title: Impaired verbal memory and otherwise spared cognition in remitted bipolar patients on monotherapy with lithium or valproate.
abstract: OBJECTIVE
  Patients with bipolar disorder have been reported to have neurocognitive deficits; however, it is not known whether the cognitive dysfunctions are state-dependent or a stable trait. Lithium and valproate, 2 of the most widely used mood stabilizers in the treatment of bipolar disorder, have also been associated with cognitive impairment. However, the degree and pattern of neurocognitive impairment in euthymic bipolar patients on either monotherapy with lithium or valproate have not been compared before in depth.
  
  
  METHODS
  We compared 17 euthymic outpatients with bipolar disorder (BD) on lithium monotherapy to 11 euthymic outpatients with BD on valproate monotherapy and 29 comparison subjects using tests measuring immediate verbal memory and executive functions in addition to 3 subtests of the Wechsler Adult Intelligence Scale Revised. The groups were similar in terms of level of education, duration and severity of illness, and gender distribution. Patients on lithium monotherapy were older than patients on valproate and healthy controls. Mood symptoms as assessed by standardized scales were mild to non-existent in both patient groups.
  
  
  RESULTS
  Immediate verbal memory was impaired in both patient groups compared to controls, where the main effect of age was not significant. No significant differences could be found on the other cognitive measures.
  
  
  CONCLUSIONS
  Both lithium and valproate may be associated with immediate verbal memory impairment, sparing other cognitive functions. Presence of a similar verbal memory deficit in the lithium and valproate groups suggests that this deficit might be intrinsic to BD or that the 2 medications influence immediate verbal memory similarly. Larger samples of remitted bipolar patients on monotherapy should be studied for more precise conclusions.
authors.affiliation: Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey. ves@ttnet.net.tr
authors.forename: Vesile
authors.initials: V
authors.lastname: Senturk
authors.forename: Ceren
authors.initials: C
authors.lastname: Goker
authors.forename: Ayhan
authors.initials: A
authors.lastname: Bilgic
authors.forename: Senay
authors.initials: S
authors.lastname: Olmez
authors.forename: Handan
authors.initials: H
authors.lastname: Tugcu
authors.forename: Bedriye
authors.initials: B
authors.lastname: Oncu
authors.forename: E Cem
authors.initials: EC
authors.lastname: Atbasoglu
mesh_terms: D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D003072:Cognition Disorders / Q000139:chemically induced*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D018021:Lithium Chloride / Q000009:adverse effects*; D008297:Male; D008568:Memory / Q000187:drug effects; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000187:drug effects; D014635:Valproic Acid / Q000009:adverse effects*; D014706:Verbal Learning / Q000187:drug effects
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid; D018021:Lithium Chloride