Combining Lithium and Sodium Valproate for Bipolar Disorder

Mitchell, Philip B.; Withers, Keri; Jacobs, George E.; Hickie, Ian B.

doi:10.3109/00048679409075856

Cited by 18 publications

(3 citation statements)

References 8 publications

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“…The apparent potent efficacy of the lithium‐ valproate combination is consistent with previous open reports [61], with a recent review noting that this appeared to be the most effective combination therapy for bipolar disorder [62].…”

Section: Anticonvulsantssupporting

confidence: 82%

The place of anticonvulsants and other putative mood stabilisers in the treatment of bipolar disorder

Mitchell

1999

Aust N Z J Psychiatry

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While lithium is an effective mood stabiliser still in widespread clinical use, a significant proportion of patients either respond poorly or are unable to tolerate its adverse effects. In the 1960s and 1970s preliminary reports of the possible effectiveness of carbamazepine and valproate began to appear, with confirmatory controlled studies being undertaken in the 1980s and 1990s. In recent years, further putative mood-stabilising agents have been described, in particular some of the newer anticonvulsants and the atypical antipsychotics. This paper critically evaluates the current evidential basis for claims for the efficacy of these compounds in bipolar disorder.

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Section: Anticonvulsantssupporting

confidence: 82%

The place of anticonvulsants and other putative mood stabilisers in the treatment of bipolar disorder

Mitchell

1999

Aust N Z J Psychiatry

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“…In open-label (5) and retrospective (6) studies, this combination was effective in both the manic and depressive phases of the illness. Single case reports (7,8) also support the efficacy of lithium and valproate together, especially for rapid cycling. Lenox et al (9) suggested that the combination of lithium and valproate may be synergistic.…”

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confidence: 63%

Mood Stabilizer Combinations: A Review of Safety and Efficacy

Freeman

Stoll²

1998

AJP

185

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There have been few controlled studies of the use of combinations of mood stabilizers. The interactions of such combinations are sometimes complex, often very useful, and potentially dangerous. One general rule that may reduce the risks of toxic drug interactions is to add medication to the patient's current regimen in modest doses and increase the dose slowly. The safest and most efficacious mood stabilizer combinations appear to be the mixtures of anticonvulsants and lithium, particularly valproate plus lithium. Once the mechanisms of the mood stabilizers are identified, it is possible that a more rational approach to combination therapy will emerge, based on synergism at the sites of action.

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“…These included lithium, carbamazepine, valproate, clonazepam, neuroleptics, and ECT. For purposes of simplicity, drug combinations such as lithium/carbamazepine, lithium/valproate, and carbamazepine/ valproate were not considered as primary treatments despite some positive reports in the literature (Kishimoto, 1992;Ketter et al, 1992;Tohen et al, 1994;Mitchell et al, 1994;Frye et al, 1996). Thus, six different treatment conditions were chosen for evaluation using decision analysis.…”

Section: Consensus Regarding Treatments and Clinical Factors In Acutementioning

confidence: 99%

Decision model for the acute treatment of mania

Steffens

Krishnan

1996

Depress. Anxiety

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Decision making in psychiatric diagnosis and treatment has not been evaluated systematically. The authors present a model for treatment of an acute manic episode using a decision analysis software program. Six treatment options were put into the model: lithium, valproate, carbamezepine, electroconvulsive therapy, clonazepam, and neuroleptics. Each treatment was evaluated on three factors, efficacy, tolerability, and cost, using data from the literature and pharmacy and billing information. Output from the computer program identified three top choices among the six options: valproate, carbamazepine, and lithium, with valproate emerging as the first choice using the data we inputted. Depression and Anxiety 4:289–293, 1996/1997.© 1997 Wiley‐Liss, Inc.

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Combining Lithium and Sodium Valproate for Bipolar Disorder

Cited by 18 publications

References 8 publications

The place of anticonvulsants and other putative mood stabilisers in the treatment of bipolar disorder

The place of anticonvulsants and other putative mood stabilisers in the treatment of bipolar disorder

Mood Stabilizer Combinations: A Review of Safety and Efficacy

Decision model for the acute treatment of mania

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