title: A single-blind, randomised controlled trial on the effects of lithium and quetiapine monotherapy on the trajectory of cognitive functioning in first episode mania: A 12-month follow-up study.
abstract: BACKGROUND
  Cognitive deficits have been reported during the early stages of bipolar disorder; however, the role of medication on such deficits remains unclear. The aim of this study was to compare the effects of lithium and quetiapine monotherapy on cognitive performance in people following first episode mania.
  
  
  METHODS
  The design was a single-blind, randomised controlled trial on a cohort of 61 participants following first episode mania. Participants received either lithium or quetiapine monotherapy as maintenance treatment over a 12-month follow-up period. The groups were compared on performance outcomes using an extensive cognitive assessment battery conducted at baseline, month 3 and month 12 follow-up time-points.
  
  
  RESULTS
  There was a significant interaction between group and time in phonemic fluency at the 3-month and 12-month endpoints, reflecting greater improvements in performance in lithium-treated participants relative to quetiapine-treated participants. After controlling for multiple comparisons, there were no other significant interactions between group and time for other measures of cognition.
  
  
  CONCLUSIONS
  Although the effects of lithium and quetiapine treatment were similar for most cognitive domains, the findings imply that early initiation of lithium treatment may benefit the trajectory of cognition, specifically verbal fluency in young people with bipolar disorder. Given that cognition is a major symptomatic domain of bipolar disorder and has substantive effects on general functioning, the ability to influence the trajectory of cognitive change is of considerable clinical importance.
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia. Electronic address: rose.daglas@orygen.org.au.
authors.forename: R
authors.initials: R
authors.lastname: Daglas
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: Cotton
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Allott
authors.affiliation: Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, 161, Barry Street, Carlton South, 3053 Victoria, Australia; Brain and Mental Health Laboratory (BMH), School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Yücel
authors.affiliation: Orygen Youth Health-Clinical Program, 35, Poplar Road, 3052 Parkville, Australia.
authors.forename: C A
authors.initials: CA
authors.lastname: Macneil
authors.affiliation: Orygen Youth Health-Clinical Program, 35, Poplar Road, 3052 Parkville, Australia.
authors.forename: M K
authors.initials: MK
authors.lastname: Hasty
authors.affiliation: Department of Psychiatry, Monash University, Clayton, Australia.
authors.forename: B
authors.initials: B
authors.lastname: Murphy
authors.affiliation: Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, 161, Barry Street, Carlton South, 3053 Victoria, Australia; Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, Royal Parade, Parkville, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Pantelis
authors.affiliation: Department of Psychology, Victoria University, Melbourne, Australia.
authors.forename: K T
authors.initials: KT
authors.lastname: Hallam
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia.
authors.forename: L P
authors.initials: LP
authors.lastname: Henry
authors.affiliation: Treatment and Early Intervention in Psychosis Program (TIPP), département de psychiatrie CHUV, université de Lausanne, clinique de Cery, Prilly, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Conus
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia; Orygen Youth Health-Clinical Program, 35, Poplar Road, 3052 Parkville, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Ratheesh
authors.affiliation: Orygen Youth Health-Clinical Program, 35, Poplar Road, 3052 Parkville, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Kader
authors.affiliation: School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia.
authors.forename: M Th
authors.initials: MT
authors.lastname: Wong
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia; Orygen Youth Health-Clinical Program, 35, Poplar Road, 3052 Parkville, Australia.
authors.forename: P D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Locked Bag 10 (35, Poplar Road), Parkville, 3052 Victoria, Australia; Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road, Parkville, 3052 Victoria, Australia; Florey Institute for Neuroscience and Mental Health, Kenneth Myer Building, Royal Parade, Parkville, Australia; IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, 3220 Geelong, Australia; Barwon Health and the Geelong Clinic, Swanston Centre, PO Box 281, Geelong, 3220 Victoria, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Berk
mesh_terms: D000293:Adolescent; D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology*; D003071:Cognition / Q000187:drug effects*; D003987:Dibenzothiazepines / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007360:Intelligence; D018020:Lithium Compounds / Q000627:therapeutic use*; D008297:Male; D008568:Memory; D000069348:Quetiapine Fumarate / Q000627:therapeutic use*; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014706:Verbal Learning; D055815:Young Adult
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D018020:Lithium Compounds; D000069348:Quetiapine Fumarate
keywords: Bipolar disorder; Cognition; Early intervention; Lithium; Mania; Quetiapine