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  • Research & Results
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  • Comparing Long-Term Treatments for Bi...

Comparing Long-Term Treatments for Bipolar Disorder

Sign Up for Updates to This Study  

Project Summary  

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Bipolar disorder is a long-term mental illness that affects about 5.7 million people in the United States. People with bipolar disorder have severe changes in mood, energy, and activity levels. Sometimes people with this illness may feel overly happy and full of energy. They may also have a false sense of reality or delusions. Other times, they may feel depressed and have low energy or suicidal thoughts. These periods, called mood episodes, can last for days or months.

There are more than 50 medicines to treat bipolar disorder. However, doctors don’t know which treatments work best over the long term. In this study, the research team is comparing the safety and effectiveness of common medicines for bipolar disorder.

Who can this research help?

Results from this study may help doctors and patients choose treatment for bipolar disorder. Professional groups may use the results to improve their recommendations on how to treat this illness.

What is the research team doing?

The research team is reviewing anonymous medical information from 2003 to 2015 for 1.3 million patients with bipolar disorder. The team is looking at how common medicines for bipolar disorder affect the risk of

  • Hospital visits
  • Suicide attempts or self-harm
  • Death
  • Kidney disease
  • High blood pressure or cholesterol
  • Obesity

In addition, the team is looking at how well treatments for bipolar disorder work for men compared with women and for people who

  • Have different types of bipolar disorder
  • Are in different age groups
  • Have other health problems
  • Take medicine for other health problems

Patients, family members, patient advocates, and doctors are advising the research team. Patients are taking part in focus groups to review findings and propose ideas for sharing results with the public.  

Research methods at a glance

Design Elements Description
Design Retrospective cohort study
Population Individuals diagnosed with bipolar disorder or schizoaffective disorder who have private insurance or Medicare
Interventions/
Comparators
  • Lithium carbonate
  • First-generation antipsychotics (haloperidol and perphenazine)
  • Second-generation antipsychotics (clozapine, risperidone, olanzapine, aripiprazole, quetiapine, ziprasidone, asenapine, lurasidone, and paliperidone)
  • Mood-stabilizing anticonvulsants (valproate, lamotrigine, carbamazepine, and oxcarbazepine)
  • Antidepressants (mirtazapine, bupropion, desvenlafaxine, duloxetine, venlafaxine, citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, vilazodone, and doxepin)
  • No treatment
Outcomes

Primary: psychiatric hospitalization, hospital readmission due to suicide attempt or self-harm, all-cause mortality

Secondary: kidney disorders, metabolic abnormalities and obesity

Timeframe Up to 12-year follow-up for primary outcomes (2003–2015)

Journal Articles

Results of This Project

Journal Of Affective Disorders

Comparison of 71 bipolar disorder pharmacotherapies for kidney disorder risk: The potential hazards of polypharmacy

Related Articles

Journal of the American Medical Informatics Association

Imputation and characterization of uncoded self-harm in major mental illness using machine learning

Psychoneuroendocrinology

Diabetes mellitus risk for 102 drugs and drug combinations used in patients with bipolar disorder

Regulatory Toxicology and Pharmacology

Low-level radon exposure and lung cancer mortality

JMIR Mental Health

Preferences of Information Dissemination on Treatment for Bipolar Disorder: Patient-Centered Focus Group Study

Bipolar Disorders

Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders

Bipolar Disorders

Systemic challenges in bipolar disorder management: A patient-centered approach

International Journal of Bipolar Disorders

Bipolar disorder and diabetes mellitus: evidence for disease-modifying effects and treatment implications

Bipolar Disorders

Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort

Project Details

Principal Investigator
Christophe Lambert, PhD
Project Status
In PCORI Peer-Review Process
Project Title
Longitudinal Comparative Effectiveness of Bipolar Disorder Therapies
Board Approval Date
April 2016
Project End Date
February 2021
Organization
University of New Mexico Health Sciences Center
Year Awarded
2016
State
New Mexico
Project Type
Research Project
Health Conditions  
Mental/Behavioral Health
Bipolar Disorder
Intervention Strategies
Drug Interventions
Populations
Children -- 18 and under
Older Adults
Funding Announcement
Assessment of Prevention, Diagnosis, and Treatment Options
Project Budget
$2,373,364
Study Registration Information
HSRP20163055
NCT02893371

Partners

Patient/Caregiver Partners

  • Alicia Smith, NAMI Montana
  • Emma Volesky, NAMI Montana
  • Quentin Schroeter, NAMI Montana
  • Jason DeShaw
  • Alan Hess
  • Matt Kuntz, NAMI Montana
  • Kimmie Jordan, NAMI New Mexico
  • Sharon Dunas, NAMI Westside Los Angeles

Other Stakeholder Partners

  • Nathaniel Hurwitz, New Mexico Behavioral Health Institute
  • Ronald Krall, University of Pittsburgh School of Medicine
  • Patrick Ryan, Janssen Research & Development Headquarters
  • Mauricio Tohen, University of New Mexico Health Sciences Center
  • Annette Crisanti, University of New Mexico Health Sciences Center
  • Douglas Perkins, University of New Mexico Health Sciences Center
  • Aurélien Mazurie, Montana State University
  • Berit Kerner, University of California Los Angeles
  • Stan Young, CGStat LLC
  • Robert Obenchain, Risk Benefit Statistics
Page Last Updated: 
July 24, 2020

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Meetings & Events

January 21
Cycle 1 2021 Broad PFA Applicant Town Hall
February 2
PCORI 2021 and Beyond: Opportunities for Funding and Involvement in Patient-Centered Research
February 9
Board of Governors Meeting: February 9, 2021

PCORI

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Washington, DC 20036
Phone: (202) 827-7700 | Fax: (202) 355-9558
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