Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-23T12:22:58.084Z Has data issue: false hasContentIssue false
  • English
  • Français

Characteristics of responders and non-responders to risperidone monotherapy or placebo in co-occurring bipolar disorder and anxiety disorder

Published online by Cambridge University Press:  29 November 2011

J.S. Seo ,
K. Jamieson ,
V. Cosgrove ,
I.S. Gwizdowski ,
H. Yang ,
D.V. Sheehan ,
S.L. McElroy  and
T. Suppes
J.S. Seo
Affiliation:
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA94304, USA Department of Psychiatry, College of Medicine, Konkuk University Chung-Ju Hospital, 620-5, Kyohyun 2 dong, Chungju-city, Chungbuk-Do, South Korea
K. Jamieson
Affiliation:
33, Mills Canyon Ct, Burlingame, CA94010, USA
V. Cosgrove
Affiliation:
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA94304, USA
I.S. Gwizdowski
Affiliation:
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA94304, USA
H. Yang
Affiliation:
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA94304, USA
D.V. Sheehan
Affiliation:
University of South Florida, USF Institute for Research in Psychiatry, 3515, East Fletcher Avenue, Tampa, FL33613, USA
S.L. McElroy
Affiliation:
Research Institute, Lindner Center of HOPE, University of Cincinnati Medical Center, 4075, Old Western Row Road, Mason, OH45040, USA Department of Psychiatry, University of Cincinnati, College of Medicine, Cincinnati, Ohio, USA
T. Suppes*
Affiliation:
Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, VA Palo Alto Health Care System, 3801, Miranda Avenue (151T), Palo Alto, CA94304, USA
*
⁎Corresponding author. Tel.: +650 493 5000x62567; fax: +650 849 1913. E-mail address:tsuppes@stanford.edu (T. Suppes).
Get access

Abstract

Clinical characteristics predicting response and remission to psychopharmacological treatment of bipolar disorder (BD) and co-occurring anxiety disorders have been understudied. We hypothesized that non-response to risperidone or placebo in individuals with co-occurring BD and anxiety symptoms would be associated with a more severe clinical course of BD, and certain demographic variables. This study was a secondary analysis of a randomized, double-blind, parallel, 8-week study comparing risperidone monotherapy and placebo in individuals with BD plus current panic disorder, current generalized anxiety disorder (GAD), or lifetime panic disorder (n = 111) [31]. We compared clinical characteristics of responders (50% improvement on the Hamilton Anxiety Scale [HAM-A]) and non-responders as well as remitters (HAM-A < 7) and non-remitters in risperidone treatment (n = 54) and placebo (n = 57) groups. For non-responders in the risperidone group, co-occurring lifetime panic disorder was significantly more common than for non-responders in the placebo group. Apart from this, no significant differences in course of illness or demographics were found either between or across groups for patients with BD and co-occurring anxiety symptoms receiving risperidone or placebo in this acute phase study.

Keywords

Anxiety disorderBipolar disorderCo-occurringRisperidoneTreatment response
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 3 , March 2013 , pp. 190 - 196
Copyright
Copyright © European Psychiatric Association 2011

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

Ballenger, J.C.Clinical guidelines for establishing remission in patients with depression and anxiety. J Clin Psychiatry 1999;60(Suppl. 22):29–34.Google ScholarPubMed
Chen, Y.W.Dilsaver, S.C.Comorbidity of panic disorder in bipolar illness: evidence from the Epidemiologic Catchment Area Survey. Am J Psychiatry 1995;152(2):180–182.Google ScholarPubMed
Coryell, W.Solomon, D.A.Fiedorowicz, J.G.Endicott, J.Schettler, P.J.Judd, L.L.Anxiety and outcome in bipolar disorder. Am J Psychiatry 2009;166:1238–1243.CrossRefGoogle ScholarPubMed
Enck, P.Klosterhalfen, S.Zipfel, S.Novel study designs to investigate the placebo response. BMC Med Res Methodol 2011;11:90.CrossRefGoogle ScholarPubMed
Frank, E.Cyranowski, J.M.Rucci, P.Shear, M.K.Fagiolini, A.Thase, M.E., et al.Clinical significance of lifetime panic spectrum symptoms in the treatment of patients with bipolar I disorder. Arch Gen Psychiatry 2002;59:905–911.CrossRefGoogle ScholarPubMed
Freeman, M.P.Freeman, S.A.McElroy, S.L.The comorbidity of bipolar and anxiety disorders: prevalence, psychobiology, and treatment issues. J Affect Disord 2002;68:1–23.CrossRefGoogle ScholarPubMed
Goldstein, B.I.Levitt, A.J.Prevalence and correlates of bipolar I disorder among adults with primary youth-onset anxiety disorders. J Affect Disord 2007;103:187–195.CrossRefGoogle ScholarPubMed
Grant, B.F.Stinson, F.S.Hasin, D.S.Dawson, D.A.Chou, S.P.Ruan, W.J., et al.Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on alcohol and related conditions. J Clin Psychiatry 2005;66:1205–1215.CrossRefGoogle ScholarPubMed
Hamilton, M.The assessment of anxiety states by rating. Br J Med Psychol 1959;32:505.CrossRefGoogle ScholarPubMed
Henry, C.Van den Bulke, D.Bellivier, F.Etain, B.Rouillon, F.Leboyer, M.Anxiety disorders in 318 bipolar patients: prevalence and impact on illness severity and response to mood stabilizer. J Clin Psychiatry 2003;64:331–335.CrossRefGoogle ScholarPubMed
Hirschfeld, R.M.Weisler, R.H.Raines, S.R.Macfadden, W.Quetiapine in the treatment of anxiety in patients with bipolar I or II depression: a secondary analysis from a randomized, double-blind, placebo-controlled study. J Clin Psychiatry 2006;67:355–362.CrossRefGoogle ScholarPubMed
Kauer-Sant’Anna, M.Kapczinski, F.Vieta, E.Epidemiology and management of anxiety in patients with bipolar disorder. CNS Drugs 2009;23(11):953–964.CrossRefGoogle ScholarPubMed
Keck, P.E. Jr.Wilson, D.R.Strakowski, S.M.McElroy, S.L.Kizer, D.L.Balistreri, T.M., et al.Clinical predictors of acute risperidone response in schizophrenia, schizoaffective disorder, and psychotic mood disorders. J Clin Psychiatry 1995;56:466–470.Google ScholarPubMed
Kemp, D.E.Ganocy, S.J.Brecher, M.Carlson, B.X.Edwards, S.Eudicone, J.M., et al.Clinical value of early partical symptomatic improvement in the prediction of response and remission during short-term treatment trials in 3369 subjects with bipolar I or II depression. J Affect Disord 2011;130:171–179.CrossRefGoogle ScholarPubMed
Kleindienst, N.Engel, R.R.Greil, W.Which clinical factors predict response to prophylactic lithium? A systematic review for bipolar disorders. Bipolar Disord 2005;7:404–417.CrossRefGoogle ScholarPubMed
Krishnan, K.R.Psychiatric and medical comorbidities of bipolar disorder. Psychosom Med 2005;67:1–8.CrossRefGoogle ScholarPubMed
Lipkovich, I.A.Houston, J.P.Ahl, J.Identifying patterns in treatment response profiles in acute bipolar mania: a cluster analysis approach. BMC Psychiatry 2008;8:65.CrossRefGoogle ScholarPubMed
MacKinnon, D.F.Zandi, P.P.Cooper, J.Potash, J.B.Simpson, S.G.Gershon, E., et al.Comorbid bipolar disorder and in families with a high prevalence of bipolar disorder. Am J Psychiatry 2002;159:30–35.CrossRefGoogle ScholarPubMed
MacKinnon, D.F.Zandi, P.P.Gershon, E.Nurnberger, J.I.DePaulo, J.R. Jr.Association of rapid mood switching with panic disorder and familial panic risk in familial bipolar disorder. Am J Psychiatry 2003;160:1696–1698.CrossRefGoogle ScholarPubMed
Maina, G.Albert, U.Rosso, G.Bogetto, F.Olanzapine or lamotrigine addition to lithium in remitted bipolar disorder patients with anxiety disorder comorbidity: a randomized, single-blind pilot study. J Clin Psychiatry 2008;69(4):609–616.CrossRefGoogle ScholarPubMed
Masi, G.Perugi, G.Toni, C.Millepiedi, S.Mucci, M.Bertini, N., et al.Predictors of treatment nonresponse in bipolar children and adolescents with manic or mixed episodes. J Child Adolesc Psychopharmacol 2004;14(3):395–404.CrossRefGoogle ScholarPubMed
McElroy, S.L.Altshuler, L.L.Suppes, T.Keck, P.E. Jr.Frye, M.A.Denicoff, K.D., et al.Axis I psychiatric comorbidity and its relationship to historical illness variables in 288 patients with bipolar disorder. Am J Psychiatry 2001;158:420–426.CrossRefGoogle ScholarPubMed
McGlashan, T.H.Adolescent versus adult onset of mania. Am J Psychiatry 1988;145:221–223.Google ScholarPubMed
Merikangas, K.R.Akiskal, H.S.Angst, J.Greenberg, P.E.Hirschfeld, R.M.Petukhova, M., et al.Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 2007;64:543–552.CrossRefGoogle ScholarPubMed
Perlis, R.H.Dennehy, E.B.Miklowitz, D.J.Delbello, M.P.Ostacher, M.Calabrese, J.R., et al.Retrospective age at onset of bipolar disorder and outcome during two-year follow-up: results from the STEP-BD study. Bipolar Disord 2009;11:391–400.CrossRefGoogle ScholarPubMed
Rane, L.J.Fekadu, A.Wooderson, S.Poon, L.Markopoulou, K.Cleare, A.J.Discrepancy between subjective and objective severity in treatment-resistant depression: Prediction of treatment outcome. J Psychiatr Res 2010;44:1082–1087.CrossRefGoogle ScholarPubMed
Rotondo, A.Mazzanti, C.Dell’Osso, L.Rucci, P.Sullivan, P.Bouanani, S., et al.Catechol O-Methyltransferase, serotonin transporter, and tryptophan hydroxylase gener polymorphisms in bipolar disorder patients with and without comorbid panic disorder. Am J Psychiatry 2002;159:23–29.CrossRefGoogle Scholar
Rush, A.J.Gullion, B.M.Basco, M.R.Jarrett, R.B.Trivedi, M.H.Inventory of Depressive Symptoms (IDS): psychometric properties. Psychol Med 1996;26:477–486.CrossRefGoogle ScholarPubMed
Schaffer, A.Cairney, J.Veldhuizen, S.Cheung, A.Levitt, A.Comparison of antidepressant use between subjects with bipolar disorder and major depressive disorder with or without comorbid anxiety. J Clin Psychiatry 2007;68:1785–1792.CrossRefGoogle ScholarPubMed
Sheehan, D.V.Lecrubier, Y.Sheehan, K.H.Amorim, P.Janavs, J.Weiller, E., et al.Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59(Suppl. 20):22–33.Google ScholarPubMed
Sheehan, D.V.McElroy, S.L.Harnett-Sheehan, K.Keck, P.E. Jr.Janavs, J.Rogers, J., et al.Randomized, placebo-controlled trial of risperidone for acute treatment of bipolar anxiety. J Affect Disord 2009;115:376–385.CrossRefGoogle ScholarPubMed
Sheehan, D.V.The anxiety disease. New York, NY: Bantam Books; 1986. p. 130–131.Google Scholar
Sheehan, D.V.The anxiety disease. New York, NY: Charles Scribner and Sons; 1983.Google Scholar
Simon, N.M.Otto, M.W.Wisniewski, S.R.Fossey, M.Sagduyu, K.Frank, E., et al.Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry 2004;161:2222–2229.CrossRefGoogle Scholar
Simon, N.M.Pollack, M.H.Ostacher, M.J.Zalta, A.K.Chow, C.W.Fischmann, D., et al.Understanding the link between anxiety symptoms and suicidal ideation and behaviors in outpatients with bipolar disorder. J Affect Disord 2007;97:91–99.CrossRefGoogle ScholarPubMed
Simon, N.M.Zalta, A.K.Otto, M.W.Ostacher, M.J.Fischmann, D.Chow, C.W., et al.The association of comorbid anxiety disorders with suicide attempts and suicidal ideation in outpatients with bipolar disorder. J Psychiatr Res 2007;41:255–264.CrossRefGoogle ScholarPubMed
Spearing, M.K.Post, R.M.Leverich, G.S.Brandt, D.Nolen, W.Modification of the Clinical Global Impressions Scale for use in bipolar illness (BP): the CGI-BP. Psychiatry Res 1997;73:159–171.CrossRefGoogle ScholarPubMed
Strober, M.Schmidt-Lackner, S.Freeman, R.Bower, S.Lampert, C.DeAntonio, M.Recovery and relapse in adolescents with bipolar affective illness: a five-year naturalistic, prospective follow-up. J Am Acad Child Adolesc Psychiatry 1995;34:724–731.CrossRefGoogle ScholarPubMed
Suppes, T.Eudicone, J.McQuade, R.Pikalov, A. IIICarlson, B.Efficacy and safety of aripiprazole in subpopulations with acute manic or mixed episodes of bipolar I disorder. J Affect Disord 2008;107:145–154.CrossRefGoogle ScholarPubMed
Swann, A.C.Bowden, C.L.Calabrese, J.R.Dilsaver, S.C.Morris, D.D.Differential effect of number of previous episodes of affective disorder on response to lithium or divalproex in acute mania. Am J Psychiatry 1999;156:1264–1266.Google ScholarPubMed
Swann, A.C.Bowden, C.L.Morris, D.Calabrese, J.R.Petty, F.P.Small, J., et al.Depression during mania. Treatment response to lithium or divalproex. Arch Gen Psychiatry 1997;54:37–42.CrossRefGoogle ScholarPubMed
Tohen, M.Calabrese, J.Vieta, E.Bowden, C.Gonzalez-Pinto, A.Lin, D., et al.Effect of comorbid anxiety on treatment response in bipolar depression. J Affect Disord 2007;104:137–146.CrossRefGoogle ScholarPubMed
Young, R.Biggs, J.Ziegler, V.A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry 1978;133:429–435.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.