Maintenance treatment in bipolar disorder: a focus on aripiprazole

Abstract

Bipolar disorders (BD) are chronic medical syndromes heterogeneous in phenomenology, pathophysiology and treatment. The longitudinal course of bipolar disorders is often characterized by nonrecovery, subsyndromal symptoms, enduring cognitive deficits and impairment in psychosocial function. The risk for premature mortality from unnatural (e.g., suicide) as well as natural causes (e.g., cardiovascular disease) is significantly higher than the general population. The therapeutic objectives of maintenance therapy are to prevent relapse/recurrence, reduce the risk for premature mortality, promote functional restoration and enhance quality of life. A chronic disease management model, which includes pharmacologic and manual-based psychosocial interventions as paradigmatic components, provides a framework for best practice and optimal patient outcome. This article provides a succinct review of treatments approved by the US FDA for maintenance in bipolar disorders, with a focus on the most recently approved atypical antipsychotic, aripiprazole.

Keywords::

• antipsychotic
• aripiprazole
• bipolar disorder
• maintenance
• pharmacology

Financial disclosure

Roger S McIntyre is a consultant and speaker for AstraZeneca, Eli Lilly, Janssen-Ortho, Organon, Wyeth, Lundbeck, GlaxoSmithKline, Oryx, Biovail, Pfizer, Prestwick, Bristol-Myers Squibb and Shire, and has received research funding from Wyeth, GlaxoSmithKline, Merck, Servier and AstraZeneca. Joanna Soczynska has received travel funds from Organon and Janssen. Jakub Konarski has served as a consultant for Wyeth and AstraZeneca, and has received a grant from Eli Lilly.