The main aims of long-term management for bipolar disorder (BD) are the prevention of new mood episodes and maintaining symptomatic and functional remission. Although several pharmacological and psychosocial interventions have shown effectiveness in maintenance treatment of BP, long-term recovery is achieved only in some patients. Little is known how these treatments are effective in routine clinical practice.

121 patients (76 women) with BD confirmed by the Schedule for Affective Disorders and Schizophrenia (SADS) interview, with mean age of 44.6 and mean duration of illness of 13.1 years who were at least one year on maintenance monotherapy with the mood stabilizers (lithium, carabamazepine, valproate, lamotrigine and olanzapine) were assessed using the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder (TRS).

Total score ≥ 7 in TRS (“full responders”) reached 22 (18%) patients. For particular mood stabilizers, we found response rate from 5% (valproate) to 28% (lithium). Responders did not differ from non-responders in the length of illness, age of onset, the polarity of first episode, number of episodes, the occurrence of psychotic symptoms and suicide attempts, rapid cycling, positive family history, and the presence of comorbid disorders.

Although mood stabilizer monotherapies remain recommended and desirable strategies for maintenance treatment of BD, our results show that a satisfactory response is achieved only in a minority of patients. This research was supported by the project 1M0517 MSMT CR.