Prophylactic Efficacy of Lithium Versus Carbamazepine in Treatment-Naive Bipolar Patients

Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder: a meta-analysis of randomized controlled trials

“…After screening, 226 publications were identified through the combined search strategies, and we identified 21 trials, with a combined total of 5364 participants that fulfilled the inclusion criteria (Bowden et al 2000bCalabrese et al 2000Calabrese et al , 2003Calabrese et al , 2005Greil et al 1997 ;Hartong et al 2003 ;Keck et al 2007 ;Macfadden et al 2009 ;McElroy et al 2008 ;Quiroz et al 2010 ;Suppes et al 2009 ;Tohen et al 2003Tohen et al , 2004Tohen et al , 2005Tohen et al , 2006Vieta et al 2008a, b ;Young et al 2008 ;Zarate & Tohen, 2004). Table 1 shows details of all trials included in the analysis.…”

“…We identified : one trial each for aripiprazole (Keck et al 2007), olanzapine+mood stabilizer , oxcarbazepine+lithium (Vieta et al 2008a), perphenazine+mood stabilizer (Zarate & Tohen, 2004), risperidone long-acting injectable monotherapy (Quiroz et al 2010), risperidone long-acting injectable+mood stabilizer (Macfadden et al 2009) and ziprasidone+mood stabilizer ; two trials for carbamazepine (Greil et al 1997 ;Hartong et al 2003) and quetiapine+mood stabilizer (Suppes et al 2009 ;Vieta et al 2008 b) and quetiapine monotherapy Young et al 2008) ; three trials each for divalproex (Bowden et al 2000a, b ;Greil et al 1997 ;Tohen et al 2003), lamotrigine Calabrese et al 2000Calabrese et al , 2003 and olanzapine (Tohen et al 2003(Tohen et al , 2005(Tohen et al , 2006 ; and eight trials for lithium (Bowden et al 2000(Bowden et al b, 2003Calabrese et al 2003Calabrese et al , 2005Greil et al 1997 ;Hartong et al 2003 ;Tohen et al 2005 ;Vieta et al 2008a). BPRS, Brief Psychiatric Rating Scale ; CGI-S, Clinical Global Impression -Severity ; CGI-C, Clinical Global Impression -Change ; CI, confidence interval ; GAF, global assessment of functioning ; HAMD, Hamilton Rating Scale for Depression ; IR, insufficient response ; MADRS, Montgomery-Å sberg Depression Rating Scale ; MRS, Mania Rating Scale ; TEM, treatment-emergent mania ; YMRS, Young Mania Rating Scale.…”

“…The length of follow-up was 26 wk in three studies Calabrese et al 2000 ;Zarate & Tohen, 2004), between 47 and 52 wk in eight studies (Bowden et al 2000b ;Macfadden et al 2009 ;McElroy et al 2008 ;Tohen et al 2003Tohen et al , 2005Tohen et al , 2006Vieta et al 2008a ;Young et al 2008), between 72 and 80 wk in four studies Calabrese et al 2003Calabrese et al , 2005Tohen et al 2004) and between 100 and 130 wk in six studies (Greil et al 1997 ;Hartong et al 2003 ;Keck et al 2007 ;Quiroz et al 2010 ;Suppes et al 2009 ;Vieta et al 2008b). Median follow-up among the 21 studies was 52 wk, and mean follow-up was 68 wk.…”

“…A number of studies were excluded from the metaanalytical calculations because they did not include a placebo group, and used different comparators Greil et al 1997 ;Hartong et al 2003 ;Tohen et al 2003Tohen et al , 2005.…”

“…All of the therapies -both monotherapy and combination -were found to have a RR for manic/mixed Studies without placebo comparator were excluded from the analysis Greil et al 1997 ;Hartong et al 2003 ;Tohen et al 2003Tohen et al , 2005.…”