Priority 19 from the Bipolar PSP

UNCERTAINTY:What are the unwanted long-term effects of medication? (JLA PSP Priority 19)
Overall ranking	19
JLA question ID	0041/19
Explanatory note	Not available for this PSP.
Evidence	McKnight RF, Adida M, Budge K, Stockton S, Goodwin GM, Geddes JR. Lithium toxicity profile: a systematic review and meta-analysis. The Lancet. 2012;379:721-8. [Comment: Single drug focus; 4 years old] Correll CU. Weight gain and metabolic effects of mood stabilizers and antipsychotics in pediatric bipolar disorder: a systematic review and pooled analysis of short-term trials. J Am Acad Child Adolesc Psychiatry2007; 46: 687–700. [Comment: 9 years old] Gao K, Kemp DE, Ganocy SJ et al. Antipsychotic-induced extrapyramidal side effects in bipolar disorder and schizophrenia: a systematic review. J Clin Psychopharmacol 2008; 28: 203–209. [Comment: 8 years old] Kryzhanovskaya LA, Robertson-Plouch CK, Xu W, Carlson JL, Merida KM, Dittmann RW. The safety of olanzapine in adolescents with schizophrenia or bipolar I disorder: a pooled analysis of 4 clinical trials. J Clin Psychiatry 2009; 70: 247–258. [Comment: Single drug focus; unclear methodological quality; 7 years old]
Health Research Classification System category	Mental Health

Extra information provided by this PSP
Original uncertainty examples	For full examples, see Category ID T2 on spreadsheet. I have taken Lithium for 20 years now, and I am concerned about its physical effects. Kidneys? Memory? My GP is not keen to discuss alternatives. ~ Need more research in to long term side effects of medication on the brain and bodies of those taking it. It seems that some of the side effects of meds are similar to the symptoms of mental illness. Difficult to know what is the illness and what is the effects of medication. ~ Do the drugs cause on average 14 years to be taken off the mortality life of person with Bipolar? Do we know? If true can it be published etc.? ~ What is the long term effect on someone who has had 24 lots of ECT,20 years ago?
Submitted by	Patients x 83 ~ Carers x 27 ~ Health Professionals x 10 ~ Others x 6

Extra information provided by this PSP

Original uncertainty examples

For full examples, see Category ID T2 on spreadsheet. I have taken Lithium for 20 years now, and I am concerned about its physical effects. Kidneys? Memory? My GP is not keen to discuss alternatives. ~ Need more research in to long term side effects of medication on the brain and bodies of those taking it. It seems that some of the side effects of meds are similar to the symptoms of mental illness. Difficult to know what is the illness and what is the effects of medication. ~ Do the drugs cause on average 14 years to be taken off the mortality life of person with Bipolar? Do we know? If true can it be published etc.? ~ What is the long term effect on someone who has had 24 lots of ECT,20 years ago?

Submitted by

Patients x 83 ~ Carers x 27 ~ Health Professionals x 10 ~ Others x 6

PSP information
PSP unique ID	0041
PSP name	Bipolar
Total number of uncertainties identified by this PSP.	363 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	14 June 2016