Risiko Stroke pada Penggunaan Mood Stabilizer untuk Gangguan Bipolar

Oleh :

dr. Zuhrotun Ulya, Sp.KJ, M.H.

Sebuah studi kohort retrospektif yang diterbitkan pada tahun 2018 menunjukkan bahwa berbagai obat mood stabilizer meningkatkan risiko stroke pada pasien gangguan bipolar. Gangguan bipolar menyebabkan seseorang mengalami perubahan siklus mood dalam range manik hingga depresi.[1] Gangguan bipolar juga memunculkan masalah lain seperti penurunan fungsi harian, penurunan fungsi kognitif, serta peningkatan risiko morbiditas dan mortalitas.[2] Selain itu, pasien gangguan bipolar berisiko 3-4 kali lebih besar mengalami gangguan kardiovaskular, sistem pulmonal, dan gangguan serebrovaskular yang menyebabkan mortalitas 2-4 kali lebih tinggi dibandingkan populasi umum.[3,4]

Antipsikotik, mood stabilizer, dan antidepresan merupakan terapi standar pada gangguan bipolar. Namun, beberapa penelitian menunjukkan potensi peningkatan risiko penyakit jantung koroner dan stroke.[5]

Penggunaan Mood Stabilizer pada Gangguan Bipolar

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. DSM-5. (2013). Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. In W. T. Carpenter, D. M. Barch, J. R. Bustillo, W. Gaebel, R. E. Gur, S. H. Heckers, J. v. Os, Schizophrenia Spectrum and Other Psychotic Disorders (pp. 94-96). Washington: American Psychiatric Publishing.
2. Sajatovic, M., Strejilevich, S., Gildengers, A., Dols, A., Al, J. R., Forester, B., Shulman, K. (2015, November). A Report on Older-age Bipolar Disorder from the International Society for Bipolar Disorder Task Force. Bipolar Disorder, 17(7), 689-704. doi:10.1111/bdi.12331
3. Ulya, Z., Syamsulhadi, M., & Septiawan, D. (2016). Cardiopulmonary Disease in Bipolar Disorder with History of SJS: Evidence Based Case Report. International Journal of Medical and Health Sciences, 10(8), 404-409.
4. Crump, C., Sundquist, K., Winkleby, M., & Sundquist, J. (2013, September). Comorbidities and Mortality in Bipolar Disorder: a Swedish National Cohort Study. JAMA Psychiatry, 70(9), 931-939. doi:10.1001/jamapsychiatry.2013.1394
5. Chuang, Y., Chuang, H., Lin, T., Chang, C., Lu, C., Chang, W., Chan, S. (2012, January). Effects of Long-term Antiepileptic Drug Monotherapy on Vascular Risk Factors and Atherosclerosis. Epilepsia, 53(1), 120-128. doi:10.1111/j.1528-1167.2011.03316.x
6. Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Berk, M. (2018). Canadian Network for Mood Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 Guidelines for the Management of Patients with Bipolar Disorders. Bipolar Disorders, 20, 97-170. doi:10.1111/bdi.12609
7. Cipriani, A., Hawton, K., Stockton, S., & Geddes, J. (2013, June). Lithium in the Prevention of Suicide in Mood Disorders: Updated Systematic Review and Meta Analysis. British Medical Journal, 27(346), 1-6. doi:10.1136/bmj.f3646
8. Mertens, J., Wang, Q., Kim, Y., Yu, D., Pham, S., Yang, B., Yao , J. (2015, November). Differential Responses to Lithium in Hyperexcitable Neurons from Patients with Bipolar Disorder. Nature, 5(527), 95-99. doi:10.1038/nature15526
9. Pan, P., Lee, M., Lo, M., Yang, E., & Yeh, C. (2014, May). Olanzapine is Superior to Lamotrigine in the Prevention of Bipolar Depression: a Naturalistic Observational Study. BMC Psychiatry, 19(14), 144-145. doi:10.1186/1471-244X-14-145
10. Cipriani A, Reid K, Young AH, Macritchie K, Geddes J. Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD003196. DOI: 10.1002/14651858.CD003196.pub2
11. Chen, P. H., Tsai, S. Y., Pan, C. H., Chang, C. K., Su, S. S., Chen, C. C., & Kuo, C. J. (2018). Mood Stabilizers and Risk of Stroke in Bipolar Disorder. The British Journal of Psychiatry, 1-6. doi:10.1192/bjp.2018.203
12. Lan, C., Liu, C., Lin, C., Lan, T., McInnis, M., Chan, C., & Lan, T. (2015, November). A Reduced Risk of Stroke with Lithium Exposure in Bipolar Disorder: a Population-based Retrospective Cohort Study. Bipolar Disorder, 17(7), 705-714. doi:10.1111/bdi.12336
13. Lopinto-Khoury, C., & Mintzer, S. (2010, July). Antiepileptic Drugs and Markers of Vascular Risk. Current Treatment Options Neurology, 12(4), 300-308. doi:10.1007/s11940-010-0080-y
14. Lorenz, M., Polak, J., Kavousi, M., Mathiesen, E., Volzke, H., Toumainen, T., PROG-IMT Study Group. (2012, Juny). Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data. Lancet, 2(379), 2053-2062. doi:10.1016/S0140-6736(12)60441-3
15. Nanau, R., & Neuman, M. (2013). Adverse Drug Reactions Induced by Valproic Acid. Clinical Biochemistry, 1323-1328. doi:10.1016/j.clinbiochem.2013.06.012
16. Ward, M., White, D., & Druss, B. (2015). A Meta-review of Lifestyle Interventions for Cardiovascular Risk Factors in the General Medical Population: Lessons for Individual with Serious Mental Illness. Journal Clinical Psychiatry, 76(4), 477-486. doi:10.4088/JCP.13r08657
17. Carliner, H., Collins, P., Cabassa, L., McNallen, A., Joestl, S., & Fernandez, R. (2014, February). Prevalence of Cardiovascular Risk Factors among Racial and Ethnic Minorities with Schizophrenia Spectrum and Bipolar Disorders: a Critical Literature Review. Comprehensive Psychiatry, 55(2), 233-247. doi:10.1016/j.comppsych.2013.09.009