title: Recurrence in bipolar I disorder: a post hoc analysis excluding relapses in two double-blind maintenance studies.
abstract: OBJECTIVE
  To assess the efficacy of lamotrigine or lithium in preventing mood recurrence (i.e., a new mood episode) in bipolar disorder.
  
  
  METHODS
  Data from bipolar I patients with relapses (i.e., mood episodes having the same polarity as the index episode within 90 or 180 days of randomization) were excluded from post hoc efficacy analyses of two 18-month, placebo-controlled maintenance trials of lamotrigine and lithium.
  
  
  RESULTS
  Both lamotrigine and lithium were more effective than placebo in delaying the time to intervention for any mood episode (depression, mania, hypomania, or mixed) when relapses that occurred in the first 90 days were excluded from the analyses (p = .002, lamotrigine vs. placebo; p = .010, lithium vs. placebo). Results were similar when patients with mood episodes within 180 days of randomization were excluded.
  
  
  CONCLUSIONS
  Both lamotrigine and lithium maintenance therapy protected against mood episode recurrence in bipolar I disorder.
authors.affiliation: Department of Psychiatry, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, Ohio 44106, USA. joseph.calabrese@uhhs.com
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Calabrese
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Goldberg
authors.forename: Terence A
authors.initials: TA
authors.lastname: Ketter
authors.forename: Trisha
authors.initials: T
authors.lastname: Suppes
authors.forename: Mark
authors.initials: M
authors.lastname: Frye
authors.forename: Robin
authors.initials: R
authors.lastname: White
authors.forename: Angela
authors.initials: A
authors.lastname: DeVeaugh-Geiss
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Thompson
mesh_terms: D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D000077213:Lamotrigine; D008094:Lithium / Q000627:therapeutic use*; D018579:Patient Selection; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D014227:Triazines; D008094:Lithium; D000077213:Lamotrigine