Starting lithium prophylaxis early v. late in bipolar disorder

No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. Nationwide registers were used to identify all patients with a diagnosis of bipolar...

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Bibliographic Details
Published in:British journal of psychiatry 2014-09, Vol.205 (3), p.214-220
Main Authors: Kessing, Lars Vedel, Vradi, Eleni, Andersen, Per Kragh
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Antimanic Agents - administration & dosage
Antimanic Agents - therapeutic use
Biological and medical sciences
Bipolar Disorder - diagnosis
Bipolar Disorder - drug therapy
Bipolar disorders
Denmark
Female
Humans
Lithium - administration & dosage
Lithium - therapeutic use
Male
Medical sciences
Middle Aged
Miscellaneous
Mood disorders
Neuropharmacology
Pharmacology. Drug treatments
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychopharmacology
Registries
Time Factors
Treatment Outcome
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Summary:No study has investigated when preventive treatment with lithium should be initiated in bipolar disorder. To compare response rates among patients with bipolar disorder starting treatment with lithium early v. late. Nationwide registers were used to identify all patients with a diagnosis of bipolar disorder in psychiatric hospital settings who were prescribed lithium during the period 1995-2012 in Denmark (n = 4714). Lithium responders were defined as patients who, following a stabilisation lithium start-up period of 6 months, continued lithium monotherapy without being admitted to hospital. Early v. late intervention was defined in two ways: (a) start of lithium following first contact; and (b) start of lithium following a diagnosis of a single manic/mixed episode. Regardless of the definition used, patients who started lithium early had significantly decreased rates of non-response to lithium compared with the rate for patients starting lithium later (adjusted analyses: first v. later contact: P
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.bp.113.142802