Brief Answer:
cure is possible in very few cases but remission can be maintained for long

Detailed Answer:
Hello,

Thanks for writing to us.

I have checked your reports. You are divlaproate sodium and olanzapine and that suggests you are likely suffering from bipolar disorder.

I would like to mention prognosis of bipolar disorder in details.

Patients with bipolar I disorder have a poorer prognosis than do patients with major depressive disorder. About 40 to 50 percent of patients with bipolar I disorder may have a second manic episode within 2 years of the first episode. Although lithium prophylaxis improves the course and prognosis of bipolar I disorder, probably only 50 to 60 percent of patients achieve significant control of their symptoms with lithium. One 4-year follow-up study of patients with bipolar I disorder found that a premorbid poor occupational status, alcohol dependence, psychotic features, depressive features, interepisode depressive features, and male gender were all factors that contributed a poor prognosis.

Short duration of manic episodes, advanced age of onset, few suicidal thoughts, and few coexisting psychiatric or medical problems predict a better outcome.

About 7 percent of patients with bipolar I disorder do not have a recurrence of symptoms; 45 percent have more than one episode, and 40 percent have a chronic disorder.

Patients may have from two to 30 manic episodes, although the mean number is about nine. About 40 percent of all patients have more than ten episodes. On long-term follow-up, 15 percent of all patients with bipolar I disorder are well, 45 percent are well but have multiple relapses, 30 percent are in partial remission, and 10 percent are chronically ill. One third of all patients with bipolar I disorder have chronic symptoms and evidence of significant social decline.

In conclusion only 5-10% of patients of bipolar disorder is cured.

Depending upon different factors patient with bipolar disorder should be on prophylactic mood stabilizer medicine like lithium or valproate for optimum duration under doctor's guidance to prevent relapse. If needed multiple medicines like quetiapine, lamotrigine or aripirazole can be used.

After stopping the medicines patient and must be watchful and at any point when they feel symptoms are reappearing help of psychiatrist should be sought as soon as possible.

At large bipolar can be kept in remission rather than cured completely.

Hope I have answered your query, I will be happy to help further.

Regards,

Dr.Chintan Solanki.

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