OBJECTIVE: To compare responses to long-term treatment of @entity1170 ( @entity1170 ) vs. non- @entity1170 @entity162 @entity1 and assess relative effectiveness of specific agents in @entity1170 @entity1 . METHOD: Studies identified by literature searching were analyzed for effects of @entity1170 status and treatment-type on clinical outcome (recurrence or non-improvement per exposure-time), using random-effects methods to estimate pooled rates and their 95% CI for quantitative meta-analytic modeling. RESULTS: Data were obtained from 16 reports with 25 trial-arms involving 1856 (905 @entity1170 and 951 non- @entity1170 ) @entity1 treated with @entity2049 , @entity2812 , @entity1091 , @entity1771 , or @entity1092 , alone or with other agents over an average of 47.5 months (7347 total @entity1 -years). Estimated @entity1170 prevalence was 15.4%. Crude rates (%/month) of recurrence (2.31/1.20) and clinical non-improvement (1.93/0.49) averaged 2.9-fold greater in @entity1170 vs. non- @entity1170 subjects. The pooled @entity1170 /non- @entity1170 risk ratio (RR) for inferior treatment-response (in 13 direct comparisons) was 1.40 (CI 1.26-1.56; P < 0.0001). Pooled crude recurrence and non-improvement rates suggested no clear advantage for any treatment, nor superiority for anticonvulsants over @entity1091 . However, only @entity1091 vs. @entity2049 could be directly compared (in four treatment-arms) meta-analytically in @entity1170 @entity1 (RR = 0.93, CI 0.74-1.18, indicating no difference in effectiveness). CONCLUSION: As expected, @entity1170 was associated with lower effectiveness of all treatments evaluated. Direct comparisons of specific treatment alternatives for @entity1170 @entity1 were rare, and provided no secure evidence of superiority of any treatment. Additional long-term studies comparing @entity1170 /non- @entity1170 @entity1 randomized to specific treatments are required.

Rapid-cycling XXXX : effects of long-term treatments.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity162 :: ('MESH:D001714', 'Disease') :: ['bipolar disorder'] @entity1170 :: ('MESH:C564983', 'Disease') :: ['rapid-cycling', 'RC'] @entity1092 :: ('MESH:D014635', 'Chemical') :: ['valproate'] @entity2049 :: ('MESH:D002220', 'Chemical') :: ['carbamazepine'] @entity1771 :: ('MESH:C052342', 'Chemical') :: ['topiramate'] @entity1091 :: ('MESH:D008094', 'Chemical') :: ['lithium'] @entity2812 :: ('MESH:C047781', 'Chemical') :: ['lamotrigine']
@entity162 :: (MESH:D001714,Disease) :: ['bipolar disorder']
