et al. Lithium plus valproate combination therapy versus monotherapy for relapse prevention in bipolar I disorder (BALANCE): a randomised open-label trial. Lancet 2010; 375: 385-395
  • 41 Calabrese JR, Bowden CL, Sachs GS et al. A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. J Clin Psychiatry 1999; 60: 79-88
  • 42 Bowden CL, Calabrese JR, Sachs G et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently manic or hypomanic patients with bipolar I disorder. Arch Gen Psychiatry 2003; 60: 392-400
  • 43 Calabrese J, Bowden CL, Sachs G et al. A Placebo-Controlled 18-Month Trial of Lamotrigine and Lithium Maintenance Treatment in Recently Depressed Patients with Bipolar I Disorder. J Clin Psychiatry 2003; 64: 1024
  • 44 Goodwin GM, Bowden CL, Calabrese JR et al. A pooled analysis of 2 placebo-controlled 18-month trials of lamotrigine and lithium maintenance in bipolar I disorder. J Clin Psychiatry 2004; 65: 432-441
  • 45 Calabrese JR, Suppes T, Bowden CL et al. A double-blind, placebo-controlled, prophylaxis study of lamotrigine in rapid-cycling bipolar disorder. Lamictal 614 Study Group. J Clin Psychiatry 2000; 61: 841-850
  • 46 Müller P, Heipertz R. Zur Behandlung manischer Psychosen mit Clozapin. Fortschr Neurol Psychiatr Grenzgeb 1977; 45: 420-424
  • 47 Harada T, Otsuki S. Antimanic effect of zotepine. Clin Ther 1986; 8: 406-414
  • 48 Amann B, Sterr A, Mergl R et al. Zotepine loading in acute and severely manic patients: a pilot study. Bipolar Disord 2005; 7: 471-476
  • 49 Vieta E, Ros S, Goikolea JM et al. An open-label study of amisulpride in the treatment of mania. J Clin Psychiatry 2005; 66: 575-578
  • 50 Tohen M, Vieta E, Calabrese J et al. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry 2003; 60: 1079-1088
  • 51 Bogart GT, Chavez B. Safety and efficacy of quetiapine in bipolar depression. Ann Pharmacother 2009; 43: 1848-1856
  • 52 Tohen M, Chengappa KN, Suppes T et al. Relapse prevention in bipolar I disorder: 18-month comparison of olanzapine plus mood stabiliser vs. mood stabiliser alone. Br J Psychiatry 2004; 184: 337-345
  • 53 Nguyen HT, Sharma V, McIntyre RS. Teratogenesis associated with antibipolar agents. Adv Ther 2009; 26: 281-294
  • 54 Remington G. Tardive dyskinesia: eliminated, forgotten, or overshadowed?. Curr Opin Psychiatry 2007; 20: 131-137
  • 55 Seemuller F, Forsthoff A, Dittmann S et al. The safety and tolerability of atypical antipsychotics in bipolar disorder. Expert Opin Drug Saf 2005; 4: 849-868
  • 56 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. Heidelberg: Springer; 2003
  • 57 Post RM, Denicoff KD, Leverich GS et al. Morbidity in 258 bipolar outpatients followed for 1 year with daily prospective ratings on the NIMH life chart method. J Clin Psychiatry 2003; 64: 680-690
  • 58 Grunze H, Vieta E, Goodwin GM et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 2009 on the Treatment of Acute Mania. World J Biol Psychiatry 2009; 10: 85-116
  • 59 DGBS e. V. und DGPPN e.V. S3-Leitlinie zur Diagnostik und Therapie Bipolarer Störungen. Langversion 1.0, Mai 2012. Abrufbar unter http://www.leitlinie-bipolar.de/wp-content/uploads/2012/05/S3_Leitlinie-Bipolar_11052012_.pdf