I'll Remain Modest

Initial results from NIMH's long-term study of treating bipolar disorder--known as STEP-BD--are just out in the new issue of the American Journal of Psychiatry. I don't have access to the full-text versions of the related journal articles yet (I will soon enough), so for now let me offer these thoughts based upon abstracts of the articles:

Treatment of bipolar disorder with medications fails to offer symptom remission 48 percent of the time, according to this first-long term study of treating bipolar disorder according to "evidence-based" practices (translation: meds). Kind of calls into the question some of the psychopharmacological revolution, eh? This half-performance is a point I've been making for a long-time, and it's damn nice for the sages of psychiatry to get my back on this point. We'll see if the press picks up on this with the same intensity with which they glommed onto the results of last fall's CATIE study (my prediction: total silence will result). Not to be a pain or anything, but we've been aggressively diagnosing bipolar disorder and treating it with meds in a wholesale fashion for the last two decades, so why the hell did it take until 2006 to get a real-world, long-term study? Are our lives and our health care that meaningless?

Also, an AJP article from the STEP-BD study reports that for bipolars with depression (already taking a mood stabilizer and anti-depressant), Lamictal proved to be fairly useful while the atypical antipsychotic Risperdal was next to useless. Hmmm, I may have made a similar point elsewhere before, no?

I'll post more about the STEP-BD study as the articles become available to me in the coming days. Until then, I'll just say it's good to be right. Damn good.