Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries
Year: 2019
Type: review
Abstract: Introduction: Appropriately managing mental disorders is a growing priority across countries in view of the impact on morbidity and mortality. This includes patients with bipolar disorders (BD). Management of BD is a concern as this is a complex disease with often misdiagnosis, which is a major issue in lower and middle-income countries (LMICs) with typically a limited number of trained personnel and resources. This needs to be addressed.Areas covered: Medicines are the cornerstone of managing patients with Bipolar II across countries including LMICs. The choice of medicines, especially antipsychotics, is important in LMICs with high rates of diabetes and HIV. However, care is currently compromised in LMICs by issues such as the stigma, cultural beliefs, a limited number of trained professionals and high patient co-payments.Expert opinion: Encouragingly, some LMICs have introduced guidelines for patients with BD; however, this is very variable. Strategies for the future include addressing the lack of national guidelines for patients with BD, improving resources for mental disorders including personnel, improving medicine availability and patients’ rights, and monitoring prescribing against agreed guidelines. A number of strategies have been identified to improve the treatment of patients with Bipolar II in LMICs, and will be followed up.
Authors: Brian Godman, Christoffel Grobler, Marianne Van-De-Lisle, Janney Wale, Wallace Breno Barbosa, Amos Massele, Philip Opondo, Guenka Petrova, Konstantin Tachkov, Israel Sefah, Suhaj Abdulsalim, Alian A. Alrasheedy, Mazhuvancherry Kesavan Unnikrishnan, Kristina Garuoliene, Kayode Bamitale, Dan Kibuule, Francis Kalemeera, Joseph Fadare, Tanveer Ahmed Khan, Shahzad Hussain, Tomasz Bochenek, Aubrey Chichonyi Kalungia, James Mwanza, Antony P Martin, Ruaraidh Hill, Corrado Barbui
Institutions: University of Liverpool, University of Strathclyde, Sefako Makgatho Health Sciences University, Karolinska Institutet, Elizabeth Donkin Hospital, Walter Sisulu University, Nelson Mandela University, Royal Edinburgh Hospital, Universidade Federal de Minas Gerais, University of Botswana, Medical University of Sofia, Ghana Health Service, Qassim University, Vilnius University, University of Namibia, Ekiti State University, National Institute of Health, Jagiellonian University, University of Zambia, University of Verona
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W2982249284