Advances in the Pharmacotherapy of Bipolar Affective Disorder

Abstract

Bipolar affective disorder is a chronic, relapsing and remitting mental illness with lifetime risk between 0.5 and 1.6% worldwide (Weissman et al. 1996). This prevalence increases to 5.5% for bipolar spectrum disorders comprising bipolar I, bipolar II and other subtypes (Reegeer et al. 2004). Bipolar disorder is a significant source of distress, disability, and loss of life through suicide (Woods 2000). It causes significant psychological and socioeconomic burden both to the patients and their carers. It remains as the sixth leading cause of disability among neuropsychiatric disorders in the world (WHO 1996). Almost 80% of the costs of bipolar disorder are indirect and only 5% is spent on drugs and another 15% on hospital charges (Dardennes et al 2006). If bipolar disorder is not treated adequately, relapses will occur more frequently with longer duration of episodes, decreased intervals between episodes and increased number of hospitalisation. In this chapter we review the recent advances in the pharmacotherapy of bipolar affective disorder, the management of which is constantly evolving due to better understanding of its pathophysiology and introduction of new drug treatments.