Lithium vs valproate in the maintenance treatment of bipolar I disorder: A post- hoc analysis of a randomized double-blind placebo-controlled trial

Dec 18, 2019The Australian and New Zealand journal of psychiatry

Comparing lithium and valproate for long-term treatment of bipolar I disorder in a controlled trial

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Abstract

No significant differences in efficacy were observed between valproate and lithium (hazard ratio: 0.99).

  • Valproate with 24 weeks of atypical antipsychotic significantly reduced the risk of any mood relapse compared to valproate monotherapy (hazard ratio: 0.46).
  • Lithium with 24 weeks of atypical antipsychotic significantly reduced the risk of mania compared to lithium monotherapy (hazard ratio: 0.27), but did not show a similar effect for depression.
  • The study indicates that both mood-stabilizing agents have comparable efficacy in maintenance treatment when used alone or with atypical antipsychotics.
  • Study design and small sample size may limit the ability to detect true differences in efficacy between the treatments.

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