title: Latest maintenance data on lithium in bipolar disorder.
abstract: Although lithium is generally considered to be the gold standard for maintenance therapy in bipolar disorder, evidence of its efficacy has rested on only a small number of adequately designed studies. Results from the lamotrigine bipolar trials, which included lithium as an active comparator, will substantially increase confidence in long-term lithium treatment. In a meta-analysis of these data, lithium was significantly more effective than placebo in preventing relapse in patients with bipolar disorder (relative risk [RR] 0.65; 95% confidence interval [CI] 0.50, 0.84). Furthermore, lithium had significant efficacy against manic relapse (RR 0.61; 95% CI 0.39, 0.95), with a less substantial, not statistically significant, effect against depressive relapse (RR 0.72; 95% CI 0.49, 1.07). Factors such as disease subtype, likelihood of adherence to treatment regimen, tolerability, and dose uncertainty should be considered in the selection of lithium maintenance therapy.
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK. guy.goodwin@psychiatry.oxford.ac.uk
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
authors.forename: John R
authors.initials: JR
authors.lastname: Geddes
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D006801:Humans; D008094:Lithium / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D008094:Lithium