A History of the Pharmacological Treatment of Bipolar Disorder
Abstract
:1. Introduction
2. The Therapeutic Precedents of the Psychopharmacological Era
3. Lithium as an Antimanic Agent
3.1. The Experiments of John Cade
- Lithium salts showed great efficacy in the treatment of manic disorder and they did so in a short period of time within several days.
- Lithium was also relatively effective in treating manic manifestations in early dementia. Three of the six most agitated schizophrenic patients became eased and calm and were docile and treatable for the first time in years. All of them returned to their original state when lithium was stopped.
- The effectiveness of lithium in chronic depression was not shown.
- The recommended dosage regimen was 900 mg/day, to be divided in 300 mg 3 times a day until clinical improvement was observed and 300 mg/day during the maintenance period.
- The discontinuation of lithium treatment led to the reappearance of manic symptoms.
- The adverse effects of lithium therapy have two—digestive system (nausea, vomiting, diarrhoea, abdominal pain, etc.) and nervous system (tremors, dizziness, asthenia, depression, etc.)—categories of side effects, which were disappeared quickly in 2 to 4 days) after lithium discontinuation. To resume treatment, the patient needs to start receiving from a lower dose, or carbonate was to substitute for citrate, since carbonate salt is more soluble and more easily absorbed.
3.2. From Discredit to Formal Recognition of the Antimanic Efficacy of Lithium
3.3. Lithium Salts in the Prevention of Manic Episodes’ Recurrence
3.4. Other Clinical Uses of Lithium in Psychiatric Therapeutics
3.5. Conclusions from the “Cinderella of Psychopharmacology”
4. Valproate as Mood Stabilizer
4.1. The Fortuitous Discovery of Valproate’s Anticonvulsant Activity
4.2. Clinical Drug Trials for Valproate’s Antiepileptic and Mood-Improving Properties
4.3. Controlled Clinical Trials Leading to Valproate’s FDA Approval for an Antimanic Indication
4.4. Increased Popularity of Prescribing Divalproex Sodium by American Psychiatrists in the 1990’s
5. The History of Carbamazepine as an Agent for Bipolar Disorders
5.1. Japanese Psychiatrists Discovered Carbamazepine’s Antimanic Properties
5.2. Information of Carbamazepine’s Research Results Spread to the West from Japan
5.3. Current Status of Carbamazepine for the Treatment of Bipolar Disorders in the USA
6. New Antiepileptics in Bipolar Disorders
- Many patients are resistant to conventional treatment.
- Good number of patients present themselves with tolerability problems, due to the frequent adverse effects of those drugs.
- The depressive phase still constitutes a serious problem, since lithium, carbamazepine and valproate are more effective in relieving symptoms in the manic than the depressive phase.
6.1. Lamotrigine in the Prevention of Depressive Episodes in Bipolar Disorder
6.2. Other Modern Antiepileptic Agents
7. Atypical Antipsychotic Agents in Bipolar Disorders
8. Conclusions
Historical Implications at the Socio-Sanitary Level of the Clinical Introduction of the First Mood Stabilizers
Author Contributions
Acknowledgments
Conflicts of Interest
Abbreviations
AAD | Atypical Antipsychotic Drug |
APA | American Psychiatric Association |
BOLDER | BipOLar DEpRession |
DSM | Diagnostic and Statistical Manual of Mental Disorders |
ECA | Epidemiological Catchment Area Study |
EMBOLDEN | Efficacy of Monotherapy Seroquel in BipOLAR DEpressioN |
FDA | Food and Drugs Administration |
FGA | First-Generation Antipsychotic Drug |
HDRS | Hamilton Depression Rating Scale |
MADRS | Montgomery-Asberg Depression Rating Scale |
NCS | National Comorbidity Survey |
POW | Prisoner of War |
PREVAIL | Program to Evaluate the Antidepressant Impact of Lurasidone |
SGA | Second-Generation Antipsychotic Drug |
SSRI | Selective Serotonin Reuptake Inhibitors |
UK | United Kingdom |
USA | United States of America |
WHO | World Health Organization |
WWII | World War II |
YMRS | Young Mania Rating Scale |
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Year | Important Events |
---|---|
1817 | Isolation of lithium (Arwedson and Berzelius) |
1832 | Synthesis of chloral hydrate (von Liebig) |
1857 | Introduction of bromides as hypnotic-sedatives (Locock) |
1863 | Synthesis of barbiturates (von Baeyer) |
1868 | Description of the sedative-hypnotic properties of Solanaceae alkaloids (Schroff) |
1869 | Use of chloral hydrate as a hypnotic (Liebreich) |
1870 | Use of chloral hydrate in manic patients (Elstun) |
1880 | Isolation of hyoscine or scopolamine (Ladenburg) |
1881 | Synthesis of valproic acid (Burton) |
1903 | Introduction of barbital in medicine (Fisher and von Mehring) |
1912 | Marketing of phenobarbital |
1915 | Introduction of barbiturate sleep cures (Epifanio) |
1920 | Application of morphine and scopolamine “sleep cures” (Klaesi) |
1943 | Introduction of promethazine in psychiatry, for the treatment of manic symptoms (Daumézon) |
1949 | Introduction of lithium in the management of manic and schizophrenic disorders (Cade) |
1954 | First controlled clinical trial with lithium in manic patients (Schou) |
1957 | II World Congress of Psychiatry (Zurich): first classification of psychotropic drugs (Delay) International Symposium on Psychotropic Drugs (Milan): first specific scientific meeting on psychotropic drugs |
1958 | Foundation of the Collegium Internationale Neuropsychopharmacologicum |
1960 | Confirmation of the prophylactic effect of lithium salts in manic episodes (Schou) |
1961 | Synthesis of carbamazepine (Schindler) Foundation of the American College of Neuropsychopharmacology |
1963 | Discovery of the anticonvulsant effect of valproic acid (Carraz) |
1966 | First data on the antimanic effect of valproic acid (Lambert) First systematic study on the effectiveness of lithium in the USA (Wharton and Fieve) |
1970 | Demonstration of the prophylactic properties of lithium in manic-depressive psychosis (Schou) Approval of the clinical use of lithium (USA FDA) |
1971 | Use of carbamazepine as mood regulator (Takezaki and Hanaoka) |
1973 | Approval of chlorpromazine in the treatment of manic episodes (USA FDA) Publication of the book Lithium: its role in psychiatric research and treatment (Gershon and Yuwiler) |
1978 | Approval of lithium salts for the prevention of manic/depressive episodes (USA FDA) First study about the antimanic effects of carbamazepine in the West (Ballenger and Post) |
1994 | First controlled trial with divalproex in mania (Bowden) First publication on the efficacy of lamotrigine in bipolar disorder (Weisler) |
1995 | Approval of valproic acid as an antimanic drug (USA FDA) |
1999 | First controlled trial with olanzapine in manic episodes (Tohen) |
2000 | Approval of olanzapine in bipolar disorder (USA FDA) |
2003 | Approval of risperidone in bipolar disorder (USA FDA) Approval of the combination olanzapine-fluoxetine in depressive episodes of bipolar disorder (USA FDA) First controlled trials of lamotrigine on relapse prophylaxis in bipolar disorder (Bowden and Calabrese) Approval of lamotrigine for the prevention of depressive episodes of bipolar disorder (USA FDA) |
2004 | Approval of quetiapine, zipresidone and aripiprazole in bipolar disorder (USA FDA) Approval of olanzapine for the prevention of new episodes of bipolar disorder (USA FDA) |
2005 | Approval of aripiprazole for the prevention of new episodes of bipolar disorder (USA FDA) |
2007 | Approval quetiapine for the prevention of new episodes of bipolar disorder (USA FDA) |
2008 | Approval of quetiapine in depressive episodes of bipolar disorder (USA FDA) |
2009 | Approval of asenapine in bipolar disorder (USA FDA) Approval of risperidone and ziprasidone for the prevention of new episodes of bipolar disorder (USA FDA) |
2013 | Approval of lurasidone in depressive episodes of bipolar disorder (USA FDA) |
2015 | Approval of cariprazine in bipolar disorder (USA FDA) |
Drug | Mania | Maintenance/Prevention | Bipolar Depression |
---|---|---|---|
Lithium | 1970 | 1978 | |
Valproate | 1995 | ||
Carbamazepine | 2004 a | ||
Lamotrigine | 2003 | ||
Chlorpromazine | 1973 | ||
Olanzapine | 2000, 2003 b | 2004 | 2003 c |
Risperidone | 2003, 2003 b | 2009 d,e | |
Quetiapine | 2003, 2004 a,b, 2008 f | 2007 g | 2008 f |
Ziprasidone | 2004, 2004 b | 2009 e,g | |
Aripiprazole | 2004 h, 2004 b | 2005 e, 2017 d | |
Asenapine | 2009 | ||
Cariprazine | 2015 | ||
Lurasidone | 2013, 2018 i |
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López-Muñoz, F.; Shen, W.W.; D’Ocon, P.; Romero, A.; Álamo, C. A History of the Pharmacological Treatment of Bipolar Disorder. Int. J. Mol. Sci. 2018, 19, 2143. https://doi.org/10.3390/ijms19072143
López-Muñoz F, Shen WW, D’Ocon P, Romero A, Álamo C. A History of the Pharmacological Treatment of Bipolar Disorder. International Journal of Molecular Sciences. 2018; 19(7):2143. https://doi.org/10.3390/ijms19072143
Chicago/Turabian StyleLópez-Muñoz, Francisco, Winston W. Shen, Pilar D’Ocon, Alejandro Romero, and Cecilio Álamo. 2018. "A History of the Pharmacological Treatment of Bipolar Disorder" International Journal of Molecular Sciences 19, no. 7: 2143. https://doi.org/10.3390/ijms19072143