Although lithium remains the preferred treatment of bipolar disorder, only 60 to 80% of patients with the classic presentation have an adequate response to this drug. When the response rate to lithium is considered across the entire spectrum of bipolar disorders, this rate probably decreases to 50%. Natural history, illness subtype, and comorbidity are all important general predictors of response to treatment. At present, the only predictors that seem to differentially favor divalproex, and possible, carbamazepine over lithium are mixed states and rapid cycling. An overview of clinical presentations that predict general and differential response to mood stabilizers is provided.
The authors and I are pleased to be able to present this collection of articles on key issues in the diagnosis and treatment of bipolar disorder. The authors and I gathered in Chicago for a 2-day meeting in July 1995 during which we discussed and debated the topics covered in this supplement. These articles, based on those discussions, have undergone extensive review and revision so that the most informative and current material as possible could be provided.
We would like to thank Abbott Laboratories for their generous support of this supplement.
The opinions expressed herein are those of the authors and do not necessarily reflect the views of the publisher, the editors, or the sponsor.
Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, Cleveland, Ohio