An update on adjunctive treatment options for bipolar disorder

Olivia M Dean; Emma Gliddon; Tamsyn E Van Rheenen; Francesco Giorlando; Sandra K Davidson; Manreena Kaur; Trung T Ngo; Lana J Williams

doi:10.1111/bdi.12601

An update on adjunctive treatment options for bipolar disorder

Bipolar Disord. 2018 Mar;20(2):87-96. doi: 10.1111/bdi.12601. Epub 2018 Jan 25.

Authors

Olivia M Dean^{1

2

3}, Emma Gliddon^{1

3}, Tamsyn E Van Rheenen^{4

5

6}, Francesco Giorlando³, Sandra K Davidson⁷, Manreena Kaur⁶, Trung T Ngo^{8

9}, Lana J Williams¹

Affiliations

¹ IMPACT Strategic Research Centre, Deakin University, Geelong, Vic., Australia.
² Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia.
³ Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.
⁴ Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Melbourne, Vic., Australia.
⁵ Centre for Mental Health, Swinburne University, Melbourne, Vic., Australia.
⁶ Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred Hospital, Melbourne, Vic., Australia.
⁷ Department of General Practice, Melbourne Medical School, University of Melbourne, Carlton, Vic., Australia.
⁸ Mater Research Institute-UQ, Faculty of Medicine, The University of Queensland and Translational Research Institute, Brisbane, Qld, Australia.
⁹ Genetic Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Qld, Australia.

PMID: 29369487
DOI: 10.1111/bdi.12601

Abstract

Objectives: Bipolar disorder is a complex illness often requiring combinations of therapies to successfully treat symptoms. In recent years, there have been significant advancements in a number of therapies for bipolar disorder. It is therefore timely to provide an overview of current adjunctive therapeutic options to help treating clinicians to inform their patients and work towards optimal outcomes.

Methods: Publications were identified from PubMed searches on bipolar disorder and pharmacotherapy, nutraceuticals, hormone therapy, psychoeducation, interpersonal and social rhythm therapy, cognitive remediation, mindfulness, e-Health and brain stimulation techniques. Relevant articles in these areas were selected for further review. This paper provides a narrative review of adjunctive treatment options and is not a systematic review of the literature.

Results: A number of pharmacotherapeutic, psychological and neuromodulation treatment options are available. These have varying efficacy but all have shown benefit to people with bipolar disorder. Due to the complex nature of treating the disorder, combination treatments are often required. Adjunctive treatments to traditional pharmacological and psychological therapies are proving useful in closing the gap between initial symptom remission and full functional recovery.

Conclusions: Given that response to monotherapy is often inadequate, combination regimens for bipolar disorder are typical. Correspondingly, psychiatric research is working towards a better understanding of the disorder's underlying biology. Therefore, treatment options are changing and adjunctive therapies are being increasingly recognized as providing significant tools to improve patient outcomes. Towards this end, this paper provides an overview of novel treatments that may improve clinical outcomes for people with bipolar disorder.

Keywords: bipolar disorder; cognition; e-health; hormones; neuromodulation techniques; nutraceuticals; psychological therapies; transcranial magnetic stimulation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adult
Bipolar Disorder / diagnosis
Bipolar Disorder / psychology
Bipolar Disorder / therapy*
Cognition Disorders / diagnosis
Cognition Disorders / psychology
Cognition Disorders / therapy
Cognitive Remediation / methods
Combined Modality Therapy / methods*
Humans
Male
Psychotherapy / methods
Psychotropic Drugs / therapeutic use
Therapy, Computer-Assisted
Transcranial Magnetic Stimulation
Treatment Outcome

Substances

Psychotropic Drugs