title: Comparative neurocognitive effects of lithium and anticonvulsants in long-term stable bipolar patients.
abstract: BACKGROUND
  The aim of choosing a mood-stabilizing drug (lithium or anticonvulsants) or a combination of them with minimal neurocognitive effects is to stimulate the development of criteria for a therapeutic adequacy, particularly in Bipolar Disorder (BD) patients who are clinically stabilized.
  
  
  METHODS
  Three groups of BD patients were established according to their treatment: (i) lithium monotherapy (n=29); (ii) lithium together with one or more anticonvulsants (n=28); and (iii) one or more anticonvulsants (n=16). A group of healthy controls served as the control (n=25). The following tests were applied: Wechsler Adult Intelligence Scale, Trail Making Test, Wechsler Memory Scale, Rey Complex Figure Test, Stroop color-word test, Wisconsin Card Sorting Test, Tower of Hanoi, Frontal Assessment Battery, and Reading the Mind in the Eyes Test.
  
  
  RESULTS
  Relative to healthy controls, BD patients showed the following: (i) those on lithium monotherapy, but not other BD groups, had preserved short-term auditory memory, long-term memory, and attention; (ii) those who took only anticonvulsants showed worse findings in short-term visual memory, working memory, and several executive functions; and (iii) all BD patients showed worse performance in processing speed, resistance to interference, and emotion recognition.
  
  
  CONCLUSIONS
  Medication alone cannot explain why all BD patients showed common cognitive deficits despite different pharmacological treatment.
  
  
  CONCLUSIONS
  The impairment on some executive functions and emotion recognition is an inherent trait in BD patients, regardless of their pharmacological treatment. However, while memory, attention, and most of the executive functions are preserved in long-term stable BD patients, these cognitive functions are impaired in those who take anticonvulsants.
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Sabater
authors.affiliation: Health Research Institute La Fe, Valencia, Spain; University of Valencia, Spain. Electronic address: ana.garcia-blanco@uv.es.
authors.forename: Ana C
authors.initials: AC
authors.lastname: García-Blanco
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Hélade M
authors.initials: HM
authors.lastname: Verdet
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Sierra
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Ribes
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Villar
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Mª José
authors.initials: MJ
authors.lastname: Lara
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Arnal
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Rojo
authors.affiliation: Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; University of Valencia, Spain; CIBERESP, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Livianos
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001288:Attention / Q000187:drug effects; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D003072:Cognition Disorders / Q000139:chemically induced* / Q000209:etiology; D004359:Drug Therapy, Combination; D056344:Executive Function / Q000187:drug effects; D005260:Female; D006801:Humans; D018020:Lithium Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008570:Memory, Short-Term / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D018692:Antimanic Agents; D018020:Lithium Compounds