Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder
Research has generated good quality evidence about the treatment and management of bipolar disorder in acute and, to some degree, sub-acute/continuation phases. This has informed various guidelines about the treatment and management of bipolar disorder (BD). However, for the long-term or maintenance...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-03-01
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| Series: | Therapeutic Advances in Psychopharmacology |
| Online Access: | https://doi.org/10.1177/20451253211000612 |
| _version_ | 1818959459974643712 |
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| author | Mutahira M. Qureshi Allan H. Young |
| author_facet | Mutahira M. Qureshi Allan H. Young |
| author_sort | Mutahira M. Qureshi |
| collection | DOAJ |
| description | Research has generated good quality evidence about the treatment and management of bipolar disorder in acute and, to some degree, sub-acute/continuation phases. This has informed various guidelines about the treatment and management of bipolar disorder (BD). However, for the long-term or maintenance phase of illness, most guidelines peter out and, in the absence of sufficiently high-quality research evidence, remain vague. This is particularly evident for the important clinical question of discontinuing mood stabilizing pharmacological agents after a period of remission has been achieved. The aim of this review is to put together current existing evidence about discontinuing mood stabilizers after a period of remission in order to come up with a structured and coherent strategy for managing such discontinuation and to make recommendations for future research. To this end, we reviewed the main relevant treatment guidelines and subsequent evidence following the publication of these guidelines. The current recommended long-term treatment of BD is usually considered within the same principles applicable to any chronic health condition (e.g. hypertension or diabetes) where the focus is on continuing treatment at minimum effective medication dose often life-long, switching to alternative choice of medication due to side-effects and very few, if any, indications for complete cessation. However, in the absence of strong evidence on long-term treatment and the high rate of non-concordance in BD, medication discontinuation is a very important aspect of the treatment that should be given due consideration at every aspect of the treatment. |
| first_indexed | 2024-12-20T11:41:59Z |
| format | Article |
| id | doaj.art-bf66069085ea4b2e8993195ab2ea2cbe |
| institution | Directory Open Access Journal |
| issn | 2045-1261 |
| language | English |
| last_indexed | 2024-12-20T11:41:59Z |
| publishDate | 2021-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Psychopharmacology |
| spelling | doaj.art-bf66069085ea4b2e8993195ab2ea2cbe2022-12-21T19:41:58ZengSAGE PublishingTherapeutic Advances in Psychopharmacology2045-12612021-03-011110.1177/20451253211000612Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorderMutahira M. QureshiAllan H. YoungResearch has generated good quality evidence about the treatment and management of bipolar disorder in acute and, to some degree, sub-acute/continuation phases. This has informed various guidelines about the treatment and management of bipolar disorder (BD). However, for the long-term or maintenance phase of illness, most guidelines peter out and, in the absence of sufficiently high-quality research evidence, remain vague. This is particularly evident for the important clinical question of discontinuing mood stabilizing pharmacological agents after a period of remission has been achieved. The aim of this review is to put together current existing evidence about discontinuing mood stabilizers after a period of remission in order to come up with a structured and coherent strategy for managing such discontinuation and to make recommendations for future research. To this end, we reviewed the main relevant treatment guidelines and subsequent evidence following the publication of these guidelines. The current recommended long-term treatment of BD is usually considered within the same principles applicable to any chronic health condition (e.g. hypertension or diabetes) where the focus is on continuing treatment at minimum effective medication dose often life-long, switching to alternative choice of medication due to side-effects and very few, if any, indications for complete cessation. However, in the absence of strong evidence on long-term treatment and the high rate of non-concordance in BD, medication discontinuation is a very important aspect of the treatment that should be given due consideration at every aspect of the treatment.https://doi.org/10.1177/20451253211000612 |
| spellingShingle | Mutahira M. Qureshi Allan H. Young Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder Therapeutic Advances in Psychopharmacology |
| title | Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder |
| title_full | Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder |
| title_fullStr | Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder |
| title_full_unstemmed | Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder |
| title_short | Hamlet’s augury: how to manage discontinuation of mood stabilizers in bipolar disorder |
| title_sort | hamlet s augury how to manage discontinuation of mood stabilizers in bipolar disorder |
| url | https://doi.org/10.1177/20451253211000612 |
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