title: Prescribing patterns of lithium or lithium+valproate in manic or mixed episodes: a naturalistic study.
abstract: The present study aimed to identify the prescribing patterns of lithium or of lithium+valproate in 75 bipolar I outpatients in a manic or a mixed phase within a naturalistic setting. The differences between the two treatments and the correlation between serum lithium levels and response were also examined. The results showed that patients with lithium levels of 0.60 mEq/l or more had higher remission rates and greater symptom reduction than the other patients. Patients on lithium and valproate showed greater improvement in mixed, anxiety, and psychotic symptoms than those on lithium only, as assessed by the Clinical Global Impression-Bipolar version scale scores. Finally, our findings suggest that a range of lithium levels between 0.40 and 0.60 mEq/l, albeit below the therapeutic range, seems sufficient to maintain a good effect when lithium is coadministered with valproate.
authors.affiliation: Departments of aTranslational Research and New Technologies in Medicine and Surgery bClinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Muti
authors.forename: Claudia
authors.initials: C
authors.lastname: Del Grande
authors.forename: Laura
authors.initials: L
authors.lastname: Musetti
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.forename: Irene
authors.initials: I
authors.lastname: Pergentini
authors.forename: Martina
authors.initials: M
authors.lastname: Corsi
authors.forename: Milo
authors.initials: M
authors.lastname: Turri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Umberto Corsini
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000008:administration & dosage* / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016651:Lithium Carbonate / Q000008:administration & dosage* / Q000097:blood; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000097:blood; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D016651:Lithium Carbonate; D014635:Valproic Acid